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1 - 10 of 21 matches in 0.011 seconds
Case Manager RN - KanCare (JC150497662)
Last Updated: 2019-11-20
Employer: Aetna
Location: Overland Park, KS

Req ID: 63711BR

Job Description

KanCare Medicaid Nurse Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member s overall wellness. Develops a proactive course of action…

Credentialing Analyst (JC149862989)
Last Updated: 2019-11-20
Employer: Aetna
Location: Overland Park, KS

Req ID: 65295BR

Job Description

Reviews, analyzes, evaluates, validates provider/producer information against business/credentialing requirements and maintains information in Credentialing data bases. Supports extensive research and analysis of sensitive provider/producer issues; addresses data integrity issues.

Fundamental Components included but are not limited to:

+ Maintains high production and quality factors.

+…

Manager, Business Information Management & Analysis (JC150620242)
Last Updated: 2019-11-20
Employer: Aetna
Location: Overland Park, KS

Req ID: 65790BR

Job Description

Formulates and implements information strategy to support operational objectives and other strategic business initiatives. Develops tactical and strategic plans to satisfy information needs across products and segments. Manages staff and processes.

Fundamental Components included but are not limited to:

Directs the implementation and delivery of…

Clinical Case Manager BH (JC150998178)
Last Updated: 2019-11-20
Employer: Aetna
Location: Overland Park, KS

Req ID: 65950BR

Job Description

This is a work at home (telework) Clinical Case Manager – Behavioral Health position working in the field 50% of the time. Candidates should be located in Johnson, Franklin, Osage, or Miami Counties & surrounding areas.

Utilizes advanced clinical judgment and critical thinking skills to…

Senior Clinical Solutions Medical Director (JC150723988)
Last Updated: 2019-11-20
Employer: Aetna
Location: Overland Park, KS

Req ID: 66008BR

Job Description

The Senior Clinical Solutions Medical Director will support Group Medicare Sales and Retention. Provide support for Medicare account teams to grow business and retain existing business. Works in close alignment with care management teams and matrixed medical management for a region or segment.

Fundamental Components…

Chief Operating Officer, Medicaid Operations (JC149367462)
Last Updated: 2019-11-20
Employer: Aetna
Location: Overland Park, KS

Req ID: 65037BR

Job Description

Responsible for increasing member and provider satisfaction, retention, and growth by efficiently delivering competitive services to members and providers through a fully-integrated organization staffed by knowledgeable, customer-focused professionals supported by exemplary technologies and processes. The Chief Operating Officer is responsible for leading and managing all…

Actuarial Consultant (JC144785676)
Last Updated: 2019-11-20
Employer: Aetna
Location: Overland Park, KS

Req ID: 61818BR

Job Description

- Primary responsibility is support of Small Group and Conversion business in New York – includes pricing, filing, implementation/testing for ACA plans and market-specific support for PEOs and other small-group initiatives in New York.

- May assist with small group / PEO (Professional Employer Organizations)…

Chief Medical Officer Aetna Better Health of KS (Medicaid) (JC143403026)
Last Updated: 2019-11-20
Employer: Aetna
Location: Overland Park, KS

Req ID: 61299BR

Job Description

POSITION SUMMARY

The Sr Director, Clinical Solutions MD (CMO) for Medicaid in Kansas is responsible for leadership of strategic medical management activities and processes which contribute to the performance of the markets and promotes quality of care for our members. These responsibilities include…

Utilization Management Clinical Consultant - Behavioral Heal (JC148308446)
Last Updated: 2019-11-20
Employer: Aetna
Location: Overland Park, KS

Req ID: 64588BR

Job Description

Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. Applies critical thinking and knowledge in clinically appropriate treatment, evidence based care and medical necessity criteria for appropriate utilization of services.

Fundamental Components included but are not limited to:

Consults…

Chief of Staff (JC149367476)
Last Updated: 2019-11-20
Employer: Aetna
Location: Overland Park, KS

Req ID: 64836BR

Job Description

Supports the chief executive officer who leads the Kansas Better Health Medicaid plan under KanCare by recommending and leading appropriate actions, strategies and/or alternatives to meet business needs. Has responsibility for leading/managing varied projects to ensure the end state of the project and/or business operations…

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