Analyst, Health Care Quality Management - Remote
Core
Conduct oversight audits of delegated entities performing credentialing functions for Aetna and implement an all-product quality management strategy.
Role type
Health Care Quality Management Analyst
Builds
Quality management work plans, activities, and compliance documentation for credentialing functions
Domain
Health Care / Credentialing / Quality Management
Deliverable
dashboards & analysis
Required skills
Process compliance evaluation, NCQA standards knowledge, Regulatory compliance, Data analysis, MS Excel, MS Word, Adobe Acrobat, Documentation
Preferred skills
Delegated credentialing experience, Multi-priority management, Attention to detail
Responsibilities
Evaluate process compliance and operational workflows for delegated credentialing functions, Review and validate accuracy of delegate-submitted reports and logs, Ensure compliance and maintain readiness for NCQA accreditation, Develop and implement QM projects and activities, Perform quantitative and qualitative data analysis to achieve operational targets, Report business information to internal and external constituents