Analyze policy/procedure/workflows on case management and utilization management for care redesign
Analyze Total Cost of Care, Stars, Risk Adjustment, etc. data for opportunities and propose Strategic Action Items and other initiatives to improve outcomes
Work collaboratively with Medical Economics Unit, Analytics and Behavioral Change, Aetna Clinical Services and Medical Affairs’ other departments to improve Medicare business operations and clinical program execution
Develop and improve Medicare reporting, such as, in Tableau
Lead and implement informatics communication efforts
Strong collaborative relationship with care management teams
Active participation in meetings and communications, including team meetings, leadership meetings, at the health plan local, state, regional or national levels
Other duties as assigned

Board certification in Medical Informatics preferred
Masters in related field preferred
5 years work experience in managed care required (preferably in Medicare)
Experience in care model design and implementation, population health program development and/or clinical product development preferred
Medical informatics and/or data science experience preferred
Care Redesign experience required
Must meet COVID-19 requirements
Active and current state medical license without encumbrances
M.D. or D.O., Board Certification in a recognized specialty including post-graduate direct patient care experience

medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families

Medical Director – Senior Clinical Solution, Population Health

Key skills