Manager for the Pennsylvania market: In 2005, I became the
Continuum of Care Manager (COC) in the Northeast Region; acting as a liaison
between National Patient Management and regional Patient Management. My span of
direction included staff based out of what is now the Hartford office as well
as staff in Blue Bell, PA office. In 2009,
Aetna piloted ‘Work From Home' as the number of employees expanded. My team became
full time WFH by the May of 2010 and included all job levels. Communication to
keep staff informed and bonded as a team was an important focus of my role as
manager; all of which was necessary to achieve annual company goals.
In May of 2007, I took on the role of a Care Team Manager in
addition to my COC role on a temporary basis and officially combined my
management of the care teams and the COC role in January of 2008. I was successful
in the management of both areas until June of 2009, when I relinquished my COC
role to take on the Care Team manager as my focus.
I was successful in the implementation of our new Case
Management program that began in 2005 and fully implemented in the NER in March
of 2006 and again in 2008, when we underwent a system change and change in the
CM program again.
My role as COC involved interactions with Supervisors to
keep them up to date with current program information and communication with
the case managers; advising of any changes or issues that are identified and
how to follow up appropriately. This COC role also involved preparation of
cases for external audits by plan sponsors; NCQA review and the follow up
action plans if needed.
I have reviewed reporting data to determine if we as a
region were on target for CM (Case Management) enrollment and worked to achieve
that target. As a Manager, I have had the lead role in many projects, all
related to achieving better outcomes for members and Aetna
as a business. Writing of workflows and processes are a forte of mine since I
had performed all of the roles that are involved in the workflows and try to
anticipate the needs of each role.
In the Market Management role, I participate on many workgroups
and committees and actively participate in all Management meetings involving
staffing issues, workload and achieving goals for the region. I also worked
directly with the patient management director and our team of Medical Directors
to identify best practice in achieving good communication between staff, management,
and the team of physicians.
I strive to build sound, professional relationships with our
providers and met with facilities in person as needed. As programs and
processes changed within the company, I met with facilities to review the
processes and develop a workflow that worked for both CM staff and the staff of the facilities.
My previous Aetna experience
includes a supervisory role; Clinical Trainer for the Northeast Region (program
and system training) and Concurrent review nurse - initially being a team
leader on my team and managing our Aetna Student Health program.
