Aetna Business Consultant in Hartford, Connecticut

Req ID: 39157BR

POSITION SUMMARY

**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.

Fundamental Components:

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

BACKGROUND/EXPERIENCE desired:

5+ years experience with one or more of the following methodologies: management consulting, project consulting, business process consulting, financial

EDUCATION

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 EXPERIENCES

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

TECHNOLOGY EXPERIENCES

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

REQUIRED SKILLS

General Business/Applying Reasoned Judgment/MASTERY

General Business/Consulting for Solutions/ADVANCED

General Business/Demonstrating Business and Industry Acumen/ADVANCED

DESIRED SKILLS

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