Aetna Health Care QM Projct Mgr in Cary, North Carolina

Req ID: 53908BR


In the HealthCare Quality Project Manager position, you will work on auditing and preparingstandards of compliance for NCQA accreditation. You will work with NCQAguidelines and help ensure all accreditation requirements are met. Youwill be accountable for health care quality projects and initiatives throughdirection setting and leadership. You will proactively develop qualityactivities aligned with company strategies and values. You will link thequality management activities to business goals. This position requiresthat you proactively build strong teams and business relationships, bothinternally and externally. You will serve as a resource and subject matterexpert (SME) on aspects of the quality program to develop and influencebusiness strategies.

Fundamental Components:

Makes business decisions based on the results of research and data analysis

Has responsibility for decision making regarding the design, development, and implementation strategy of quality improvement projects, and initiatives.

Forms and leads cross functional teams to assist business units in integrating quality into their strategic and operational plans.

Develops, implements, and evaluates the organizations' policies and procedures to meet business needs. Translates knowledge of subject and business needs into clear strategic business plans.


Registered Nurse with Background in quality management.

Previous CM/UM experience; involvement in NCQA Accreditation.


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


Active unrestricted Nursing/Board of Nursing (Any State) licensure is required.


Functional - Leadership/Act as company spokesperson to external constituents/4+ Years Experience

Functional - Quality Management/Quality Management/4+ Years Experience


Technical - Aetna Applications/Aetna Total clinical View/4+ Years Experience/End User

Technical - Desktop Tools/Microsoft Word/4+ Years Experience/End User


Leadership/Collaborating for Results/MASTERY

Leadership/Driving a Culture of Compliance/MASTERY


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.

Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

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.

Job Function: Quality Management

Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.