Registered Nurse (RN) - Clinical Health Services Supervisor

This is an in-office position based out of Richfield, OH.

Candidates must have prior experience working in a management or supervisory role and clinical nursing experience.

POSITION SUMMARY

The Supervisor is responsible for oversight of healthcare management operations and staff including the organization and development of high performing teams. Works closely with functional area managers to ensure consistency in clinical interventions supporting our members. Accountable for meeting the financial, operational and quality objectives of the unit

Oversees the implementation of healthcare management services for National Accounts in the Customer Care Unit

- Implements clinical policies & procedures in accordance with applicable regulatory and accreditation standards (e.g. NCQA, URAC, state and federal standards and mandates as applicable)

- Serve as a content model expert and mentor to the team regarding practice standards, quality of interventions, problem resolution and critical thinking

- Ensure implementation and monitoring of best practice approaches and innovations to better address the member's needs across the continuum of care

- May act as a liaison with other key business areas.

- May develop/assist in development and/review new training content

- May collaborate/deliver inter and intra-departmental training sessions

- Protects the confidentiality of member information and adheres to company policies regarding confidentiality

- Manages resources responsible for identification of members, development and implementation of care plans, enhancement of medical appropriateness and quality of care and monitoring, evaluating and documenting of care

- Develop, initiate, monitor and communicate performance expectations

- Ensures the team's understanding and use of information system capability and functionality

- May act as a single point of contact for the customer and the Account Team including: participation in customer meetings, implementation and oversight of customer cultural requirements, and support implementation of new customers.

- Participate in the recruitment and hiring process for staff using clearly defined requirements in terms of education, experience, technical and performance skills

- Assesses developmental needs and collaborates with others to identify and implement action plans that support the development of high performing teams

- Establish an environment and work style that promotes the concept of teamwork, cross product integration, and continuum of care thinking that results in strong performance

- Consistently demonstrates the ability to serve as an model change agent and lead change efforts

- Create a positive work environment by acknowledging team contributions, soliciting input, and offering personal assistance, when needed

- Accountable for maintaining compliance with policies and procedures and implements them at the employee level

BACKGROUND/EXPERIENCE

Registered Nurse Required

Active unrestricted State Licensure in applicable functional area

3 - 5 years in clinical area of expertise.

Computer literacy

Strong communication skills

Ability to analyze data related to daily operations and outcomes

Implement process improvements to improve outcomes

Supervisory experience with staff of at level.

EDUCATION

The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience

LICENSES AND CERTIFICATIONS

Nursing/Registered Nurse (RN) is required

Nursing/Certified Case Manager (CCM) is desired

Nursing/Certified Professional in Healthcare Quality is desired

FUNCTIONAL EXPERIENCES&

Functional - Nursing/Medical-Surgical Care/1-3 Years

Functional - Nursing/Case Management/1-3 Years

Functional - Nursing/Management/Supervising/1-3 Years

Functional - Nursing/Concurrent Review/discharge planning/1-3 Years

Functional - Nursing/Quality Management/1-3 Years

TECHNOLOGY EXPERIENCES&

Technical - Desktop Tools/Microsoft Outlook/4-6 Years

Technical - Desktop Tools/Microsoft PowerPoint/1-3 Years

Technical - Desktop Tools/Microsoft Word/4-6 Years

Technical - Desktop Tools/TE Microsoft Excel/1-3 Years/

ADDITIONAL JOB INFORMATION

We value leadership, creativity, flexibility, and initiative. If you share those values and a commitment to excellence and innovation, consider a career with our company.

Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.

We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.

Together we will empower people to live healthier lives.

Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

We conduct pre-employment drug and background testing. Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Employment Type Regular Career Band Description Management