Licensed Health Care Quality Management (QM) Consultant (RN, LPN, LVN)

This is a full-time work at home position but you must live in the state of CT.

POSITION SUMMARY

Supports and influences health care quality projects and initiatives through design, development, and implementation. These activities enable Aetna to improve health care quality products, services, and processes by partnering across business units to meet business needs and accomplish goals.

Fundamental Components:

Processes and evaluates complex data and information sets (e.g. Accreditation and HEDIS data) Use of clinical knowledge to interpret medical record information Performs quantitative and qualitative data analysis Converts the results of data analysis into meaningful business information and reaches conclusions about the data Documents QM initiatives to demonstrate compliance with business, regulatory, and accreditation requirements Assists in the development and implementation of QM projects and activities Supports quality improvement through ongoing collaboration with internal constituents and external network providers Responsible for the ongoing support and implementation of quality improvement projects and initiatives

BACKGROUND/EXPERIENCE desired:

1+ years work related experience in the healthcare industry.

1+ years clinical and/or managed care experience in the healthcare industry and quality management.

Basic computer skills are required

EDUCATION

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

LICENSES AND CERTIFICATIONS

Nursing/Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) is required

Nursing/Registered Nurse (RN) is preferred

FUNCTIONAL EXPERIENCES

Functional - Clinical / Medical/Quality management/1-3 Years

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

Functional - Project Management/Issue identification and analysis/1-3 Years

Functional - Nursing/Medical-Surgical Care/1-3 Years

TECHNOLOGY EXPERIENCES

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

Technical - Operating Systems/Windows/1-3 Years/End User

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

REQUIRED SKILLS

General Business/Applying Reasoned Judgment/ADVANCED

General Business/Turning Data into Information/ADVANCED

Leadership/Collaborating for Results/ADVANCED

DESIRED SKILLS

General Business/Demonstrating Business and Industry Acumen/FOUNDATION

Leadership/Anticipating and Innovating/FOUNDATION

Leadership/Driving a Culture of Compliance/ADVANCED

Telework Specifications:

Full-Time Telework (WAH) in Connecticut or New Jersey

ADDITIONAL JOB INFORMATION

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.

We conduct pre-employment drug and background testing. Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Employment Type Regular Career Band Description Professional