Aetna Manager, Health Insurance Operations in Sugar Land, Texas

Req ID: 48349BR


Lead a team consisting of sales support functions in support of stated mission and achievement of Health key

performance measures.

Fundamental Components:

Qualifying Requests

Reviews incoming requests (new/growth RFPs/RFIs and proactive quotes) for strategic and capabilities match

Completes preliminary and/or final risk evaluation.

Assesses likelihood of success vs. resource allocation

Makes quote/no quote decision

Consultative Selling

Cultivate critical relationships (field sales/service, broker/consultant community/customer teams, Health local market

and Home Office operations, plan sponsor.)

Analyze competition and competitive position

Oversee completion of annual broker/consultant surveys in support of proposal process

Assess customer needs and expectations vs. Health capabilities/strategy

Assist in development of customer sales strategies

Assists team members in handling difficult sales situations (rates, exceptions, conflicts)

Oversee Development and Delivery of Proposals -- may include some or all of the following:

Development of proposal response strategy

Coordinate from all Health resources in support of Aetna's response- GI, SH, local market, operations, (remove return)

ancillary products/services areas- Determine exceptions and resource commitments

  • Negotiate appropriate Aetna response

    Provide oversight and sign-off on financial and exceptions- Claim evaluation

  • Expense calculation

  • Guarantee structure

  • Stop loss pricing

    Assure that all work is completed according to deadline

    Participates in meetings/presentations/site visits

    Coordinate logistics

    Prepare/coach participants

    Develop presentation materials

    Participate as presenter

    Negotiate terms of deal

    Function Head

    Accountable for achieving team and organizational KPMs

    Manage all HR related functions of the team (staffing, motivational and training)

    Operationalize overall direction from senior management (translating applicable business plan into everyday activities

    and operations)

    Significant input into the development of sales strategy

    Serves on Health projects as designated by immediate supervisor

    Serves as liaison between team members and Health policy and senior management

    Negotiates resolutions to internal/external barriers relative to the sales support process

    Cultivates and manages relationships with various internal/external customers. May include existing plan sponsors/

    prospects, brokers, consultants, etc.


    Bachelors degree

    1-2 years of experience in health plan operations, included sales support, customer service, claims processing, etc.

    Analytics skills required, including Excel and Salesforce experience

    Process improvement experience preferred

    Ability to manage multiple and competing deadlines


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


    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: Sales and Service