Aetna Medical Economics Consultant - Value Based Contract in Blue Bell, Pennsylvania
Req ID: 54911BR
Medical Economics is charged with managing Aetna's medical costs and ensuring healthcare remains affordable. It is an exciting time to be part of our Value Based Contracting Team with Aetna committed to growing influence of these model beyond 75% of our total market by 2020. These incentive models reward providers partners for efficient and quality care to our members. We are currently seeking a Medical Economics Consultant for our expanding VBC responsibilities across both commercial and Medicare lines of business. This opportunity will give broad exposure across various areas of healthcare and senior leadership.
Leads or participates on complex medical economic projects related to Value Based Contracting. Accountabilities include project initiation, identification and completion of key deliverables to ensure all business objectives are met. Responsible for the development and implementation of key medical economics business efforts (e.g. medical cost initiatives, policies/programs and analytical models). Accountable for all financial projections associated with project.
Analytical modeling and consulting on provider specific negotiations related to Value Based Contracting programs.
Work both independently and collaboratively with business units across the company and be part of a team that provides medical cost and outcomes focused analytical research, complex financial modeling and business decision support reporting. This includes both contractual reconciliation and ad hoc consulting supporting.
Performs analyses of varied healthcare data to evaluate programs and product solutions using healthcare medical, pharmacy, lab, survey and utilization data.
Requires strong communication skills creating an environment of teamwork with internal Aetna and external provider constituents.
Participate as subject matter expert in provider negotiations including support for proposals along with reviewing interim reports with markets and providers regarding progress towards goals.
Presents complex information in a way that multiple levels within an organization can understand and utilize to make appropriate decisions to meet business objectives.
Works collaboratively with other Consultants and Analysts with opportunity for project leadership as well as coaching others.
Motivated and is willing to understand and probe into data. Contributes to a positive environment by working effectively to achieve common goals.
Must be skilled in complex financial data collection, modeling & analysis, advanced use of Microsoft Excel, understand relational database concepts and related query tools.
Capable of taking project through issue identification, design specifications, data query/programs, financial analysis and resolution/recommendation stages.
2-5 years experience in the managed care industry with knowledge of provider contracting, provider reimbursement, patient management, product and benefits design. Medicare experience a plus but not required.
Advanced skills in Excel, MS-Access, SAS, Tableau and Web-based query tools. Ability to learn new technologies.
Strong analytical ability and familiarity with advanced financial and healthcare concepts.
Demonstrated written and verbal communication
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
Functional - Information Management/Business information analysis/1-3 Years
Functional - Communications/Translating & Interpreting/1-3 Years
Functional - Finance/Financial analysis/1-3 Years
Technical - Desktop Tools//1-3 Years/
Technical - Modeling//1-3 Years/
General Business/Communicating for Impact/ADVANCED
General Business/Turning Data into Information/ADVANCED
General Business/Demonstrating Business and Industry Acumen/ADVANCED
Leadership/Collaborating for Results/FOUNDATION
Service/Working Across Boundaries/ADVANCED
Option for part-time telework will be evaluated after a certain period of employment
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 candidates'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: Health Care
Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.