Aetna Medical Economics Senior Consultant in Hartford, Connecticut

Req ID: 45309BR


Manages, leads, or participates on complex medical economic projects related to Value Based Contracting. Accountabilities include project oversight including initiation, identification and completion of key deliverables to ensure all business objectives are met. Responsible for the development and implementation of key medical economics business efforts (e.g. medical cost initiatives, policies/programs and analytical models). Accountable for all financial projections associated with project.

Fundamental Components:

Analytical modeling and consulting on provider specific negotiations related to Value Based Contracting programs such as Pay for Performance(P4P), Patient Centered Medical Home(PCMH), Accountable Care Organization(ACO) Attribution and Product models.Work both independently and collaboratively with business units across the company and be part of a team that provides medical cost and outcomes focused analytical research, complex financial modeling and business decision support reporting. This includes but contractual reconciliation and ad hoc consulting supporting.Performs analyses of varied healthcare data to evaluate programs and product solutions using healthcare medical, pharmacy, lab, survey and utilization data.Requires strong communication skills creating an environment of teamwork with internal Aetna and external provider constituents.Participate as subject matter expert in provider negotiations including support for proposals along with reviewing interim reports with markets and providers regarding progress towards goals.Presents complex information in a way that multiple levels within an organization can understand and utilize to make appropriate decisions to meet business objectives.

Assists in development/mentoring of Consultants and Analysts - project leadership as well as mentoring.

Motivated and is willing to understand and probe into data. Contributes to a positive work environment by working effectively to achieve common goals.Must be skilled in complex financial data collection, modeling & analysis, advanced use of Microsoft Excel, understand relational database concepts and related query tools. Capable of taking project through issue identification, design specifications, data query/programs, financial analysis and resolution/recommendation stages.


3+ yrs of client-facing experience (internal or external), demonstrating excellent written and verbal communication skills presenting analytical results

Data query / programming knowledge/experience and 2+ yrs using either: SQL, SAS, R, Hadoop, or other languages.

Demonstrated leadership and project management experience


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


Technical - Development Languages/SQL/1-3 Years/Power User


General Business/Communicating for Impact/ADVANCED

General Business/Turning Data into Information/MASTERY


General Business/Demonstrating Business and Industry Acumen/ADVANCED

Leadership/Collaborating for Results/ADVANCED

Service/Improving constituent-focused Processes/ADVANCED


Medical Economics is charged with managing Aetna's medical costs and ensuring healthcare remains affordable. To that end, the value-based contracting team is responsible for supporting alternative care models; replacing volume-based incentive models to models rewarding efficient and quality care to our members. Aetna's is committed to growing these models to 80% of our total market by 2020. We are currently seeking a Med Eco Sr Cnslt/Team Ld for our expanding team, this opportunity will give broad exposure across various areas of healthcare and exposure to senior leadership.

CONSIDERED LOCATIONS: Hartford, CT - Pittsburg, PA - Blue Bell, PA

Job Function: Health Care