QM Operations Manager

Aetna   •  

Overland Park, KS

Industry: Healthcare


5 - 7 years

Posted 35 days ago

This job is no longer available.

Accountable for quality projects and initiatives through direction setting and leadership. Assimilates information to proactively develop quality activities aligned with company values, strategies and business goals. Serves as subject matter expert and resource for quality management program goals and requirements.

Fundamental Components:
Has responsibility for oversight and decision making regarding the design, development, and implementation strategy of quality programming, including improvement projects and organizational initiatives. Uses research and data analysis to drive decision-making to meet business objectives. Key functions include development and oversight of quality programming including compliance with contractual requirements; state and federal regulations; adherence to accreditation standards; and design and development of performance metrics and change initiatives. Develops and deploys the infrastructure of the QM program and Patient Safety strategy throughout the organization. Forms and leads multidisciplinary teams to assist business units in integrating quality into their strategy and operating plans and provides ongoing support as the subject matter expert and resource to these units. Directs/provides enhancements to business processes, policies and infrastructure to improve operational efficiency across the organization. Performs strategic analysis on business performance data to evaluate opportunities and make recommendations to executive leadership which address business needs and strategic objectives. In partnership with business owners, supports design /development of new or enhanced products and services. Serves as a technical, professional and/or business expert that may cross multiple business functions.

Background Experience:

6+ years progressive experience in quality management operations in the healthcare industry, managed care or regulatory environment.
Demonstrated leadership ability in quality management department operation, including performance measurement and change initiatives.
Bachelor's degree, Nursing degree, or other comparable healthcare experience.


External Stakeholder Consultation experience
Master's degree in business administration, health policy or other healthcare discipline
Six sigma, lean, CPHQ, or other quality certification

Additional Job Information:
Understanding of trends and constituency expectations.

Required Skills:
Benefits Management - Maximizing Healthcare Quality, General Business - Consulting for Solutions, Leadership - Collaborating for Results

Desired Skills:
General Business - Consulting for Solutions, General Business - Turning Data into Information, Leadership - Collaborating for Results

Functional Skills:
Management - Management - Quality

Technology Experience:
Desktop Tool - Microsoft Outlook, Desktop Tool - TE Microsoft Excel

Potential Telework Position:

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.

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