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Aetna is now a CVS Health Company

HEDIS Project Manager

Primary Location: Phoenix, AZ
Additional Locations: AZ-Phoenix
This is a work at home role with 10-25% of local travel in Phoenix.
The HEDIS Project Manager is responsible for managing 1-4 CMS STAR and HEDIS measures throughout the year, including developing outreaches to members and providers to improve compliance with preventative health and wellness measures. During the HEDIS annual audit, the HEDIS PM will manage 1-2 specific HEDIS hybrid measures as the subject matter expert.
The HEDIS Project Manager will also work on the active, year-round medical record review project to support the HEDIS audit.

Fundamental Components:
-The priority focus of the HEDIS Project Manager is to improve member compliance to health and wellness preventative measures.
-This is accomplished primarily through the development of outreaches to both members and providers, including educational materials.
-The HEDIS PM becomes a subject matter expert on their measure(s) through research and utilization of provided resources, enabling the PM to explore new or improved methods for outreaching to our members and providers.
-Annually, during the HEDIS audit, the PM will manage 1-2 hybrid measures for which they are a subject matter expert.
-This management also includes training contingent staff on what data to obtain from member charts for their specific hybrid measure(s), and over-reading the data collected to ensure accuracy.
-Throughout the year, the HEDIS PM will also work to manage incoming medical record data received through the Year-round medical record review process.

Background Experience:
-An active and good standing Registered Nurse required
-3+ years of clinical experience is required
-1+ year of quality management or project management experience is required
-Managed care experience is preferred
-HEDIS annual audit experience is preferred
-Year-round record review experience is preferred

Additional Job Information:
- Computer Savvy
- Comfortable with technology
- Training experience
- Self starter

Required Skills:
Leadership - Anticipating and Innovating, Leadership - Collaborating for Results, Leadership - Creating Accountability, Leadership - Driving Change

Desired Skills:
General Business - Ensuring Project Discipline, General Business - Maximizing Work Practices, General Business - Turning Data into Information

Functional Skills:
Management - Management - Project management (non-IT), Nursing - Quality Management

Technology Experience:
Desktop Tool - Adobe Acrobat Suite v5, Desktop Tool - Microsoft Outlook, Desktop Tool - TE Microsoft Excel

Nursing - Registered Nurse

Potential Telework Position:

Percent of Travel Required:
10 - 25%

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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