Quality Improvement Coordinator Nurse occupation at Aetna in Richmond

Aetna is at present recruited Quality Improvement Coordinator Nurse on Sat, 07 Dec 2013 18:21:22 GMT. Basic Qualifications: • Licensed Practical Nurse (LPN) or Registered Nurse (RN) with active state license... Qualifications: • Registered Nurse (RN) with active...

Quality Improvement Coordinator Nurse

Location: Richmond Virginia

Description: Aetna is at present recruited Quality Improvement Coordinator Nurse right now, this occupation will be placed in Virginia. More details about this occupation opportunity kindly read the description below. Req ID: 14941BR
Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities and health care management services for Medicaid plans. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, governmental units, government-sponsored plans, labor groups and expatriates. We believe we can help create a better health c! are system. This belief drives our daily decisions as one of t! he nation's leading health care benefits companies. We work hard to provide our members with information and resources to help them make informed decisions about their health. Health care is an ever-changing business, and Aetna's committed to bringing value to our customers and putting them at the center of everything we do. Discover exciting careers at Aetna.

We are currently seeking a Quality Improvement Coordinator in our Richmond, VA location. The successful candidate will be responsible for the research and identification of quality of care issues to ensure compliance with Coventry’s quality improvement programs as well as accreditation and regulatory standards.

Essential Responsibilities:

• Performs quality improvement studies as they relate to trends identified via utilization review activities, utilization patterns, audits, Healthcare Effectiveness Data and Information Set (HEDIS) results, appeals, etc.
• Maintains accura! te documentation of all quality improvement activities, i.e., studies, surveys, audits, peer reviews, etc. Performs analysis and provides oversight for delegated functions.
• Identifies possible quality of care issues through research and data analysis. Prepares and distributes accurate and timely reports according to department policies, documentation standards, and regulatory requirements.
• Under the direction of assigned Medical Directors and quality improvement management, conducts audits to research quality of care issues.
• Assists in conducting peer review chart audits, compiling statistics, and reporting results to the appropriate oversight committees.
• Monitors and assures that follow-up re-evaluation activities take place when deficiencies are identified and recommendations for corrective action have been made.
• Develops and provides training to members and employer groups regarding preventive health and wellness as they relat! e to trends identified via review activities and audits.
• Assis! ts in preparing the annual quality improvement program evaluation and work plan.
• May complete an annual review of department policies and procedures and make recommendations for updates based on changing needs or trends.
• Performs other duties as required.

Basic Qualifications:

• Licensed Practical Nurse (LPN) or Registered Nurse (RN) with active state license required.
• Complies with all state certification requirements in the state where job duties are performed.
• 2 â€" 4 years clinical experience required.
• Fundamental knowledge of relevant legal, medical, and regulatory terms, issues, and practices.
• Working knowledge of MS Office Suite.

Preferred Qualifications:

• Registered Nurse (RN) with active state license required.
• Previous quality improvement and/or managed health care experience preferred.

Other:

• Highly self-motivate! d and able to work well under stress in a fast-paced environment.
• Demonstrated data analysis and report preparation skills.
• Effective communication and presentation skills.

Please apply directly to www.aetna.jobs and refer to Req#14941BR, Quality Improvement Coordinator.

Job Function: Quality Management
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If you were eligible to this occupation, please email us your resume, with salary requirements and a resume to Aetna.

If you interested on this occupation just click on the Apply button, you will be redirected to the official website

This occupation starts available on: Sat, 07 Dec 2013 18:21:22 GMT

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