Aetna HEDIS Provider Engagement Coordinator in Oklahoma City, Oklahoma
Req ID: 65998BR
Office-based position. Candidates must live in one of the following states near an office location: Oklahoma, Michigan, New Jersey, or North Carolina. Please note, even internals currently working from home will be required to work out of an office.
Participates in the implementation of QM Work Plan activities by effectively collaborating with our provider community with the goal of positively impacting our member's lives through specific provider outreach and engagement objectives.
Fundamental Components included but are not limited to:
Processes and evaluates complex data and information sets to perform quantitative and qualitative data analysis (e.g., accreditation and regulatory standards, HEDIS data, Geoaccess data). Prepares and completes QM Documents based on interpretation and application of business requirements. Accurately documents and reports QM activities to demonstrate compliance with business, regulatory, and accreditation requirements. Participantes in the implementation of QM Work Plan Activities by effectively collaborating with our provider community with the goal of positively impacting our member's lives through specific provider outreach and engagement objectives. Responsible for the ongoing maintenance and implementation of provider outreach and engagement objectives.
Qualifications Requirements and Preferences:
3+ years health care provider relations or network experience required
Account management experience preferred
Medical sales experience preferred
Training or mentoring experience
Clinical claims or coding experience preferred
Communication - Provider communications, Learning - External constituents (i.e., broker, provider), Network Management - Provider relations
Desktop Tool - Microsoft PowerPoint, Desktop Tool - Microsoft SharePoint, Desktop Tool - Microsoft Word, Desktop Tool - TE Microsoft Excel
Leadership - Collaborating for Results, Service - Creating a Differentiated Service Experience, Service - Providing Solutions to Constituent Needs
Leadership - Developing and Executing Strategy, Leadership - Driving Change, Leadership - Driving Strategic and Organizational Agility
Benefit eligibility may vary by position.
Job Function: Quality Management
Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.