Aetna’s Medicaid SKY Care Management is an initiative that provides comprehensive support and holistic care for enrollees who are either in Out of Home Care (foster care), youth who are dually committed in the Juvenile Justice system, youth under age 18 who receive adoption assistance, or young adults who are former foster care enrollees.  

 
KY SKY focuses on prioritizing Medicaid member interaction, maximizing touchpoints and communication to solve members’ needs and create behavioral change. We understand each unique enrollee in the context of their lives, while partnering with them to design a person-centered holistic model of supports and services that enhance their quality of life and assist them to reach their individual life goals. How we do this is through a dedicated and caring team of health care professionals who connect with passion, caring and behavioral interviewing techniques with a focus on the trauma and other life activities that impact their current health and wellness status. This team has a drive to exceed the delivery of Medicaid Health care services. Focus is on the SKY Teams efficiency and productivity efforts whereby the Care Management team interacts and engages either telephonically or in person with enrollees. Through the successful supports orchestrated by the SKY Care Management team, this comprehensive care coordination is a collaborative demonstration of innovative healthcare navigation and motivational health plan representation. This is an exciting time to join Aetna, a CVS Health Company, in our journey to change the way healthcare is delivered today. We are health care innovators.  
 
The SKY Care Management Project Coordinator supports the development, implementation and ongoing management of project(s) associated to the healthcare services related to member outreach and engagement. The Project Coordinator has responsibility for supporting and leading the Prevention and Wellness level of CM Support. This leader ensures the end state of the project meets business objective(s) and that all deliverables and due dates are met. Highly collaborative process often requires managing relationships across the segments or multiple functional areas. The Project Coordinator may retain and managed a reduced caseload. The Project Coordinator is accountable to leadership to support the day to day operations of the team. This position has no supervisory oversight of staff, but requires a solid understanding of the workflows, policies and procedures, along with evaluation strategies to provide early identification of any rising risk needs and skills to support ongoing prevention and wellness self-care activities to ensure the team is producing at a successful level.  
 
Adheres to Compliance with policies and procedure/regulatory standards. Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements. Protects the confidentiality of member information and adheres to company policies regarding confidentiality.  

Required Qualifications : 

- Serve as a mentor and resource to team members and support to Supervisor for coordination of projects, highly collaborative and astute to business needs and project oversight. 
- Demonstrates effective communication, telephonic and organization skills with ability to be agile, managing multiple priorities at one time, and adapting to change with enthusiasm. Ability to meet project deadlines and ability to meet metrics and assist in productivity metric oversight with accuracy. 
- Support a positive work environment that promotes the concept of teamwork. 
- Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members, adhering to care management processes (to include, but not limited to, privacy and confidentiality, quality management processes in compliance with regulatory, accreditation guidelines, company policies and procedures).  
- Works independently and competently, meeting deliverables and deadlines while demonstrating an outgoing, enthusiastic and caring presence telephonically. The Project Coordinator may assist with team duties, workflow and project workflow during times of staff absence or as directed by leadership. 
- Ability to effectively participate in a multi-disciplinary team including internal and external participants. 

Preferred Qualifications : 

- 2 years related work experience.  
- Proven track record meeting project dates. 
- Proficiency with computers including knowledge of Microsoft Word, Outlook, and Excel – data entry and documentation within member records.  
- Familiarity with basic medical terminology and concepts used in care management preferred.  
- Strong organizational skills, including effective verbal and written communication skills.  

Education : 

Bachelor's degree or equivalent experience.