Aetna Health Care QM Project Manager - HEDIS in St Louis, Missouri

Req ID: 42019BR

POSITION SUMMARY

This position is on a team within the National Quality management department that is responsible for HEDIS quality auditing and training for the annual HEDIS Project as well as ongoing Supplemental Data Collection. This is a multi-functional role in which the entire team contributes to all aspects of the process including preparation of training materials, presentation of materials via distance learning, scoring inter-rater reliability testing post training, and ongoing auditing of data abstraction.

Telework:

Potential Telework but preference to be office base in one of the following locations:

St. Louis, MO; Hartford, CT; Tulsa, OK; or Wichita, KS

Fundamental Components:

Responsibilities include but are not limited to:

Review and interpretation of technical specifications

Creation and review of training materials

Conducting web based training

Ongoing audit of data entry/record review

Serves as a subject matter expert for the Regional Quality management teams performing record review

BACKGROUND/EXPERIENCE desired:

3-5 years of HEDIS experience

3 to 5 years clinical or managed care experience in the healthcare industry and quality management.

Project management experience.

Training and auditing experience desired

Ability to collaborate with others to achieve result

Applying reasoned judgment and recognizing results that do make sense

EDUCATION

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

LICENSES AND CERTIFICATIONS

Quality Management/ is desired

Medical/ is desired

FUNCTIONAL EXPERIENCES

Functional - Quality Management/Quality Management/4-6 Years

Functional - Medical Management//4-6 Years

Functional - Nursing//4-6 Years

TECHNOLOGY EXPERIENCES

Technical - Aetna Applications/DARTH/1-3 Years/End User

Technical - Desktop Tools//1-3 Years/End User

REQUIRED SKILLS

General Business/Maximizing Work Practices/MASTERY

Leadership/Collaborating for Results/MASTERY

Service/Working Across Boundaries/MASTERY

DESIRED SKILLS

Benefits Management/Maximizing Healthcare Quality/ADVANCED

Leadership/Driving a Culture of Compliance/MASTERY

TELEWORK:

Internal employees currently WAH will be considered for telework.

External candidates/hire would be office based in one of the following locations

St. Louis, MO; Hartford, CT; Tulsa, OK; or Wichita, KS

ADDITIONAL JOB INFORMATION

This is an opportunity to work in team atmosphere with the opportunity for independent project work

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 candidate'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.

Job Function: Quality Management