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Aetna HEDIS Provider Engagement Coordinator in Oklahoma City, Oklahoma

Req ID: 65998BR

Job Description

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

Functional Skills:

Communication - Provider communications, Learning - External constituents (i.e., broker, provider), Network Management - Provider relations

Technology Experience:

Desktop Tool - Microsoft PowerPoint, Desktop Tool - Microsoft SharePoint, Desktop Tool - Microsoft Word, Desktop Tool - TE Microsoft Excel

Required Skills:

Leadership - Collaborating for Results, Service - Creating a Differentiated Service Experience, Service - Providing Solutions to Constituent Needs

Desired Skills:

Leadership - Developing and Executing Strategy, Leadership - Driving Change, Leadership - Driving Strategic and Organizational Agility

Benefit Eligibility

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.

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