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Health Care QM Project Manager

Primary Location: Charlotte, North Carolina
Additional Locations: NC-Charlotte
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Description:
POSITION SUMMARY
Clinical leader to oversee and coordinate quality management activities for DSNP population. Will be liaison between quality department and local DSNP plans


ADDITIONAL JOB INFORMATION
In the Health Care Quality Project Manager position, you will work on auditing and preparing standards of compliance for NCQA accreditation. You will work with NCQA guidelines and help ensure all accreditation requirements are met. You will be accountable for health care quality projects and initiatives through direction setting and leadership. You will proactively develop quality activities aligned with company strategies and values. You will link the quality management activities to business goals. This position requires that you proactively build strong teams and business relationships, both internally and externally. You will serve as a resource and subject matter expert (SME) on aspects of the quality program to develop and influence business strategies.


Fundamental Components:
Makes business decisions based on the results of research and data analysis.
Has responsibility for decision making regarding the design, development, and implementation strategy of quality improvement projects, and initiatives.
Forms and leads cross functional teams to assist business units in integrating quality into their strategic and operational plans.
Develops, implements, and evaluates the organizations policies and procedures to meet business needs.
Translates knowledge of subject and business needs into clear strategic business plans.

Background Experience:

5+ years progressive experience in operational quality management roles in the healthcare industry, regulatory environment and quality management.
Knowledge of NCQA audit processes and procedures.
Knowledge of Medicaid and Medicare plans
Good business acumen
Proficient with reporting survey results and data gathered
MS Office Programs: Excel, Word and Outlook.
Demonstrated leadership , project management ability.

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

LICENSES AND CERTIFICATIONS

Nursing/ Registered Nurse - RN - Required
Nursing/American Nurses Credentialing Center


FUNCTIONAL EXPERIENCES
Functional - Leadership/Lead a business in different geographies or multiple markets/1+ Years
Functional - Project Management/Cross-functional project management/1+ Years


TECHNOLOGY EXPERIENCES
Technical - Aetna Applications/Aetna Total clinical View/1+ Years/End User


REQUIRED SKILLS
Leadership/Anticipating and Innovating/ADVANCED
General Business/Applying Reasoned Judgment/MASTERY
Leadership/Collaborating for Results/MASTERY

Telework Specifications:
Considered for any US location depending on available space in office and or proximity to an Aetna office.


Education:
Nursing - Registered Nurse

Potential Telework Position:
Yes

Percent of Travel Required:
0 - 10%

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 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 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.



Click To Review Our Benefits (PDF)

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