Aetna Business Consultant in Hartford, Connecticut
Req ID: 39157BR
**Please note: This position is located in our Hartford CT office, but other Aetna offices will be considered. It is not a full-time work-from-home.
Business advisor for multiple teams within and outside group life operations. Provides technical advice for complex claim investigation/application review, workload management and system direction. Subject matter expert for department process and procedures. Approval authority up to maximum of $750,000.
Addresses issues related to contract interpretation in order to determine Aetnas liability under the policies: Mentors and trains team members. Analyzes and completes weekly/monthly statistical reports; provides results to appropriate senior management.
Directs analysts on appropriate claim settlements Researches and analyses facts and responds to Department of Insurance and Office of the Chairman complaints. Conducts audits to evaluate compliance with standards and outcomes. Identifies and communicates trends such as quality of results, training needs, efficiencies of processes, performance input, etc.
Collaborates with Law Department and outside counsel pertaining to legal advice, interpretation, and litigation. Contributes new, creative ideas, approaches and concepts using technology, where appropriate.
Responds to inquiries promptly and creatively and uses data to resolve issues through effective verbal and written communication and by involving appropriate people within or outside Aetna
5+ years experience with one or more of the following methodologies: management consulting, project consulting, business process consulting, financial
The highest level of education desired for candidates in this position is a Bachelor's degree, a JD or equivalent experience.
LICENSES AND CERTIFICATIONS
Human Resources/Certified Employee Benefits Specialist is desired
Legal/New York Bar is desired
Legal/Paralegal Certificate is desired
Insurance/Life, Health & Accident License (CT, NY) is desired
Functional - Claims/Claim processing - Life/7-10 Years
Functional - Claims/Claim processing - Long Term Disability/4-6 Years
Functional - Legal/Compliance - market conduct/regulatory exams/1-3 Years
Functional - Administration / Operations/Document production & distribution/4-6 Years
Technical - Reporting Tools/Crystal Reports / Crystal Enterprise/4-6 Years/End User
Technical - Desktop Tools/Microsoft Word/More Than 10 Years/End User
Technical - Desktop Tools/Microsoft PowerPoint/4-6 Years/End User
Technical - Desktop Tools/TE Microsoft Excel/More Than 10 Years/End User
General Business/Applying Reasoned Judgment/MASTERY
General Business/Consulting for Solutions/ADVANCED
General Business/Demonstrating Business and Industry Acumen/ADVANCED
Leadership/Driving a Culture of Compliance/FOUNDATION
Leadership/Anticipating and Innovating/FOUNDATION
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 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.
Job Function: Management