Aetna Executive Director Health Care Quality in Downers Grove, Illinois
Req ID: 71496BR
Provide executive leadership and develop enterprise-wide, results oriented quality strategy to drive improvements at the national, regional and market level. Responsible for the overall coordination, implementation, and monitoring of activities to yield quality driven, innovative, compliant, efficient, and cost-effective results.
Fundamental Components included but are not limited to:
Sets the direction of the strategic business plan and translates into vision for staff/others. Ensures the implementation and ongoing execution of the Health Care Quality Management Program to support business, regulatory and accreditation requirements, and improve HEDIS Stars results. Foster a culture of quality using innovation, integration and information to support revenue and membership growth while achieving business goals. Establish strategic relationships with executive leadership throughout the organization to develop and remove barriers, if needed, to implement program strategies that meet business, regulatory and accreditation requirements. As a business leader, influences all stake holders, internal and external, to support key projects/programs to ensure positive outcomes that deliver on results. Build strong high performing leadership teams through training, stretch assignments, coaching, performance management and other development techniques. Maintains a working knowledge of legislative changes that may potentially affect quality and care management practices and standards.
Qualifications Requirements and Preferences:
Multiple years proven leadership experience setting strategic direction and influencing change that resulted in quantifiable positive outcomes. Excellent verbal and written communication skills. Demonstrated negotiation skills. Proven track record managing complex projects and or programs that resulted in cost savings. Experience managing large budgets. Effective and advanced organizational, decision-making, and analytical skills required. Ability to communicate effectively with all levels of management. Ability to work in a fast paced environment. Thorough knowledge of NCQA and/or HEDIS management. Previous quality improvement and management experience in a managed care organization required. 8-10 years clinical/managed care/health care industry experience. Proficient computer skills and knowledge of Microsoft Word, Excel and Access. Proven ability to anticipate customer needs and requirements. Certified Professional in Health Quality (CPHQ) or other certification a plus. Masters degree preferred. Bachelor's degree or equivalent work experience.
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.