Aetna Medical Economics Manager in Plano, Texas

Req ID: 54081BR

POSITION SUMMARY

We are seeking an analytical professional to join our Medical Economics - Medical Expense Review (MER) team to support a large plan sponsor analysis. The primary goals of this team are to develop, interpret and favorably impact local market medical cost trend and provide analysis and network actions leading to medical cost improvement. This position will provide consultative support and medical cost based analysis of markets and network initiatives, as well as require creating reports or presentations as necessary and the candidate will need to be able to articulate results to a wide range of audiences including customers and consultants.

Fundamental Components:

  • Analyze and research medical costs drivers

  • Provides consultative analytics to account management teams, clinicians, customers and consultants

  • Creates detailed analyses using various data sources through a variety of technical applications

  • Articulates results to a wide audience internally and externally using reports/presentations

  • Supports a large plan sponsor account team on ad hoc analyses in areas such as: medical cost trends, utilization patterns, population health, program participation and geographic reviews

  • Own, track and document all aspects of related work from beginning to end of a project

    BACKGROUND/EXPERIENCE desired:

    Applicants must have relevant analytical financial experience. An understanding of the healthcare industry is preferred. Familiarity with key managed care functions including provider contracting, benefit design, medical management as well as knowledge of business functions and impact on financials (underwriting, sales, product development, network management) is also strongly preferred. Minimum of 1-3 years experience in the managed care industry with knowledge of provider contracting, provider reimbursement, patient management, product and benefits design. Advanced skills in Excel, MS-Access and Web-based query tools (i.e. data warehouse). Ability to learn new technologies. SAS Enterprise Guide experience preferred. Strong analytical ability and familiarity with advanced financial and healthcare concepts. Demonstrates critical thinking and expresses ideas clearly, concisely and logically from a cross functional perspective. Ability to manage conflicting priorities and multiple projects concurrently. Demonstrates initiative, innovation and leadership in achieving results.

    EDUCATION

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

    FUNCTIONAL EXPERIENCES

    Functional - Information Management/Medical economics/4-6 Years

    Functional - Information Management/Provides very complex programming and analytical support for medical cost trend analysis and strategic planning/4-6 Years

    Functional - Information Management/Utilizes and maintains pricing models and medical cost tracking tools/4-6 Years

    TECHNOLOGY EXPERIENCES

    Technical - Desktop Tools/TE Microsoft Excel/4-6 Years/End User

    Technical - Database/Microsoft Access/4-6 Years/End User

    Technical - Desktop Tools/Microsoft PowerPoint/4-6 Years/End User

    REQUIRED SKILLS

    Leadership/Driving a Culture of Compliance/FOUNDATION

    Leadership/Fostering a Global Perspective/FOUNDATION

    Telework Specifications:

    Part-Time Telework (ex: 3 days office-based, 2 days telework), consideration only for locations near certain office location; training period in the office may be required

    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.

    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.