Aetna Senior Quality Consultant in Phoenix, Arizona

Req ID: 41019BR


Position requires individual with experience in policy and procedure development in alignment with health plan contractual and/or regulatory requirements and NCQA health plan standards. Audit and compliance experience in preparing documentation and presentation to external audit organizations.

Fundamental Components:

Policy and procedure development and maintenance (40%)

NCQA audit and compliance (30%)

Workflow development and maintenance (10%)

Audit presentation (10%)

Health plan support (10%)


2+ years work experience in the development and maintenance of policies and procedures.

3+ years work experience in the audit environment that reflects a proven track record or proficiency in the competencies noted.


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


Pharmacy/Pharmacy Technician is desired


Functional - Quality Management/FE NCQA accreditation/1-3 Years

Functional - Medical Management/Medical Management - Pharmacy/1-3 Years


Technical - Desktop Tools/Microsoft Visio/1-3 Years/End User

Technical - Desktop Tools/Microsoft PowerPoint/1-3 Years/End User

Technical - Desktop Tools/Microsoft Word/1-3 Years/End User

Technical - Desktop Tools/Microsoft Visio/1-3 Years/End User


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