Regional Program Operations Manager
Aetna - Plantation, FL

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  • This is a full time Work at Home opportunity.POSITION SUMMARY:
Develops and executes strategic business plans for Patient Centered Medical Home (PCMH) customer relationships, revenue growth, member retention and achievement of financial objectives.RESPONSIBILITIES:
  • Responsible for the overall primary care physician customer practice/group relationship and experience with the Patient Centered Primary Care (PCPC) Solution, including achievement of annual revenue and AFIT targets for the PCPC business. - Will be responsible for coordinating the following services/components of the PCPC Solution: PCPC PCMH Operations, IT, Care Management Services, Medical Informatics, Patient Engagement, and Value-Based Contracting Consulting. - PCPC PCMH Operations responsibilities include: Facilitate PCP practice transformation from FFS Care Model to the PCMH Care Model, focusing specifically on optimizing PCMH value in the context of the PCPC Solution; Initial education/training on the PCPC technology solution and any on-going training/education needed; The initial and ongoing clinical and operational workflow consulting to optimize clinical and financial success; Ongoing/continuous refinement of practice clinical and operational processes.EDUCATION:
  • Bachelor's degree required.REQUIRED SKILLS:
  • Experience in large physician group practice management or technology implementation, IPA management, and/or healthcare consulting focused within primary care practice operations and value-based reimbursement models.- Experience in the management and/or implementation of PCMH Care Model; engaged in regional or national thought leadership regarding PCMH and value-based reimbursement.- Demonstrated understanding of healthcare technology and how it can be applied to solve key issues facing the US Healthcare System. - Specific experience with technologies and solutions deployed into the Primary Care market place: Electronic Medical Record (EMR) systems, Practice Management (PM) systems, Revenue Cycle Management (RCM) systems/solutions, Patient access and convenience systems and Health Information Exchanges (HIE).- Demonstrated knowledge of healthcare reform and the macro and micro trends in healthcare, including: Patient Centered Medical Home, Accountable Care Organizations, Pay for Performance/value based reimbursement contracting, Evidence Based Medicine, Patient engagement and Consumer driven healthcare.- Demonstrated project management skills.- Effective communication/influencing skills applied to broad internal/external audience.- Demonstrated group leadership and performance management skills.- Demonstrated ability to thrive in a matrix management and resource environment.FUNCTIONAL EXPERIENCES:
  • Communications/Communication Delivery - Public SpeakingPlease note that benefit eligibility may vary by position. Clickhereto review the benefits associated with this position.
Aetna does not permit the use of tobacco related products or drugs in the workplace.

Job Function: Management

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