Medicaid Health Care QM Project Manager (HEDIS)
Location: Newark Delaware
Description: Aetna is employing Medicaid Health Care QM Project Manager (HEDIS) right now, this job will be placed in Delaware. More complete informations about this job opportunity kindly see the descriptions. Working At Aetna -- the Value To YouWhat does it mean to work at Aetna? A lot. From programs and benefits that support your financial, physical and emotional health to opportunities to build your knowledge and expand your career, the company makes working here a valuable experience in many ways.
Come join this dynamic team that won the 2013 Health Care Innovation Award from Medicaid Health Care Programs!
This is an in-office role supporting the HEDIS Intervention Committee and quality reviews for Delaware Medicaid. In this position, the empl! oyee will be required to pursue the Six Sigma Yellow Belt once! hired.
POSITION SUMMARY
Manages and influences health care quality projects and initiatives through design, development, and implementation. These activities enable Aetna to improve health care quality products, services, and processes by partnering across business units to meet business needs and accomplish goals.
Scope of job includes project and process coordination and facilitation of all aspects of the HEDIS program and processes at the local plan level:
a) annual and ongoing MRR
b) creating and driving HEDIS interventions with and through others
c) required HEDIS and State mandatory reporting
d) data analysis and ongoing monitoring of HEDIS interventions using rapid cycle processes
e) facilitation of the HEDIS Intervention workgroup and other meetings as required to get targeted measures within the 75th Percentile
f) handle Adult Core Measures and CHIPRA quality measures
Required Skills:Minimum backgrou! nd requirements:
- 3-5 years working in a Managed Care setting
- 2-4 years work with HEDIS
- 2-4 years in Quality Management
- 1-3 years working with Excel at a mastery level
- 3-5 years experience working in a clinical setting (med/surg, ICU, ER, etc)
- 1-3 years experience in cross functional project management
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Nursing/Registered Nurse (RN) is required
Managed Care/Managed Healthcare Professional is desired
Healthcare Management/Case Manager Society of America (CMSA) is desired
Healthcare Management/Certified Professional in HealthCare Quality is desired
Project Management/Project Management Professional (PMP) is desired
FUNCTIONAL EXPERIENCES
Functional - Nursing/Quality Management/4-6 Years
Functional - In! formation Management/Query and Database Access Tools/Microsoft Excel/1-! 3 Years
Functional - Nursing/Medical-Surgical Care/clinical experience/4-6 Years
Functional - Project Management/Cross-functional project management/1-3 Years
Functional - Management/Management - Leadership/1-3 Years
REQUIRED SKILLS
Leadership/Driving a Culture of Compliance
General Business/Applying Reasoned Judgment
General Business/Maximizing Work Practices
DESIRED SKILLS
Leadership/Anticipating and Innovating
Leadership/Collaborating for Results
Leadership/Developing and Executing Strategy
Please note that benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Aetna does not permit the use of tobacco related products or drugs in the workplace.
How to apply
Please use the "Apply" link to apply to this position. If you cannot view this link, you can find this position on our website by visiting: www.aetna.com/working, click on apply online, s! earch openings, and enter 14470BR in the keyword field. Additional information on what it’s like to work for Aetna and more can also be found on our website.
We value leadership, creativity and initiative. If you share those values and a commitment to excellence and innovation, consider a career with Aetna.
We conduct pre-employment drug and background testing.
Aetna does not permit the use of tobacco related products or drugs in the workplace.
Aetna is an Equal Opportunity/Affirmative Action Employer. M/F/D/V
Aetna is committed to maintaining an environment in which all employees are treated equitably and given the opportunity within the context of the business to achieve their potential. Aetna's Affirmative Action responsibilities extend to women, minorities, persons with disabilities and veterans. Company policy also provides for equal opportunity for qualified individuals regardless of race, color, sex, national origin, religion! , age, disability, veteran status, sexual orientation, gender identity ! or marital status.
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You will not be asked for personal information until you have been fully evaluated through Aetna's screening processes. Aetna will never ask applicants for money. If you want to verify the identity of someone who contacts you from Aetna, call 1-800-AETNAHR (1-800-238-6247).
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If you were eligible to this job, please email us your resume, with salary requirements and a resume to Aetna.
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This job starts available on: Mon, 25 Nov 2013 18:49:58 GMT