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Health Care QM Projct Mgr

Expired Job

Aetna Inc. Atlanta , GA 30301

Posted 2 months ago

Job Description:

This position is open across the US, not location specific and open to work from home full time

Health Care QM Project Mgr

  • Medicaid HEDIS Measures Training

Subject Matter Expert (SME) for all Medicaid HEDIS Measures, training Health Plan staff on HEDIS abstraction and working with an external auditor on all things HEDIS.

Fundamental Components:

This position will be responsible for being the HEDIS measure subject matter expert. They will be conducting web-ex training to all Health Plan fulltime staff and HEDIS temps that will be preforming HEDIS abstraction.

They will be responsible for preparing the training manual and materials prior to training and submitting materials to the auditor for approval. They will be responsible for all Inter rater reliability testing of the HEDIS measure, to include tacking the scores and trending the results for opportunities for improvement. This position will also be a single point of contact Resource Manager for a list of assigned Health Plans.

BACKGROUND/EXPERIENCE desired:

(*) 5 to 7 years clinical and/or managed care experience in the healthcare industry and quality management.

(*) Project management and leadership experience.

(*) HEDIS Experience

EDUCATION

(*) The highest level of education desired for candidates in this position is a Associate's degree or equivalent experience.

LICENSES AND CERTIFICATIONS

Quality Management/National Committee For Quality Assurance is desired

FUNCTIONAL EXPERIENCES

Functional

  • Quality Management/Quality Management/4-6 Years

Functional

  • Communications/Employee communications/1-3 Years

TECHNOLOGY EXPERIENCES

Technical

  • Desktop Tools/Microsoft Outlook/1-3 Years/End User

Technical

  • Desktop Tools/Microsoft Word/1-3 Years/End User

Technical

  • Desktop Tools/Microsoft PowerPoint/1-3 Years/End User

REQUIRED SKILLS

General Business/Applying Reasoned Judgment/MASTERY

Leadership/Creating Accountability/ADVANCED

Leadership/Collaborating for Results/MASTERY

DESIRED SKILLS

Leadership/Fostering a Global Perspective/ADVANCED

General Business/Communicating for Impact/ADVANCED

Leadership/Driving a Culture of Compliance/MASTERY

Telework Specifications:

Full-Time Telework (WAH)

ADDITIONAL JOB INFORMATION

This position offers an opportunity for someone that likes to train others, in addition offers an opportunity to assist Health Plans to achieve their goals for a successful season by facilitating and coordinating meetings with the plans to address barriers and opportunities.

Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe.

We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.

We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.

Together we will empower people to live healthier lives.

Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Aetna takes our candidates's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail.

Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.



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Health Care QM Projct Mgr

Expired Job

Aetna Inc.