Aetna Mgr, Health Care QM in Tampa, Florida

Req ID: 53292BR

POSITION SUMMARY

The Health Care QM Manager will be responsible for end to end accreditation activities for our national health plan NCQA (National Committee for Quality Assurance) surveys.. This includes direction setting and leadership to the non-clinical standards team, serves as a subject matter expert to the quality program, and audits analysis and materials to meet compliance of accreditation.

Fundamental Components:

  • Act as subject matter expert for NCQA accreditation.

  • Collaborate across teams to support state regulatory requirements.

  • Proactively develops strong relationships across departments to support accreditation.

  • Set direction and provide guidance for the accreditation team staff ensuring successful NCQA survey's.

  • Provides updates to leadership on accreditation status, issues, risks, and resolutions.

  • Links quality management activities to business goals.

    BACKGROUND/EXPERIENCE desired:

  • 6+ years progressive experience in operational quality management roles in the healthcare industry, regulatory environment and quality management.

  • 2+ years Performance Management experience, able to coach and mentor in a goal driven environment

  • Change Management and Quality Management experience

  • Excellent business acumen and professional communication skill

  • Demonstrated strong leadership ability.

  • 3+ years NCQA Accreditation experience

  • NCQA Surveyor experience preferred but not required

  • Proficient skill level with MS Office Suite Programs, able to create reports

    EDUCATION

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

    FUNCTIONAL EXPERIENCES

    • Management/Management - Multifunctional management: < 25 employees/1-3 Years
  • Quality Management/Quality Management/4-6 Years

  • General Management/Process & quality improvement/4-6 Years

    TECHNOLOGY EXPERIENCES

    • Desktop Tools/Adobe Acrobat Suite v5/1-3 Years/End User
  • Desktop Tools/Microsoft Outlook/1-3 Years/End User

    • Desktop Tools/Microsoft SharePoint/1-3 Years/End User

    REQUIRED SKILLS

    General Business/Communicating for Impact/ADVANCED

    General Business/Applying Reasoned Judgment/MASTERY

    Leadership/Anticipating and Innovating/ADVANCED

    DESIRED SKILLS

    General Business/Demonstrating Business and Industry Acumen/MASTERY

    Leadership/Collaborating for Results/MASTERY

    Leadership/Driving a Culture of Compliance/MASTERY

    ADDITIONAL JOB INFORMATION

  • The location is nationwide, but must be near an Aetna office.

    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.

Job Function: Quality Management