Aetna is hiring a Manager of Utilization Management/Concurrent Review MCO

This position plays a pivotal role in managing and enhancing clinical operations within a comprehensive managed care setting. The incumbent is responsible for leading a multidisciplinary team to ensure optimal patient outcomes through effective utilization management, concurrent review, and care coordination. Key responsibilities include developing and implementing clinical policies and procedures, monitoring performance metrics, and driving continuous quality improvement initiatives. The role requires strong leadership skills to mentor staff, streamline workflows, and align clinical strategies with organizational goals. Additionally, the position ensures adherence to regulatory standards and accreditation requirements while promoting cost-effective healthcare delivery. Collaboration with medical directors, providers, and other stakeholders is essential to evaluate complex cases, resolve clinical issues, and support evidence-based decision-making. The ideal candidate will have extensive experience in healthcare management, a deep understanding of clinical guidelines, and a proven ability to lead in a dynamic, fast-paced environment.