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Job Information

Aetna SAI Management in Boise, Idaho

Req ID: 61010BR

Job Description

Responsible for identifying, executing and monitoring trend mitigating initiatives across local network and medical management operations for the PNW market.

Project Management responsibilityfor the end to end process related to opportunity ideation and discovery,validation and analytics supporting all commercial and Medicare business segments.

Collaborates with Network, Medical Management, MEU, Finance andActuarial teams in the PNW to convert insights into data that is actionable.

Fundamental Components included but are not limited to:

Educates business and technical

resources on purpose and value of quality and cost metrics and assists in

interpretation to solve problems and improve outcomes

Monitors market level metrics and

performance for utilization, market level medical cost, premiums, financial

results, etc. to identify trends

Coordinates tracking and execution

of trend mitigating action items in collaboration with Network Management,

Medical Management and Medical Economics Unit (MEU)

Responsible for supporting the

network leader through the network strategy development process by leveraging

network design tools

Provides insights to Network

Management team to help inform network strategy based on insights and


Supports Medical Economics Review

process on behalf of Local Network team

Ability to effectively communicate

and negotiate across the business and in the external health care environment.

Provides leadership in negotiation

support and ability to influence sound business decisions based on data,

results and information derived from industry trends, research findings, and

Aetna-specific reports and analyses

Qualifications Requirements and Preferences:

5+ years experience in healthcare

analytics role.

Deep knowledge of health care

industry, policy, research design, statistical analyses, predictive modeling,

provider reimbursement methods, case-mix and risk adjustment methods and tools

Demonstrated experience developing

analysis, presentations and support material to successfully implement strategy

or change initiatives.

Demonstrated relationship

management skills at peer levels within an organization and external


Advanced technical, analytic and

consultative skills, extensive knowledge of health care data and information

systems, as well as an understanding of health care benefits, health care

financing and health care delivery systems

Advanced proficiency in excel and

power point

Benefit Eligibility

Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Job Function: Planning

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.