Quality Management Project ManagerPrimary Location: Philadelphia, Pennsylvania
Additional Locations: PA-Philadelphia Apply
Responsible for managing the processes required for NCQA accreditation throughout the Pennsylvania Medicaid plan. Includes data analysis, collection and management of documents and leading workgroups through requirements.
Ability to successfully manage NCQA accreditation project from start to finish. Responsible for educating plan staff on requirements, writing performance improvement projects, collection of evidence to meet the standards, and working with others to complete evidence that meets the NCQA standards. Will work closely with Plan QM Director to ensure all requirements are met.
Hiring Manager will consider telework for experienced candidates only.
5 to 7 years clinical and/or managed care experience in the healthcare industry and quality management.
2 - 3 years project management and leadership experience.
2 - 3 years NCQA, including knowledge of standards as well as at least completion of the management of an NCQA project through submission.
Experience communicating with departments within a health plan.
Ability to write and manage Performance Improvement Projects/Quality Improvement Projects (PIPs/QIPs).
Experience with Microsoft Excel, PowerPoint and Word.
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 is desired
Project Management/Six Sigma Trained is desired
Functional - Clinical / Medical/Quality management/4-6 Years
Functional - Communications/Communication Delivery - Public Speaking/1-3 Years
Functional - General Management/Process & quality improvement/4-6 Years
Functional - Medical Management/Medical Management - Quality Management/1-3 Years
Technical - Desktop Tools/Microsoft PowerPoint/1-3 Years/End User
Technical - Desktop Tools/Microsoft Word/1-3 Years/Power User
Technical - Desktop Tools/Microsoft Outlook/1-3 Years/Power User
Technical - Desktop Tools/Microsoft SharePoint/1-3 Years/End User
General Business/Communicating for Impact/ADVANCED
Leadership/Anticipating and Innovating/ADVANCED
Leadership/Collaborating for Results/MASTERY
General Business/Applying Reasoned Judgment/MASTERY
Flexible telework / office-based schedule (must live near certain office location)
ADDITIONAL JOB INFORMATION
Provides an opportunity to manage daily schedule to meet established NCQA goals. Excellent opportunity to influence practices that result in successful completion of NCQA standards requirements. 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.
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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