Adult System Of Care Administrator

Aetna Inc. Louisville , KY 40202

Posted 2 months ago

Job Description:

The Adult System of Care Administrator is a clinical practitioner who collaborates with adult welfare, adult corrections and other adult-serving agencies; and is responsible to oversee the adult's service delivery system. The Adult System of Care Administrator oversees the development and implementation of community support programs and processes that ensure the needs of adults and families are met.

Fundamental Components

Responsibilities include:

  • Collaborates with adult welfare, adult corrections and other adult-serving agencies, as well as internal teams to ensure coordination of efforts.

  • Oversees the adult's system service delivery system consistent with the state

  • Oversees the design and implementation of the integrated delivery programs [Behavioral Health (BH), Physical Health (PH) and Social Determinants of Health (SDoH)] to ensure the needs of adults and their families in the health system are met.

  • Ensures collaboration with adult welfare agencies and the justice system.

  • Coordinates with members of various State agencies to ensure that programs developed reflect the goals and values of the ASoC.

  • Develops and implements practice adjustments and policy and procedure revisions.

  • Provides training and support in effort to provide continuous improvement in serving adults and families

  • Coordinates the assimilation of measures with continuous quality improvement efforts at the provider and network levels.

  • Establishes a positive organization and company image within the state health care community.

  • Participates in shaping state integrated (BH, PH and SDoH) health system of care and resolving issues and challenges identified.

  • Establishes and maintains on-going relationships with community organizations and contract stakeholders.

  • Ensures the health care needs of members are well served.

  • Establishes and maintains ongoing relationships with key agencies, providers, physicians, hospitals, advocacy groups and State officials.

  • Collaborates with state entities.

  • Creates effective organizational structure, roles and jobs.

  • Leads by example to create desired culture and motivated staff.

  • Establishes a positive organization and company image within the state health care community.

  • Acts as a SME to gather necessary information to respond in writing to state RFP request(s) and renewals

Background Experience

  • Two or more years of experience in public sector, managed health care.

  • Two or more years of experience Adult's System Administrator or similar role for a managed health care organization overseeing collaboration with adult welfare agencies and the justice system.

  • Knowledge and understanding of the state Medicaid managed care market, regulations, practices and integrated health system strongly preferred.

Additional Job Information

Ability to communicate effectively with all levels of management.Proven ability to satisfy customers needs and develop alternatives to resolve issues.

Education

Master's degree

Percent of Travel Required

10 - 25%

Business Overview

At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Crisis And Emergency Services System Of Care Admin

Aetna Inc.

Posted 2 months ago

VIEW JOBS 10/13/2020 12:00:00 AM 2021-01-11T00:00 Job Description The Crisis and Emergency Service Administrator demonstrates expertise in facilitating and coordinating care transitions across the continuum of care settings and throughout the members lifespan. The Crisis and Emergency Service Administrator is responsible for working across internal business units and directly coordinating with care coordination staff, external community entities and participating providers to provide advice and support for complex transition of care cases. Fundamental Components Responsibilities include: * Coordination duties related to complex patient populations and collaboration of services with community programs and providers including both mental health, substance use and medical services. * Identification of crisis response service gaps and development of solutions * Oversee transition of care for members discharging from inpatient settings and to/from the Aetna Medicaid program * Consult with community providers and care management providers, including State and local community providers, providing information on physical and mental health and substance abuse programs, resources, and care program referrals Interact with clinical and senior leaders within the health plan to discuss member specific health and service needs * Monitor the administration of state specific programs to ensure compliance with required processes, identify staff training needs, and to collect program outcome data. * Participate in the review of policies and procedures related to crisis response behavioral and physical health services. * Coordinate with health plan staff (e.g. Member Services, Utilization Management, Care Management) to secure needed services for individual members in conjunction with health plan staff (e.g. Utilization Management, Care Management) coordinate processes related to behavioral and physical health services, involving primary care physicians and related care team participants. * Collaborate with Provider Services in monitoring the network to ensure compliance with state/contractual requirements and to identify service gaps in the crisis response network. * Identify areas of concern related to program administration and participate in the development and implementation of appropriate corrective action. * May participate in training new and existing health plan staff on new programs, member health and service needs, and provider-related processes. * Facilitate effective interactions with network and community service providers through provider education on behavioral and physical health, social service needs, and utilization. * Acts as a SME to gather necessary information to respond in writing to state RFP request(s) and renewals Background Experience * Two or more years of experience in public sector, managed health care. * Knowledge and understanding of the state Medicaid managed care market, regulations, practices and health care system strongly preferred. * Experience working with diverse teams and populations. * Knowledge of community resources and provider networks. Additional Job Information Ability to communicate effectively with all levels of management.Proven ability to satisfy customers needs and develop alternatives to resolve issues. Education Master's degree Percent of Travel Required 10 - 25% Business Overview At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart. We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. Aetna Inc. Louisville KY

Adult System Of Care Administrator

Aetna Inc.