Req ID: 34864BR
POSITION SUMMARYAetna is searching for a HEDIS Quality Manager to direct a diverse team of clinical and non-clinical staff in the successful completion of HEDIS data collection activities in compliance with HEDIS technical specifications, and to conduct comprehensive analyses of HEDIS results, identify opportunities, and design and implement quality improvement activities to increase HEDIS and Medicare Stars rates across multiple markets.Fundamental Components:-Manage a diverse HEDIS team, including clinical and non-clinical project managers, consultants, analysts and outreach coordinators, encourage staff development, provide oversight of performance metrics and ensure compliance with all HR policies and procedures-Assist in developing annual HEDIS project plans, monitor project progress, and ensure all project deadlines are met-Ensure compliance with all HEDIS technical specifications, policies, operating procedures, and goals in compliance with internal and external guidelines-Provide comprehensive analysis of HEDIS results, barriers, and identify opportunities for quality improvement across multiple markets-Design and implement quality improvement activities to increase HEDIS and Medicare Stars rates across multiple markets-Monitor effectiveness of quality improvement activities and implement modifications as needed to increase HEDIS and Medicare Stars rates across multiple markets-Collaborate with cross functional departments to design, implement and monitor effectiveness of quality improvement activities to increase HEDIS and Medicare Stars rates across multiple markets-Serve as a HEDIS subject matter expert for internal and external constituentBACKGROUND/EXPERIENCE:-MINIMUM of 5+ years of HEDIS data collection, HEDIS project management, and HEDIS quality improvement experience in the healthcare industry-MINIMUM of 2+ years of Medicare Stars project management and Medicare Stars quality improvement experience in the healthcare industry- MINIMUM of 2+ years of Supervisory and Performance Management experience. - Proven experience with process improvements and procedures with HEDIS Data Collection.- Ability to manage multiple, complex projects with strict deadlines. Project Management experience.- Strong experience with coaching and mentoring a team.- Professional communication skills both written and verbal, good business acumen,- Proficient skill level with MS Office Programs: Word, Excel and Outlook. Able to generate reports.EDUCATIONThe highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.REQUIRED SKILLSGeneral Business/Demonstrating Business and Industry Acumen/MASTERYLeadership/Anticipating and Innovating/ADVANCEDLeadership/Developing and Executing Strategy/ADVANCEDProject Management HEDIS DATA Collect processes and proceduresHEDIS Medicare STAR DESIRED SKILLSGeneral Business/Applying Reasoned Judgment/MASTERYGeneral Business/Turning Data into Information/ADVANCEDLeadership/Driving a Culture of Compliance/MASTERYTelework Specifications:Option for telework will be evaluated after a certain period of employmentADDITIONAL JOB INFORMATION;* The location of the position is CA based only with the preferred location to be Walnut Creek, CA. * This is an exceptional opportunity to do meaningful work to build a healthier world by improving the quality of health care for those that we serve at one of America's leading health benefits companies. Aetna offers a competitive salary and a generous benefits package. We are an equal opportunity employer dedicated to workforce diversity and a drug and tobacco-free workplace. If you're seeking a career that affects change in the health care system, consider joining our team at Aetna. Our mission is to build a healthier world. We are a leading diversified health care benefits company, serving an estimated 46.5 million people with information and resources to help them, in consultation with their health care professionals, make better informed decisions about their health care. In partnership with health care providers, we are committed to transforming the health care system. The goal: to simplify the health care experience and help people enjoy more healthy days.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.
Job Function: Quality Management