Aetna Medical Economics / Clinical Ops. Lead - 49864BR in New York, New York

Req ID: 49864BR

POSITION SUMMARY

Leader of the Clinical Services & Joint Venture Markets SAI strategy including financial tracking, major initiative support, ideation, analytics, and project management. Steward of CS&JVM related medical cost drivers, including UM, CM, and Medical Policies. Support for strategic initiative execution related to the broader CS&JVM member-centric strategy around the single care model.

This high exposure role serves as a bridge between the various clinical operations areas and senior leadership, Medical Economic Unit (MEU), finance, actuarial, and various other areas in the organization. Project management, communication, and analytics skills will be developed. Deep healthcare industry knowledge will be acquired. The candidate will have the opportunity to make meaningful changes as the organization transforms it's clinical operations to drive Aetna's member-centric strategy

Fundamental Components:

The Medical Economic / Clinical Operations Lead will be responsible for creating, tracking, communicating, and impacting all key performance metrics for the CS&JVM organization. This includes overall management of the Scoreable Action Item process, from ideation, tracking, expense management, and implementation. Support for strategic initiative execution related to the broader CS&JVM member-centric strategy around the single care model will involve leadership from a project management perspective. This will involve working across the many CS&JVM teams. They will also oversee the production and analysis of UM and CM results as an input into the Management Process for senior leadership.

BACKGROUND/EXPERIENCE:

  • 5+ years of Project Management / Medical Economics experience within the Managed Health Care industry, Clinical experience strongly preferred.

  • Proficient experience with health care analytics.

  • Solid experience in analyzing medical costs.* Financial acumen is a must.

  • Demonstrated ability to work across many teams in a cross functional capacity to enact meaningful change.

  • Experience creating executive level materials for presentations.

  • Excellent business acumen skills.

  • Professional communication skills both written and verbal.

  • Advanced skill level with MS Office Programs: Excel, PowerPoint, SharePoint and Word.

  • Knowledge of statistical databases; SAS preferred.

    EDUCATION

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

    ADDITIONAL JOB INFORMATION

  • The Primary Location is Hartford, CT

  • Travel requirement is up to 25% ( East Coast Region only)

  • No Relocation Package offered

    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.

    #LI-DT1

Job Function: Health Care