Aetna Director, Quality Management - 43812BR in Louisville, Kentucky

Req ID: 43812BR


Lead and Manage all aspects of quality programs and projects that enable Aetna to measure, monitor, and improve the quality of its products, services, and processes. Responsible for coordinating, leading, and managing multiple functional areas/units including full accountability for business/financial results.

Fundamental Components:Oversees the implementation and management of effective processes to achieve the goals of the organization relating to performance for multiple functional areasDrives or guides development of holistic solutions and/or key strategic plansProactively identifies opportunities for improvement and influences business leader(s) to implement recommendations through complex negotiations and/or expert consultation that promotes issue resolutionProvides direction setting and leadership, with accountability for quality program(s), specialized audits, special reviews, projects, and initiatives Manages complex projects, people, and business priorities to achieve customer satisfactionDrives compliance, legislative, and regulatory issues to resolutionMonitors and manages compliance risks on business processes, systems, and productsInfluences all stakeholders to support key quality projects/programs to ensure positive solutions that deliver resultsConsults with internal/external customers on solutions that impact QualityProvides input on business plan to achieve business goalsIdentifies gaps and influences change/enhancements to business processes, policies, workflows, and system

infrastructure in order to improve performance results, organization effectiveness, and/or systems/quality/services

based on a broad view of the organizationAnalyzes and forecasts key financial drivers and makes recommendations for adjustments to budgets and business

plansBACKGROUND/EXPERIENCE desired:5 - 7+ years related experience in quality management and HEDIS that reflects a proven track record or proficiency in the competencies notedPrevious experience with Medicaid/MedicarePrevious experience managing staff (2-3 direct reports; 15-20 indirect reports)Demonstrated ability to plan, organize, and execute multiple functional business objectivesEDUCATION

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


Exceptional communications skills are required, including the ability to interact with a variety of external and internal audiences including senior management.

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