Aetna Work from Home – Manager

Job Description:

As part of the bold vision to deliver the “Next Generation” of managed care in Ohio Medicaid, Ohio RISE will help struggling children and their families by focusing on the individual with strong coordination and partnership among MCOs, vendors, and ODM to support specialization in addressing critical needs. The OhioRISE Program is designed to provide comprehensive and highly coordinated behavioral health services for children with serious/complex behavioral health needs involved in, or at risk for involvement in, multiple child-serving systems.

Job Responsibilities:

• Develop, initiate, monitor and communicate performance expectations.
• Communicates strategic plan and specific tactics to meet plan.
• Works closely with functional area managers to ensure consistency in clinical interventions supporting our plan sponsors.
• Demonstrate clinically and culturally competent/responsive with training and experience necessary to manage complex cases in the community across child-serving systems.
• Accountable for meeting the financial, operational and quality objectives of the unit.
• Ensures implementation of tactics to meet strategic direction for cost and quality outcomes.
• Creates direction and communicates a business case for change by focusing on and addressing key priorities to achieve business results.
• Consistently demonstrates the ability to serve as a model change agent and lead change efforts.
• Reinforces clinical philosophy, programs, policies and procedures.
• Identifies opportunities to implement best practice approaches and introduce innovations to better improve outcomes.
• May act as a single point of contact for the customer and the Account Team which includes 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.
• May be accountable for the day-to-day management of teams for appropriate implementation and adherence with established practices, policies and procedures if there is not supervisor position.
• Assesses developmental needs and collaborates with others to identify and implement action plans that support the development of high performing teams.

Job Requirements:

• Ability to travel in-state 10-25% of the time with personal vehicle; must possess reliable transportation, valid/active driver’s license, and proof of vehicle insurance.
• Willing and able to work beyond core business hours of Monday-Friday, 8am-5pm as needed is required
• If BH Clinician, minimum of a Master’s degree in behavioral health field is required.
• Managed Care Experience.
• Experience in one or more of the following areas of expertise: family systems, community systems and resources, case management, child and family counseling/therapy, child protection, or child development
• 5+ years of experience in clinical area of expertise.
• Care Management Experience.
• Active unrestricted Ohio Licensure in one of the following clinical areas: LISW, LPCC/PCC, IMFT, or RN
• If RN, BSN is preferred.
• 1+ year(s) of supervisory/managerial experience
• 2+ years of experience in children’s mental health, child welfare, developmental disabilities, juvenile justice, or a public sector human services or behavioral healthcare field, providing community-based services to children and youth, and their family/caregivers
• Demonstrated proficiency with personal computer, keyboard navigation, and MS Office Suite applications.

Job Details:

Company: Aetna

Vacancy Type:  Full Time

Job Location: Cincinnati, OH, US

Application Deadline: N/A

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