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Aetna Manager, Configuration Standards and Solutions in Harrisburg, Pennsylvania

Req ID: 60205BR

Job Description

Formulates and implements information strategy to support operational objectives and other strategic business initiatives. Develops tactical and strategic plans to satisfy information needs across products and segments. Manages staff and processes. Responsible to collaborate and work with all Medicaid Health plans regarding system configuration, health plan reimbursement and understanding and meeting contractual and regulatory requirements

Fundamental Components included but are not limited to:

Directs the implementation and delivery of information and transaction products through education, user technology, organizational methods and procedures.

Oversees and or assists staff with creating complex queries, complex technical programming, and complex applications. Influences change/enhancements to business processes, policies and system infrastructure to improve information quality, availability and access.

Develops and participates in presentation and consultation to existing and prospective customers and internal business areas on information services, capabilities and performance results.

Collaborates on the development of project cost estimates, benefits and assessment of potential project risks.

Manages people and business priorities, and oversees projects to achieve customer satisfaction.

Selects and builds strong team.

Participates in internal and external health industry development efforts (e.g., performance measures, transaction standards).

Accountable for managing to budget, plans and expenses. Manages vendor relationships.

Qualifications Requirements and Preferences:

Demonstrated ability to effectively coordinate multiple projects simultaneously.

Excellent verbal and written communication skills.

4+ years of data interpretation and analysis experience.

Project/program/process management experience.

Management experience required.

Bachelor's degree or equivalent experience.

Functional Skills:

Administration / Operation - Management: < 25 employees, Claim - Claim processing - Medical - Medicare, Communication - Employee communications, Information Management - Analyzes all types of capitated and fee-for-service provider contracts, performs variance analysis

Technology Experience:

Aetna Application - Operational Reporting System, Aetna Application - QNXT, Database - SQL Server

Required Skills:

Leadership - Collaborating for Results, Leadership - Driving Strategic and Organizational Agility, Service - Demonstrating Service Discipline

Desired Skills:

Benefits Management - Applying Life Cycle Intelligence, General Business - Maximizing Work Practices, Leadership - Creating Accountability

Additional Job Information:

QNXT knowledge, configuration contract and benefit knowledge, Medicaid and Medicare regulations

Benefit Eligibility

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

Job Function: Health Care

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.

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