Aetna Project Lead in Hartford, Connecticut
Req ID: 54506BR
This position will coordinate and support legislative and regulatory network filings, working with cross-functional stakeholders to assist with development and submission of compliant filings.
Coordinates with stakeholders and key functional areas to support the local markets with new state network adequacy filing requirements, including leading development of work plans and timelines to meet filing submission deadlines.
Works with advisers from key functional areas to understand potential legislative/regulatory impacts on the network organization, aligns project work, and executes activities accordingly.
Presents to internal/external customers, constituents and business partners.
Strong business as well as systems knowledge and can perform reasonability checks.
Leads the analysis, planning, design and development being performed by project team to support accurate state network filings.
Influences change or enhancements to business processes, policies and system infrastructure to improve information quality, availability and access.
Develops and participates in presentation and consultation to internal business partners on accessibility results.
Negotiates resources in peer organizations to meet high priority department objectives.
Proactively evaluates project activities, builds contingency plans, executes corrective action, and monitors issue
resolution to mitigate risks such as scope and/or budget variances.
4-6 years of project management experience, including demonstrated ability to effectively coordinate multiple projects simultaneously and successfully.
ABX certification (minimal: Green Belt).
Experience with Compliance C-360 application and review of legislation and regulations to determine business impact.
Experience with state, CMS, and NCQA network filing and regulatory requirements.
Healthcare background and knowledge of Aetna commercial products and networks.
Excellent verbal and written communication skills.
Strong Microsoft Word, PowerPoint, Excel (v-look ups, pivots), Outlook, and SharePoint (administrator) skills.
EPDB familiarity, Crystal Reporting capability, Archer Certified Professional (preferred).
Ability to assess a situation, determine a course of action, and make recommendations.
Positive attitude, capable of learning on the job, self-directed and self-starter.
Bachelor's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Project Management/Project Management Certification is desired
Functional - Project Management/Cross-functional project management/4-6 Years
Functional - Legal/Product and regulatory filings/4-6 Years
Functional - Legal/Compliance - state/federal legislation implementation/4-6 Years
Functional - Products-Medical/All Aetna Standard Plans/1-3 Years
Functional - General Management/Process & quality improvement/1-3 Years
General Business/Ensuring Project Discipline/ADVANCED
Leadership/Engaging and Developing People/MASTERY
General Business/Applying Reasoned Judgment/MASTERY
General Business/Communicating for Impact/MASTERY
General Business/Turning Data into Information/MASTERY
Part-time telework (e.g. 3 days office based, 2 days telework) will be considered for current internal teleworkers not in CT; options for telework will be evaluated after a certain period of employment; telework considered on individual basis.
ADDITIONAL JOB INFORMATION
Join a small and dedicated team focused on supporting regulatory compliance, working closely with cross functional areas to provide accurate and timely analysis of network adequacy. Opportunity for skill development and subject matter expertise in an area of growing need.
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 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: 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.