Job Overview
Company:
Location:
Base Pay:
 $57,600 - $72,400 /Year
Other Pay:
Employee Type:
 Full-Time
Industry:
 Healthcare - Health Services
Insurance
Managed Care
Manages Others:
 No
Job Type:
 Health Care
Insurance
Req'd Education:
 4 Year Degree
Req'd Experience:
 At least 3 year(s)
Req'd Travel:
 Negligible
Relocation Covered:
 No
Reference ID:
27745002_308520755
 
  
Contact:
Not Available
Phone:
Not Available
Email:
Send Email Now
Fax:
Not Available
 

company overview

Aetna is one of the nation’s leading diversified health care benefits companies, serving members with information and resources to help them make better informed decisions about their health care.

Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life, long-term care and disability plans and medical management capabilities. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans and government-sponsored plans.

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Healthcare Data Analysis/Medical Cost Analysis (Full Time Work a    
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job description

ABOUT OUR COMPANY
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.


JOB GROUP SUMMARY
The dedication of talented and caring health care professionals drives the delivery of high quality, cost effective products and services. They make it possible for members to get the right health care treatment for their needs and for Aetna to keep its competitive edge.

This is a full time Work at Home opportunity if you reside in Missouri.

POSITION SUMMARY:
The Medical Economics Consultant retrieves, organizes and performs analysis on healthcare data and financial relationships.  The Medical Economics Consultant define, develop and provides information and analysis to drive the decision-making process and support business operations for internal and external customers with respect to reporting and controlling medical cost of services provided to members. Manages the production and analysis of medical cost information used to formulate effective strategies.

RESPONSIBILITIES:
  • Responsible for the development of scoreable action items by identifying outstanding cost issues, providing ad hoc analysis and generating ideas for moderation of trend increases.
  • Active involvement in the decision making process to provide results against plan objectives.
  • Perform ad hoc reporting to satisfy information needs across products and markets.
  • Utilizes, maintains the development of pricing models and medical cost tracking tools.
  • Provides analysis and support for planning and forecasting of medical costs.

    EDUCATION:
  • Bachelor s Degree (Mathematics, Finance, Healthcare Administration or Accounting) or equivalent experience.


    • job Requirements

    REQUIRED SKILLS:
  • Experience in managed care industry with knowledge of provider contracting, provider reimbursement, patient management, product and benefits design.
  • 3-5 years of Healthcare/Medicaid (Medical Cost Analysis) experience desired.
  • Position requires an understanding of the healthcare industry, healthcare data, common healthcare terminology and medical cost issues and strategies.
  • Must be skilled in complex financial data collection, modeling and analysis and able to work with MS Excel, MS Access and SQL software.
  • Must be capable of distilling large amounts of data into concise, actionable information and must be able to create strategic alternatives.
  • Must be skilled in clearly presenting data and reports in oral and written format.
  • Must be capable of meeting tight deadlines within the context of continually changing priorities and be able not only to draw on cross functional teams but also to work autonomously to obtain desired goals. 
  • Advanced skills in Excel, MS-Access and Web-based query tools (MCM, data warehouse). Ability to learn new technologies.
  • Strong analytical ability and familiarity with advanced financial and healthcare concepts.
  • Demonstrates critical thinking and expresses ideas clearly, concisely and logically from a cross functional perspective.
  • Ability to manage conflicting priorities and multiple projects concurrently.
  • Demonstrates initiative, innovation and leadership in achieving results.

    FUNCTIONAL WORK EXPERIENCES:
  • Network: Medical Cost Analysis
  • Network: Medical Cost Management
  • Finance: Financial Analysis
  • Information Management: Medical Economics

    We value leadership, creativity and initiative.  If you share those values and a commitment to excellence and innovation, consider a career with Aetna.

    We conduct pre-employment drug and background testing.
    Aetna does not permit the use of tobacco related products or drugs in the workplace. No agencies, please.
     
    Aetna is an Equal Opportunity/Affirmative Action Employer. M/F/D/V

    Aetna is committed to maintaining an environment in which all employees are treated equitably and given the opportunity within the context of the business to achieve their potential. Aetna's Affirmative Action responsibilities extend to women, minorities, persons with disabilities and veterans. Company policy also provides for equal opportunity for qualified individuals regardless of race, color, sex, national origin, religion, age, disability, veteran status, sexual orientation, gender identity or marital status.

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