Aetna Quality Management Operations Manager in Kenner, Louisiana
Req ID: 67402BR
Accountable for health care quality projects and initiatives through direction setting and leadership. Assimilates information to proactively develop quality activities aligned with company strategies and values. Links the quality management activities to business goals. Proactively builds strong teams and business relationships, both internally and externally. Serves as a resource and subject matter expert (SME) on aspects of the quality program to develop and influence business strategies.
Fundamental Components included but are not limited to:
Makes business decisions based on the results of research and data analysis. Has responsibility for decision making regarding the design, development, and implementation strategy of quality improvement projects, and initiatives. May manage a QM functional department including development and oversight of performance metrics and application of HR policies and procedures. Forms and leads cross functional teams to assist business units in integrating quality into their strategic and operational plans. Evaluates and prioritizes recommendations for quality improvement to senior management and/or customers. Partners with sales and marketing across all segments in their efforts to acquire and retain customers (e.g. responding to RFPs), quality presentations, request for measurement information. Develops and implements the infrastructure of the QM program and Patient Safety strategy. Develops, implements, and evaluates the organization s policies and procedures to meet business needs. Directs/provides enhancements to business processes, policies and infrastructure to improve operational efficiency across the organization. Influences department business owners and leaders to reach solutions to meet the needs of Plan Sponsors, regulators and other customers while meeting departmental objectives. Performs strategic analysis of business performance data to address Plan Sponsor needs. In partnership with business owners, supports design /development of new or enhanced products and services. Translates knowledge of subject and business needs into clear strategic business plans. Serves as a technical, professional and/or business expert that may cross multiple business functions.
Qualifications Requirements and Preferences:
6+ years progressive experience in operational quality management roles in the healthcare industry, & regulatory environment.
5 years project management experience
PMP certification is preferred
Data analytics skills & analyze data
Lean Six Sigma belt preferred
Demonstrated leadership ability.
Managed care experience is preferred
Master's degree preferred
Project Management - Cross-functional project management
Leadership - Collaborating for Results, Leadership - Developing and Executing Strategy
General Business - Ensuring Project Discipline, General Business - Maximizing Work Practices, General Business - Turning Data into Information
Additional Job Information:
Understanding of trends, data and constituency expectations.
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.