Aetna Aetna Better Health of Virginia Quality Managment Director (55072BR) in Richmond, Virginia

Req ID: 55072BR

Aetna Better Health of Virginia is hiring a Quality Management Director

Our Quality Management Director will act as an Advocate for, and support, the business by serving as a quality champion through measuring and monitoring the quality and effectiveness of the care and service provided to our members. Lead and Manage all aspects of quality programs and projects that enable Aetna to measure, monitor, and improve the quality of the care and service provided to its members. Consult and/or work cross functionally to influence and promote change in order to continually deliver quality service to our internal and external customers. Responsible for coordinating, leading, and managing multiple functional areas/units including full accountability for business/financial results related to following as appropriate: HEDIS reporting, quality of care, NCQA accreditation activities and/or member satisfaction (CAHPS).

Fundamental Components:

(*) Assures compliance with all State and Federal quality regulations, Aetna quality standards, and National Committee for Quality Assurance (NCQA) standards.

(*) Ensures maintenance of accurate documentation for quality improvement activities such as HEDIS reporting, surveys, audits, peer reviews, etc.

(*) In conjunction with key business leaders, responsible for directing the activities of quality committees.

(*) Provides direction setting and leadership, with accountability for quality program(s), specialized audits, special reviews, projects and initiatives. Manage complex projects, people, and business priorities to achieve member satisfaction.

(*) Develops and implements quality improvement activities nationally and/or within an assigned region.

(*) Directs data collection for HEDIS and/or other quality reporting; identifies opportunities for improvement based on results.

(*) Influences all stakeholders to support key quality projects/programs to ensure positive solutions that deliver results.

(*) Consults with internal/external customers on solutions that impact Quality.

(*) Controls expenses while meeting operational, functional and service requirements.

(*) Recruits, develops, and motivates staff. Initiates and communicates a variety of personnel.

BACKGROUND/EXPERIENCE desired:

(*) 5 - 7+ years related experience that reflects a proven track record or proficiency in the competencies noted.

(*) Previous experience managing staff

(*) Demonstrated ability to plan, organize, and execute multiple functional business objectives.

EDUCATION

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

LICENSES AND CERTIFICATIONS

Quality Management/Six Sigma is desired

ADDITIONAL JOB INFORMATION

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 candidates'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.

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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.