Aetna HEDIS Practice Liaison (Florida Medicaid) in Tampa, Florida
Req ID: 53452BR
This position is Work From Home with the requirement that the employee reside in/ near Tampa, FL to cover the specific assigned territory.
Our Provider Practice Liaisons are assigned to specific areas in Florida to perform on-site provider office visits to discuss HEDIS improvement activities. Provide education to close gaps in the care of members with Medicaid insurance. Provides an opportunity to manage daily schedule to meet established HEDIS goals. Excellent opportunity to influence practices that result in improved outcomes for members with Medicaid insurance. While part of a robust Quality Management team, the candidate will have the ability to work independently with the full support of peers and management. This position will be in the field traveling 75% of the time. Reliable transportation and Driver s License are required.
Ability to successfully manage a number of providers and provide in person education to improve HEDIS and specific performance measure. rates.
Knowledge of medical record documentation, HEDIS, coding and services performed in the provider's office.
Ability to interpret and analyze data and provide the information in a format that is actionable for providers.
Must have critical and analytical thinking skills and ability to present information at the provider and/or practice site level.
Background/ Experience Desired:
3+ years clinical experience
1-3 managed care experience in the healthcare industry and quality management
Project management and leadership experience
HEDIS and/or coding knowledge
Knowledge of medical terminology
Experience communicating with physicians, other providers and office staff
Independent worker with ability to telecommute and travel at least 75% of the time in areas assigned within Tampa, Florida
Ability to write and manage Performance Improvement Projects/Quality Improvement Projects (PIPs/QIPs)
Experience with Microsoft Excel, PowerPoint and Word
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
Certified Coder, LPN, RN or other relevant healthcare/practice management
Nursing/Registered Nurse is desired
Project Management/Six Sigma Trained is desired
Functional - Clinical / Medical/Quality management/4-6 Years
Functional - Communications/Provider communications/1-3 Years
Functional - General Management/Process & quality improvement/4-6 Years
Functional - Medical Management/Medical Management - Quality Management/1-3 Years
Technical - Desktop Tools/Microsoft PowerPoint/1-3 Years/End User
Technical - Desktop Tools/Microsoft Word/1-3 Years/Power User
Technical - Desktop Tools/Microsoft Outlook/1-3 Years/Power User
Technical - Desktop Tools/Microsoft SharePoint/1-3 Years/End User
General Business/Communicating for Impact/ADVANCED
Leadership/Anticipating and Innovating/ADVANCED
Leadership/Collaborating for Results/MASTERY
General Business/Applying Reasoned Judgment/MASTERY
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. 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.
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.
Aetna takes our candidates 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