Job Overview
Company:
Location:
Base Pay:
 $75,600 - $95,300 /Year
Other Pay:
Employee Type:
 Full-Time
Industry:
 Insurance
Manages Others:
 No
Job Type:
 Health Care
Req'd Education:
 4 Year Degree
Req'd Experience:
 At least 5 year(s)
Req'd Travel:
 Negligible
Relocation Covered:
 No
Reference ID:
27745002_307561719
 
  
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.

Visit our Website
Compliance Manager    
Report It

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.


POSITION SUMMARY
Formulates and implements information strategy to support operational objectives and other strategic business initiatives. Develops tactical and strategic plans to satisfy information needs across products and segments. May manage staff, processes, programs and/or projects.

This position will report into Aetna Medicare Operations. The successful candidate will be responsible for management of regulatory/compliance requirements for billing and eligibility. Specific responsibilities include
  • development and ownership of compliance quality assurance programs
  • analysis of routine CMS directives to plans. Will identify process or technology impacts to operations and will translate them into updates to P&Ps or service requests for technology needs.
  • coordinate with operations and training to implement process changes that are necessary due to CMS directives
  • act as business lead / subject matter expert in support of IT service requests or project requests
  • management of member communications (letters) and changes to those communications as directed by CMS


    • job Requirements

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

    REQUIRED SKILLS
  • Data Presentation and Communication
  • Demonstrating Business and Industry Acumen
  • Manage translation of business needs into business requirements
  • Project Plan Development
  • Set individual performance expectations for staff

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

    How to apply
     
    To learn more about this opportunity, visit us at www.aetna.com/working . Under requisition # select 28658 and submit your resume. 
     
    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.

    •  

      Report It   


    CareerBuilder.com's Advice

    For your privacy and protection , when applying to a job online:
    Never give your social security number to a prospective employer, provide credit card or bank account information, or perform any sort of monetary transaction.   Learn More >>

    By applying to a job using CareerBuilder.com you are agreeing to comply with and be subject to the CareerBuilder.com Terms and Conditions for use of our website. To use our website, you must agree with the Terms and Conditions and both meet and comply with their provisions.

    Register