Description: Office-based position. Candidates must live in one of the following states near an office location: Oklahoma, Michigan, New Jersey, or North Carolina. Please note, even internals currently working from home will be required to work out of an office.
Participates in the implementation of QM Work Plan activities by effectively collaborating with our provider community with the goal of positively impacting our member's lives through specific provider outreach and engagement objectives.
Fundamental Components: Processes and evaluates complex data and information sets to perform quantitative and qualitative data analysis (e.g., accreditation and regulatory standards, HEDIS data, Geoaccess data). Prepares and completes QM Documents based on interpretation and application of business requirements. Accurately documents and reports QM activities to demonstrate compliance with business, regulatory, and accreditation requirements. Participantes in the implementation of QM Work Plan Activities by effectively collaborating with our provider community with the goal of positively impacting our member's lives through specific provider outreach and engagement objectives. Responsible for the ongoing maintenance and implementation of provider outreach and engagement objectives. Background Experience: 3+ years health care provider relations or network experience required
Account management experience preferred Medical sales experience preferred Training or mentoring experience Clinical claims or coding experience preferred Required Skills: Leadership - Collaborating for Results, Service - Creating a Differentiated Service Experience, Service - Providing Solutions to Constituent Needs Desired Skills: Leadership - Developing and Executing Strategy, Leadership - Driving Change, Leadership - Driving Strategic and Organizational Agility Functional Skills: Communication - Provider communications, Learning - External constituents (i.e., broker, provider), Network Management - Provider relations Technology Experience: Desktop Tool - Microsoft PowerPoint, Desktop Tool - Microsoft SharePoint, Desktop Tool - Microsoft Word, Desktop Tool - TE Microsoft Excel Potential Telework Position: Yes Percent of Travel Required: 10 - 25% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: 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.