Aetna MD MCD HEDIS Manager - 42788BR in Linthicum, Maryland

Req ID: 42788BR


Experienced HEDIS Manager needed to drive improvement and manage the annual HEDIS Medical Record Review project.

Fundamental Components:

Experienced HEDIS Manager needed to successfully manage HEDIS and the HEDIS Medical Record Review (MRR) project. The experienced manager must have extensive knowledge of the HEDIS technical specifications, and proven experience with successfully managing the medical record review project for a health plan from start to finish, including managing internal and temporary staff. Experience working with other departments to meet and exceed HEDIS and quality goals is also needed. In addition to managing the project, the position will be responsible for monitoring HEDIS rates monthly and taking action as needed year round.

BACKGROUND/EXPERIENCE desired:6+ years progressive experience in operational quality management roles in the healthcare industry, regulatory environment and quality management.HEDIS audit experience is required.Demonstrated leadership ability (will be managing temporary employees at audit time.)Certified professional in healthcare quality (CPHQ) or certified in health care quality management (CHCQM) or comparable education and experience in data and outcomes measurement is preferred.Bachelor's degree, Nursing degree, or other comparable healthcare experience.Proficiency with MS Office Suite.


The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.


Functional - Quality Management/Quality Management/4-6 Years


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

Technical - Desktop Tools/Microsoft Word/4-6 Years/End User

Technical - Desktop Tools/Microsoft SharePoint/4-6 Years/End User


Maximizing Healthcare Quality

Promoting Health Information Technology

Demonstrating Business and Industry Acumen


Consulting for Solutions

Driving a Culture of Compliance

Fostering a Global Perspective


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, you ll 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.


Job Function: Quality Management