Upvote
Downvote
Senior Medical Director - Medicaid LTSS & SAI Lead
Share Job
- Suggest Revision
$184,112.5 - $396,600 a year
Full-time
- The LTSS/SAI National Senior Medical Director, reporting to a Regional CMO of Medicaid, will collaborate with Aetna National Medicaid, Regional and health plan leadership to identify, develop, implement, and evaluate the effectiveness of key LTSS strategic initiatives including trends, policies and programs, designed to drive the delivery of high value healthcare supporting a sustainable competitive business advantage for Aetna LTSS members.
- Support the RFP and RFI processes in all LTSS markets with participation in meetings and SME revisions with proposal writers and provide guidance to or participate in including orals presentations- Support NCQA recertification in all LTSS markets- Actively participate in SAI activities to identify and appropriately convert eligible members to LTSS products- Assure compliance with State contracted mandates for cost, quality, and care management initiatives.
- Assess and redesign as needed LTSS dashboards specific to LTSS state contracts- Serve as RFP/RFI/RFA LTSS SME input and participation for writing and orals.
- Collaborate with Care Management, quality, and population health t teams and others to drive comprehensive, innovative care solutions for LTSS members.
- Participate in SAI/MEU reviews with LTSS markets states to identify possible areas of improvement particularly with rate cell changes and transitions into community- Provide clinical expertise and guidance for Quality focused initiatives as determined by the plan leadership for NCQA and audits.
Active Job
Updated TodaySimilar Job
Relevance
Active