Aetna Sr Dir, Medical Economics - 38018BR in New Albany, Ohio
Req ID: 38018BR
**National Search but candidates must live near certain Aetna office locations
A senior level position responsible for managing a regional Medical Economics department. Provides leadership in managing overall medical costs, directs market and regional medical cost action plans, and participates in the development and maintenance marketable, high quality, cost effective provider networks. Key business partner in formulating market and regional network and medical management strategies. Maintains overall accountability for medical cost planning within the region.
1) Manages a department with the following regional responsibilities: planning and forecasting medical costs; developing gross medical trend estimates; developing medical cost action plans; identifying overpayments; analyzing and communicating medical cost changes that impact reserves;
2) Provides cross-functional leadership in designing, developing, and assessing local, regional, and national strategic Health Care Delivery initiatives.
3) Tracks business results and captures critical information for financial accountability and support for performance management team.
4) Oversees the development of analytical tools and models.
5) Designs and oversees the design of effective processes for achieving business goals.
6) Participates in the evaluation of product design and its impact on medical cost.
*7+ years experience in a health care delivery system role with accountability for business results.
*3-5 years experience with Medicare products.
*Extensive experience in the managed care industry with an in-depth knowledge of health care analytics and tools.
Bachelor's degree or equivalent experience.
Functional - Leadership//4-6 Years
Functional - Finance/Financial reporting and analysis/4-6 Years
Functional - Project Management/Cross-functional project management/4-6 Years
Finance/Delivering Profit and Performance/MASTERY
Leadership/Collaborating for Results/MASTERY
General Business/Communicating for Impact/MASTERY
Flexible telework / office-based schedule (must live near certain office location)
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.
Job Function: Health Care