Aetna Prevention & Wellness Coordinator in Sunrise, Florida

Req ID: 54564BR

Position Summary:

The Prevention & Wellness Coordinator participates in the development and ongoing implementation of QM Work Plan activities. Improves quality products and services by using measurement and analysis to process, evaluate and make recommendations to meet QM objectives.

This position is responsible for coordinating the Plan's prevention and wellness activities specifically designed to promote the importance and benefits of accessing timely preventive and well care through targeted member/provider education and outreach initiatives. Additionally, this position may include community outreach and public relations initiatives as assigned. This position is responsible for monitoring the Plan's overall performance against state and federal standards for health education and preventive care and recommending options for improving performance.

Job Responsibilities:

  • Under the direction of the Director/Manager of Quality, develops the annual Prevention and Wellness Plan, including assessments on enrollee participation and program impact.

  • Develops, implements and assures ongoing coordination of designated prevention/wellness activities outlined within the quality improvement plan and Prevention and Wellness work plan.

  • Assists Manager in strategies for readying (the Plans) Prevention and Wellness initiatives and goals.

  • Researches annually the plans clinical guidelines which include: EPSDT, preventive health guidelines, anticipatory guidance updates and clinical guidelines provided by SA and Delaware Medical Society. Also responsible for disseminating updated guidelines through approval process and posting of outcomes to appropriate venues.

  • Provides HEDIS interventions for Plan based on driver recommendations that include the P&W outreach calendar and HEDIS measures.

  • Supports HEDIS groups and subgroups providing assistance in developing interventions for specific departments.

  • Organizes special or pilot HEDIS interventions to target specific population initiatives

  • Attends HEDIS conferences, SA staff meetings and other professional organizational meetings to support and promote plans objectives.

  • Evaluates, analyzes, reports on and records outcomes of scheduled P&W interventions

  • Develops mailing deliverables which include: EPSDT, Well Women and Prenatal

  • Assists Director/Manager as necessary in meeting Prevention and Wellness budget and is also responsible for outlining cost analysis and appropriate collaterals.

  • Assists with the production of quarterly member newsletters, submitting HEDIS articles and.

  • Assists with the production of quarterly scheduled provider newsletters.

  • Produces and distributes quarterly community Partnerships in Health newsletters.

  • Attends as necessary Quality Department meetings that include QM/UM, SIC, to provide P&W updates

  • Provides necessary updates as needed and supporting documents for state RFP, NCQA and EQRA reviews and proposal submissions.

  • Ensures mandatory RFP outcomes regarding quarterly EPSDT updates.

  • Develops and maintains HEDIS Prevention and Wellness calendar and organizes member health educational events.

    Background/ Experience Desired:

  • 3 years experience in professional communications.

  • Managed care experience, as provider and manager of care.

  • Minimum of one year of recent and related experience working with local health departments, community agencies or managed care organizations serving Medicaid recipients

  • Effective communication/influencing skills applied to broad internal/external audience.

  • Minimum 3 years' recent and related health care marketing, outreach and/ or health education experience.

  • Bilingual (Spanish speaking) required.

    Education:

    The minimum level of education desired for candidates in this position is an Associate s degree in a health-related field or equivalent experience.

    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. 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.

    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.

    Aetna takes our candidates'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: Product & Marketing

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.