Medical Economics SrCnslt at Aetna Inc. in Plano, Texas

Posted in Other 5 days ago.

Type: Full Time





Job Description:

Job DescriptionParticipates in complex medical economics projects including medical cost savings initiatives, revenue enhancement initiatives, network and contracting reimbursement analysis.Project management accountabilities include project oversight including initiation, identification and completion of key deliverables. Create and provide key metrics for management of Texas Medicaid health plan and a key contributor to local finance team. Manages and develops provider reimbursement programs, policies, and strategies to ensure unit cost controls meet or exceed corporate objectives for medical cost containment. Provides analytical support critical in positioning system or network changes needed.EEO StatementAetna is an Equal Opportunity, Affirmative Action EmployerFundamental Components* Serves as project manager and/or participant on selected project(s).* Develops critical and complex information in support of strategic business plans to meet projected requirements of business area.* Provides very complex programming and analytical support for medical cost trend analysis and strategic planning (such as verifying trends developed by Actuarial team and developing new tools for the regions to analyze medical costs).* Works cross-functionally throughout the region toward achieving operational targets.* Presents highly 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 less experienced team members.* May assist in providing direction of day to day activities.Background Experience* Advanced software and programming skills including database querying knowledge such as SQL* 5-8 years demonstrated leadership and project management experience.* Strong analytical ability and familiarity with advanced financial and healthcare concepts.* Ability to manage conflicting priorities and multiple projects concurrently.* Bachelor's Degree in business, finance, related field preferred or 3 to 5 years equivalent work experience in the healthcare industry.Benefits ProgramBenefit eligibility may vary by position.Candidate Privacy InformationAetna takes our candidate'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.