Registered Nurse

Aetna - Owensboro, KY 42303
September 8, 2020
Full Time
Req ID: 72751BRJob DescriptionThe Supervisor is responsible for oversight of healthcare management 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. This position requires the ability to travel up to 25% of the time with use of a personal vehicle. Must have active KY driver's license, proof of vehicle insurance, and reliable transportation. Routine travel is anticipated within the assigned region. Additional travel to the Louisville office is also anticipated for meetings and training. This position is assigned to the Two Rivers region (Includes following counties: Allen, Barren, Butler, Daviess, Edmonson, Hancock, Hart, Henderson, Logan, McLean, Metcalfe, Monroe, Simpson, Union, Warren, Weber). Qualified candidates may reside in or adjacent to the assigned region. Fundamental Components included but are not limited to:+ Oversees the implementation of healthcare management services for assigned functional area.+ 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 have responsibility for their own case load work.+ May act as a single point of contact for the customer and the Account Team 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 a 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.Qualifications Requirements and Preferences:+ Master's degree in behavioral health field; or+ Registered Nurse (BSN preferred).+ Active unrestricted State Licensure in applicable functional area is required. (eg RN, LCSW, LPCC or LMFT+ 3 - 5 years in clinical area of expertise. (Certain functional areas may require additional clinical experience such as for BH triage and referral. Supervision decisions must have 5 years post master's degree clinical experience required.)+ Minimum of 1 year previous supervisory or leadership experience is required.+ Experience or detailed knowledge of the Foster Care and juvenile justice systems, Adoption Assistance, the delivery of Behavior Health Services, Trauma-informed Care, ACEs, Crisis Intervention services, and evidence-based practices applicable to the Kentucky SKY populations, is required.+ Managed care experience is preferred.+ Medicaid experience is preferred.+ Computer literacy and demonstrated proficiency is required in order to navigate through internal/external computer systems, and MS Office Suite applications, including Word and Excel.+ Ability to work with people in such a manner as to build high morale and group commitment to goals and objectives.+ Ability to evaluate and interpret data, identify areas of improvement, and focus on interventions to improve outcomes.+ Ability to communicate effectively with Providers, Members, Staff and other Leaders both in oral and written formats (e.g., may provide support to the sales staff & network staff via onsite customer visits and/or presentations)+ Flexibility to work beyond core business hours of Monday-Friday, 8am-5pm, is required. We are serving the needs of children and families that may require working after school, after work, etc.Additional Job Information:At Aetna Better Health of Kentucky, we reach beyond ensuring access to quality health care by focusing on resilient healing for children and their families. Our vision is to construct local, regional, and state-level coalitions to create a shared, in-common vision of health promoting and resiliency building approaches, to engage and support children to have membership in a family and community, while services and permanency planning are occurring. By keeping families safely together, children in Kentucky SKY will experience less trauma, which leads to better outcomes. To accomplish this, we are looking for people like you who value excellence, integrity, caring and innovation. As an employee, you'll join a team dedicated to supporting children, young people, parents, and other important partners involved with child protection systems. We value diversity and are dedicated to helping you achieve your career goals.Benefit EligibilityBenefit eligibility may vary by position.Job Function: HealthcareAetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.
Location/Region: Owensboro, KY (42303)