Job: Health Care QM Manager

Jobing Description

POSITION SUMMARY

Accountable for health care quality projects and initiatives through direction setting and leadership. Assimilates information to proactively develop quality activities aligned with company strategies and values. Links the quality management activities to business goals. Proactively builds strong teams and business relationships, both internally and externally. Serves as a resource and subject matter expert (SME) on aspects of the quality program to develop and influence business strategies.

EDUCATION

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 (RN) or licensed professional with relevant clinical experience. required

Quality Management/Six Sigma Certification: Yellow Belt is desired

Project Management/Six Sigma Trained is desired

Managed Care/Managed Healthcare Professional is desired

Quality Management/Certified Manager of Quality/Organizational Excellence is desired

FUNCTIONAL EXPERIENCES

Quality Management/Quality Management/7-10 Years

Quality Management/Six Sigma/1-3 Years

Quality Management/NCQA accreditation/1-3 Years

Clinical / Medical/Quality management/1-3 Years

Management/Management - Process and quality improvement/4-6 Years

TECHNOLOGY EXPERIENCES

Desktop Tools/Microsoft Excel/4-6 Years/End User

Desktop Tools/Microsoft Access/4-6 Years/End User

Desktop Tools/Microsoft Visio Pro/1-3 Years/End User

Desktop Tools/Microsoft PowerPoint/1-3 Years/End User

Desktop Tools/Microsoft Project/1-3 Years/End User

REQUIRED SKILLS

Service/Improving constituent-focused Processes/MASTERY

General Business/Demonstrating Business and Industry Acumen/MASTERY

Leadership/Anticipating and Innovating/ADVANCED

DESIRED SKILLS

Leadership/Engaging and Developing People/ADVANCED

Leadership/Driving Change/ADVANCED

Leadership/Collaborating for Results/MASTERY

ADDITIONAL JOB INFORMATION

*Will oversee and manage major projects: HEDIS - all measures for Medicaid, CHIP and Long Term Care; Provider Profiling; Prevention and Wellness Activities; and Quality of Care issues.
*Medicaid experience preferred
*Managed care experience preferred.
*Previous managerial experience in directing, supervising, monitoring and developing staff required.

Please note that benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Aetna does not permit the use of tobacco related products or drugs in the workplace.
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Aetna does not permit the use of tobacco related products or drugs in the workplace.