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Director of Care Management - Aetna Better Health of Texas

Rewritten Job Description:

About the Role:

Join our team as a Director of Care Management at Aetna Better Health of Texas, where you will play a critical role in shaping the future of healthcare. As a leader in our organization, you will oversee the implementation and execution of our clinical operations, ensuring that our members receive holistic, cost-effective care that meets their unique needs.

Key Responsibilities:

  • Lead a clinical team in developing and implementing care plans that improve health outcomes, member engagement, and satisfaction.
  • Develop and manage clinical operations that align with our business strategy, regulatory requirements, and best practices.
  • Collaborate with cross-functional teams, including claims, member services, compliance, quality, utilization management, and network/provider services.
  • Serve as a liaison with regulatory and accrediting agencies, ensuring compliance with relevant standards and policies.
  • Formulate and implement strategies to achieve departmental metrics and provide operational direction.
  • Develop and participate in presentations and consultations with stakeholders, including existing and prospective clients.
  • Direct and provide enhancements to business processes, policies, and infrastructure to improve clinical operational efficiency.

Requirements:

  • Must reside in Texas.
  • Texas-licensed registered nurse with current unencumbered license and experience in care management.
  • Nationally recognized case management certification or ability to obtain within 90 days.
  • 5+ years of clinical practice experience in physical or behavioral healthcare.
  • 5+ years of management or clinical leadership experience.
  • 3+ years of experience with personal computer, keyboard navigation, and MS Office Suite applications.
  • Must possess reliable transportation and be willing and able to travel in-state up to 15% of the time.

Preferred Qualifications:

  • Master's degree preferred.
  • Medicaid, insurance, managed care, experience.

What We Offer:

  • A competitive salary range of $110,467.50 - $237,930.00.
  • A bonus, commission, or short-term incentive program.
  • An award target in the company's equity award program.
  • A comprehensive benefits package, including medical, dental, and vision benefits.
  • A 401(k) retirement savings plan and an Employee Stock Purchase Plan.
  • A fully-paid term life insurance plan and short-term and long-term disability benefits.
  • Well-being programs, education assistance, free development courses, and a CVS store discount.
  • Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year.

How to Apply:

Don't miss out on this exciting opportunity. Apply now to become our Director of Care Management at Aetna Better Health of Texas.

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