Aetna Bus Project Program Mgr in Phoenix, Arizona

Req ID: 43801BR


Dynamic position within the NextGen Product/Network/Claim Enablement and Configuration team, responsible for leading the delivery of critical components or large cross functional requirements in support of the full conversion, implementation, and maintenance of Aetna products and networks offered on the NextGen systems platform, specifically, Health Rules Payor (HRP). As a strong project lead you will be responsible for the timely and accurate delivery of critical business and operational requirements, needed to support business objectives. You will plan, prioritize, and be on point to resolve issues and risks. You will be responsible to deliver assigned work in compliance with all regulatory requirements, and aligned to all Aetna clinical/medical and claim policies. You will participate in the development of business requirements, and lead the delivery of assigned systems enhancements, business data configuration, and/or work flow adjustments, as needed to successfully manage the projects assigned and the positions scope. Your work will be varied, with opportunities to focus on multiple disciplines including product assessment and delivery, network composition and provider pricing, claim administration, data migration and integration, and/or numerous other potential focus areas. You will be challenged to develop end to end knowledge of critical Aetna business processes.

Fundamental Components:

Success in this position will require a self-starter able to collaborate across multiple disciplines while managing multiple priorities in a fast paced, changing environment. Areas involved in the typical delivery of your work will include Network, Product, Claim, Legal/Compliance, Medical Policy, Aetna IT, and external vendors partnering to support the overall NextGen platform development and experience. You will be responsible, with assistance from more senior team members as needed, to identify, define, and deliver all required business requirements, workflow processes, and regulatory requirements. You will prioritize the work, manage the delivery, and make recommendations on system enhancement opportunities or on the enhancement of business tools or business workflows. You will identify and help implement appropriate control points, and you will document issues, decisions, risk mitigation, requirement changes, and status as needed to keep the project on track toward delivery and to support reporting to senior leadership. You will be challenged to understand how the work you are doing integrates into the work across all product, network, and/or claim functions, and you will be responsible to ensure delivery will support the end to end goals of the larger initiative. You will support production by triaging and resolving issues impacting our ability to accurately service our providers and members. Strong and effective oral and written communication skills and the ability to negotiate effective outcomes will be required.


Proven track record demonstrating effective management of multiple and complex projects with on-time, on budget delivery; prior experience in medical product development, network systems or development, and/or claim adjudication background a plus. Medicare background or project work supporting Medicare implementation or compliance a plus.


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


Functional - Project Management/Cross-functional project management/4-6 Years

Functional - Project Management/Project Manager/1-3 Years

Functional - Claims/Claim processing - Medical or Hospital- HMO/1-3 Years

Functional - Products-Medical/All Aetna Standard Plans/1-3 Years

Functional - Network Management/Provider connectivity/1-3 Years


Technical - Aetna Applications/Strategic Contracts Manager/1-3 Years/

Technical - Aetna Applications/Automated Claim Adjudication System/1-3 Years/

Technical - Aetna Applications/Enterprise Provider Database System/1-3 Years/

Technical - Aetna Applications/HMO Claims Processing System/1-3 Years/


General Business/Applying Reasoned Judgment/MASTERY

General Business/Ensuring Project Discipline/MASTERY

Leadership/Developing and Executing Strategy/ADVANCED


General Business/Demonstrating Business and Industry Acumen/ADVANCED

Leadership/Creating Accountability/ADVANCED

Leadership/Driving Change/ADVANCED

Telework Specifications:

Flexible telework / office-based schedule (can live near any office location)


We are looking for dynamic, energetic, self-starters to join our cross functional, multi-disciplined organization responsible for the conversion, development, and maintenance of complex data and/or compliance requirements in support of all Product, Network, and Claim functions for the NextGen platform. The environment is fast-paced, challenging and ever changing. This is an opportunity to develop both professionally and personally while supporting a challenging growth initiative for Aetna.

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