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Quality Management Project Manager (DENTAL)

Primary Location: Avondale, PA
Additional Locations: PA-Allentown, PA-Ardmore, PA-Avondale, PA-Beaver, PA-Bellefonte, PA-Bethlehem, PA-Blue Bell, PA-Bristol, PA-Bucks, PA-Butler, PA-Carlisle, PA-Chambersburg, PA-Chester, PA-Clearfield, PA-Coatesville, PA-Cranberry, PA-Croydon, PA-Danville, PA-Delaware, PA-Doylestown, PA-Drexel Hill, PA-Easton, PA-Erie, PA-Gettysburg, PA-Greensburg, PA-Harrisburg, PA-Hollidaysburg, PA-King of Prussia, PA-Kittanning, PA-Lancaster, PA-Lebanon, PA-Levittown, PA-Lewisburg, PA-Malvern, PA-Meadville, PA-Media, PA-Mercer, PA-Montgomery, PA-Moon township, PA-New Castle, PA-Norristown, PA-Oxford, PA-Pittsburgh, PA-Plymouth Meeting, PA-Pottsville, PA-Reading, PA-Spring City, PA-Sunbury, PA-Uniontown, PA-Washington, PA-Waynesburg, PA-West Chester, PA-Wilkes-Barre, PA-Williamsport

Aetna Better Health of PA is hiring 2 Quality Management Project Managers with a background as a dental professional to support our growing Medicaid Health Plan!

These 2 positions are Work From Home Full Time, with the requirement that the employee reside in PA to cover specific assigned territories

Territories will be assigned based on a candidates location and business need. This position will be in the field traveling 75-100% of the time. Reliable transportation and Drivers License are required

Our Quality Management Project Managers will have the ability to successfully manage a number of dental providers and provide in person education to providers on HEDIS and state dental measures to increase HEDIS rates.

Knowledge of medical record documentation, HEDIS, coding and outpatient services.

Fundamental Components:

(*) Conduct onsite visits to Dental provider offices in Pennsylvania to provide education on closing gaps that lead to improved HEDIS rates focusing on preventive dentistry. Provides an opportunity to manage daily schedule to meet established HEDIS goals. Excellent opportunity to influence practices that result in improved outcomes for members with Medicaid insurance. While part of a robust Quality Management team, the candidate will have the ability to work independently with the full support of peers and management.

Background Experience:

3+ years experience in Dental or managed care quality management experience; required

Project management experience; required

HEDIS and/or coding knowledge specific to Dental; preferred

Independent worker with ability to telecommute and travel at least 75% of the time in areas assigned within Pennsylvania; required

Experience communicating with Dentists and Dental office staff; required

Required Skills:
Benefits Management - Encouraging Wellness and Prevention, Benefits Management - Interacting with Medical Professionals, Benefits Management - Maximizing Healthcare Quality

Desired Skills:
Benefits Management - Promoting Health Information Technology, Benefits Management - Shaping the Healthcare System, Benefits Management - Understanding Clinical Impacts

Functional Skills:
Claim - Claim processing - Dental, Dental - Dental Assistant, Dental - Dental Hygienist, Medical Management - Medical Management - Dental - General Dentistry

Technology Experience:
Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft PowerPoint, Desktop Tool - Microsoft Word, Desktop Tool - TE Microsoft Excel

Dental - CDA - Certified Dental Assistant, Dental - Certified Expanded Dental Assistant, Dental - Licensed Hygienist

Potential Telework Position:

Percent of Travel Required:
75 - 100%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

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

Candidate Privacy Information:
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.

Click To Review Our Benefits (PDF)


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