MD MCD NCQA Manager

Working At Aetna -- the Value To You
What does it mean to work at Aetna? A lot. From programs and benefits that support your financial, physical and emotional health to opportunities to build your knowledge and expand your career, the company makes working here a valuable experience in many ways.
POSITION SUMMARY
Accountable for NCQA and other 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.
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. -May manage a QM functional department including development and oversight of performance metrics and application of HR policies and procedures. -Forms and leads cross functional teams to assist business units in integrating quality into their strategic and operational plans. -Evaluates and prioritizes recommendations for quality improvement to senior management and/or customers. -Partners with sales and marketing across all segments in their efforts to acquire and retain customers (e.g. responding to RFPs), quality presentations, request for measurement information. -Develops and implements the infrastructure of the QM program and Patient Safety strategy. -Develops, implements, and evaluates the organizations policies and procedures to meet business needs. -Directs/provides enhancements to business processes, policies and infrastructure to improve operational efficiency across the organization. -Influences department business owners and leaders to reach solutions to meet the needs of Plan Sponsors, regulators and other customers while meeting departmental objectives. -Performs strategic analysis of business performance data to address Plan Sponsor needs. -In partnership with business owners, supports design /development of new or enhanced products and services. -Translates knowledge of subject and business needs into clear strategic business plans. -Serves as a technical, professional and/or business expert that may cross multiple business functions.
BACKGROUND/EXPERIENCE desired:
6+ years progressive experience in operational quality management roles in the healthcare industry, regulatory environment and quality management is required
Demonstrated leadership ability required
Bachelor's degree, Nursing degree, or other comparable healthcare experience is required
Understanding of trends and constituency expectations is required
Proficiency with MS Office suite required
NCQA accreditation experience is required - must have experience managing healthcare NCQA accreditation activity
RN is preferred
CPHQ certification is preferred
EDUCATION
The minimum level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
REQUIRED SKILLS
Maximizing Healthcare Quality
Promoting Health Information Technology
Profit and Quality Vigilance
DESIRED SKILLS
Demonstrating Business and Industry Acumen
Fostering a Global Perspective
Improving constituent-focused Processes
ADDITIONAL JOB INFORMATION
Are you ready to join a company that is changing the face of health care across the nation? Aetna Better Health of Maryland is looking for people like you who value excellence, integrity, caring and innovation. As an employee, youll join a team dedicated to improving the lives of the most vulnerable in our population. Our vision incorporates community-based health care that works. We value diversity. Align your career goals with Aetna Better Health of Maryland, and we will support you all the way.
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 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.
How to apply
Please use the "Apply" link to apply to this position. If you cannot view this link, you can find this position on our website by visiting: www.aetna.com/working, click on apply online, search openings, and enter 42790br in the keyword field. Additional information on what its like to work for Aetna and more can also be found on our website.
We value leadership, creativity and initiative. If you share those values and a commitment to excellence and innovation, consider a career with Aetna.
Aetna does not permit the use of tobacco related products or drugs in the workplace.
Aetna is an EO/AA Employer-Minorities/Women/Veterans/Disability.
No search firms please.
You will not be asked for personal information until you have been fully evaluated through Aetna's screening processes. Aetna will never ask applicants for money. If you want to verify the identity of someone who contacts you from Aetna, call 1-800-AETNAHR (1-800-238-6247).

Don't Be Fooled

The fraudster will send a check to the victim who has accepted a job. The check can be for multiple reasons such as signing bonus, supplies, etc. The victim will be instructed to deposit the check and use the money for any of these reasons and then instructed to send the remaining funds to the fraudster. The check will bounce and the victim is left responsible.

More Jobs

Macys Bowie Town Center, Bowie, MD: Receiving ...
Bowie, MD Macy's, Inc.
Macys St. Charles Town Center, Waldorf, MD: Re...
Waldorf, MD Macy's, Inc.
Assistant Manager - Aeropostale Towson Town Ce...
Towson, MD Aeropostale, Inc.
Salon Manager-NEW Store-The Mall at Prince Geo...
Hyattsville, MD ULTA Salon, Cosmetics & Fragrance, INC.
Financial Center Manager II - Crofton-Bowie-An...
Crofton, MD Bank of America Corporation
Retail Store Manager - Laurel, MD
Laurel, MD Red Wing Shoe Company, Inc.