Director, Care Management - Service Coordination (LCSW, LCPC, RN, LCP, LCMFT, LCAC) - KS MCD - 51963

Overland Park, KS
United States

Job Description
Are you ready to join a company that is changing the face of health care across the nation? Aetna Better Health of Kansas is looking for people like you who value excellence, integrity, caring and innovation. As an employee, you will join team dedicated to improving the lives of KanCare members. Our vision incorporates community-based health care that works. We value diversity. Align your career goals with Aetna Better Health of Kansas, and we will support you all the way.

The Director of Care Management - Service Coordination is responsible for all Service Coordination activities within the Service Coordination Program for KanCare members. This position works closely with the Behavioral Health Supports Director and the Health Services Director to provide integrated, holistic care for all KanCare populations covered under the KanCare contract. The position develops, implements, supports, and promotes Health Services strategies, tactics, policies, and programs that drive the delivery of quality healthcare to establish competitive business advantage for Aetna. Health Services strategies, policies, and programs are comprised of care management and clinical coverage and policies; oversight and management of care management clinical team processes including the organization and development of high performing teams.

Offices in Overland Park and Topeka; position will require in-state travel and travel to corporate Medicaid offices in Phoenix, AZ. Approximately 10-25% travel involved; primarily in-state.

Fundamental Components:
- Reinforces clinical philosophy, programs, policies, and procedures.
- Communicates strategic plan and specific tactics to meet plan.
- 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.
- Assesses developmental needs and collaborates with others to identify and implement action plans that support the development of high performing teams.

Qualification Requirements:
- Licensed clinician with at least five (5) years case and Care Management experience and who is knowledgeable about all KanCare Waiver programs required.
- 8-10 years clinical leadership required; ability to synthesize program performance and clinical outcomes.
- Managed care experience required.
- Demonstrated management experience selecting, motivating and leading teams; mentoring and coaching staff required.
- Must possess exceptional communication skills (verbal, written and presentation) required.
- Knowledgeable about waiver programs and who will provide oversight for the contractor(s) quality improvement initiatives regarding care coordination, Social Determinants of Health and Independence and health Outcomes required.
- Data analysis and monitoring of data required.
- Reporting: ability to understand and create reports with productivity and service metrics and identify gaps required.
- Computer skills: advanced in Microsoft Office suite (Word, Excel) and proficient in web and Access databases required.
- RN with active and unencumbered KS license (BSN preferred) OR a master’s level Behavioral Health professional independently licensed in KS (e.g., LSCSW, LCPC, LCP, LCMFT, LCAC) is required.
- I/DD experience is strongly desired.
- Behavioral health experience strongly desired.
- 1+ years' experience managing chronic conditions desired.
- Experience in self-directed care desired.

The minimum level of education required for candidates in this position is an Associate's degree or equivalent experience.

At least ONE of the following is required (active and unrestricted for the State of KS):
- Registered Nurse (RN) License
- Licensed Specialist Clinical Social Worker (LSCSW)
- Licensed Clinical Professional Counselor (LCPC) - Licensed Clinical Psychologist (LCP)
- Licensed Clinical Marriage and Family Therapist (LCMFT)
- Licensed Clinical Addiction Counselor (LCAC)

Functional - Clinical / Medical/Direct patient care (hospital, private practice)/7-10 Years
Functional - Medical Management/Medical Management - Case Management/4-6 Years
Functional - Medical Management/Medical Management - Clinical coverage and policies/4-6 Years
Functional - Nursing/Case Management/4-6 Years

Technical - Desktop Tools/Microsoft Word/7-10 Years/End User
Technical - Desktop Tools/TE Microsoft Excel/7-10 Years/End User
Technical - Desktop Tools/Microsoft Outlook/7-10 Years/End User

Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.

We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.

Together we will empower people to live healthier lives.

Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

Benefit eligibility may vary by position.

Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.