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Apr 18, 2018
Req ID: 49859BR POSITION SUMMARY Responsible for coordinating end to end account servicing in order to implement and maintain provider operations according to the Joint Venture contract. This includes setup and on-going maintenance of tech / care management solutions, organizing consultative services and guidance from subject matter experts as needed, as well as back office functions such as billing, claims and appeals processing. He/she will interact with providers on a regular basis to handle provider requests and concerns while managing routine servicing operations to realize the terms of the JV contract and responding to ad-hoc requests /issues raised by providers and the Joint Venture Management Team. He/she will coordinate cross-functional groups across the Joint Venture, the wider Aetna organization to carry out these servicing activities, many of which are not lead by groups within ACS (e.g.,Medicity, Informatics). He/she works to ensure that the providers / JV are functioning successfully and the JV arrangement is working to improve quality of care while reducing costs. Fundamental Components: Provides deal support during Business Development negotiations if applicable Partners with the Implementation project lead for sold Joint Venture transactions Sets the strategic vision and tone for the relationship and carries out the operational plan to execute that strategy. Establishes appropriate governance and management processes to drive strategic direction Manages a cross-functional team of various Aetna, client and external resources to implement and maintain ongoing account services in JV arrangements with combinations of financial, product, technology, clinical, and operational elements, ranging from infrastructure / network installation for provider solutions, ongoing maintenance of provider solutions (e.g., tech / population health services), payments / appeals processes, report generation, and compliance Ensures adherence to compliance policies and procedures throughout provider account operations, proactively identifying risks and escalating to leadership as appropriate Collaborates cross-functionally to monitor performance and customer service efficiencies, including performance guarantees, client and company clinical as well as financial goals. Looks for ways to enhance the solution with the JV to include identifying new functionality, programs, products, services and technology to ensure better outcomes and achievement of program objectives. Has ultimate accountability for the project/engagement management services being delivered including the organizations budget and/or financial implications. Actively reports and resolves issues; removes barriers to successful execution Manages partner expectations, anticipating possible issues and communicating turnaround times with reasonable delivery dates Works with the technology lead(s) to support technology prioritization and delivery to ensure adequate infrastructure to support Joint Venture requirements Provides accurate, timely and insightful analysis in response to ad hoc requests BACKGROUND/EXPERIENCE desired: 15+ years of hospital system and/or health insurance industry experience. 15+ years of client management, healthcare industry preferred. 8+ years demonstrated knowledge of healthcare industry and particularly ACOs. Strong strategic consulting experience with either a provider or payer. Must have provider or payer experience. Proven ability to interact with, influence and collaborate with clients at all levels. Proven experience managing matrixed staff with ability to leverage non direct reports to complete tasks. Proven track record managing complex projects and/or programs that resulted in cost savings and high customer satisfaction. Strong interpersonal skills. EDUCATION The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. FUNCTIONAL EXPERIENCES Functional - Project Management/Cross-functional project management/4-6 Years Telework Specifications: The position should be located near the Joint Venture in Falls Church, VA. ADDITIONAL JOB INFORMATION Masters Degree Preferred 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: Management
Aetna McLean, VA, USA
Apr 18, 2018
Req ID: 49821BR POSITION SUMMARY In support of the General Manager, the incumbent has responsibility for the implementation of all Medicare Part D and Medicare Advantage activities and programs across a market to achieve all earnings and growth objectives. Provides guidance and consultation for new product start-up, program design and regulatory compliance. Leads Medicare Part D and Medicare Advantage operational interface and ensures strategic and tactical business goals are achieved across the organization. Responsible for all CMS, Bid and application activities. The Medicare Operations Leader will manage all aspects of operational activities related to Medicare in the Capitol Market. *This is a virtual position and can be worked out of any location in the U.S.* Fundamental Components: Directs operational functions of Medicare products across a marketResponsible for the oversight and execution of all CMS required activities and processes including the accuracy and compliance of the annual bid application, expansion application, member materials, and group set up.Facilitates internal and external Medicare audit activity including CMS and operation integrity audits. Coordinates file pulls, data requests, universe development, and supporting documentation.Maintains awareness of trends, developments, and governmental regulations in Medicare and managed health care organizations.Responsible for Medicare product design features, integration schedule, and operational readiness for existing and new product start-ups.Participates in various committees to represent the Medicare department including NCQA, Internal Research, UM, QI, Trend/MER, Risk Mitigation, Complaint and Appeals, bid, implementation, migration, etc.Leads member retention activities, including development of outreach material, design/implementation of outreach programs both directly and in coordination with corporate member retention team, development of talking points/educational pieces about market specific issues.Monitors sales and marketing activities to assure adherence to State and Federal regulations.Uses competitive intelligence to guide, consult, and drive product implementation and strategic focus for Medicare Part D and Medicare Advantage.Coordinates strategies and recommends policy positions with senior management regarding legislative issues and regulatory with a key support function in program and project management in support of Medicare Advantage and Medicare Part D, including STARS and Revenue Management, Quality, and Network concerns.Develops and implements business strategies to provide accurate and proactive customer service to members, plan sponsors, and brokers. Provides operational support for market management of plan sponsors, members, and network providers.BACKGROUND/EXPERIENCE desired:Significant (5+ years) experience in Medicare operations and/or product development.Familiarity with regulations and statutes impacting the Medicare business.Ability to perform analysis and legal research to identify and clarify issues.Business acumen and experience with managing complex processes. EDUCATION The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. FUNCTIONAL EXPERIENCES Functional - Products-Other/Health FSA/1-3 Years Functional - Project Management/Project Leader/1-3 Years Telework Specifications: Considered for any US location; training period in the office may be required ADDITIONAL JOB INFORMATION 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: Management
Aetna Richmond, VA, USA
Apr 18, 2018
Req ID: 49876BR POSITION SUMMARY The Shared Administration Account Liaisons serve as the primary liaison between the business partner (TPA or Fund), the service operations team, and the account management team. Primary responsibility is to manage the relationship with the business partner, to allow for membership and revenue growth in the Shared Administration market. Fundamental Components: The Shared Administration Account Liaison will manage and resolve escalated and complex global issues for their assigned business partner(s). Actively participates with sales implementation and account management activities. Serves as the expert on the needs and requirements for their assigned business partner(s). Advocates for the business partners with internal Aetna teams (claim operations, provider services, medical management, etc.). Works closely with the account management team to provide meaningful reporting packages to the business partners. Supports the leadership of the TPA Relations and Program Management teams by driving results, and identifying potential risks to the Shared Administration program and platform. Proactively identifies root causes and provides potential solutions. BACKGROUND/EXPERIENCE desired: The successful candidate will have experience with claim processing on ACAS; exceptional written and verbal communication skills; demonstrated problem solving and root cause analysis skills; and a proven record at adapting to and/or leading change. The ability to work independently and make business decisions that balance risk and reward for Aetna and the business partner is critical. EDUCATION The highest level of education desired for candidates in this position is a Associate's degree or equivalent experience. FUNCTIONAL EXPERIENCES Functional - Claims/Claim processing - Medical or Hospital - ACAS/1-3 Years Functional - Customer Service/Customer Service - Member Services - Traditional products/1-3 Years Functional - General Management/Project management (non-IT)/1-3 Years REQUIRED SKILLS General Business/Communicating for Impact/ADVANCED Leadership/Anticipating and Innovating/FOUNDATION Leadership/Creating Accountability/FOUNDATION DESIRED SKILLS Leadership/Collaborating for Results/FOUNDATION Leadership/Fostering a Global Perspective/FOUNDATION Service/Working Across Boundaries/FOUNDATION Telework Specifications: **Candidates considered from all locations. Telework option available** ADDITIONAL JOB INFORMATION 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: Management
Aetna Seattle, WA, USA
Apr 18, 2018
Req ID: 49666BR POSITION SUMMARY The Product Implementation Manager/Associate position will be responsible for CMS bid submission and implementation of Individual Medicare products to downstream systems with a focus on quality assurance, ensuring end-to-end that what we implement is consistent with our product filings. *For business continuity, we would prefer candidates on the west coast for this position.* Fundamental Components:Support and assist local market expansion application submission as needed. Ensure SAE/SAR HPMS activities are completed timely. Understand and communicate CMS regulation changes impact to benefit design and system set up. Ensure all CMS bid submission activities are on time and accurate with respect to CMS requirements, corporate systems requirements, and strategic initiatives. Ensure accuracy of benefit data in bid submission, member materials, sales/marketing materials and internal/external websites. Work with local market and operational partners to implement new plans and benefits internally and externally (vendor set up, claims adjudication, system setup, etc.) Other product implementation activities and assignments as needed.BACKGROUND/EXPERIENCE desired:5+ years related cross-functional, project management experience. 3 - 5+ years CMS Bid submission experience, including PBP software setup, PBP entry and HPMS submission, Desk Review and NAMBA. Highly organized and detail oriented with proof-reading and quality control skills. Have strong interpersonal skills and the ability to work independently and in a team environment. Must demonstrate strong project management skills: multi-tasking priorities and facilitating/executing multiple marketing programs. Strong written and verbal communication skills. Proven ability to collaborate across boundaries. Intermediate analytic skills. EDUCATION The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. FUNCTIONAL EXPERIENCES Functional - Management/Management - Medicare/1-3 Years Functional - Project Management/Cross-functional project management/1-3 Years Telework Specifications: Full-Time Telework (WAH) ADDITIONAL JOB INFORMATION 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-MR1 Job Function: Marketing
Aetna Seattle, WA, USA
Apr 18, 2018
Req ID: 49820BR POSITION SUMMARY Builds strategic partnerships with assigned producers and customers to achieve profitable growth and cross-sell objectives for assigned business or customer segments, products and assigned geographies. Develops, executes and communicates a comprehensive strategy that is aligned with prospects objectives, financial position and employee benefits strategy while providing profitable revenue and growth to Aetna and supporting segment business objectives. Fundamental Components: - Achieves sales and profitability targets. - Manages and builds strategic partnerships with assigned producers to create focused sales strategies. - Maximizes sales by articulating how Aetnas capabilities can contribute to constituents long-term strategies. - Delivers organized polished presentations of solutions with benefits tied to constituents needs. - Takes leadership role in setting strategy and collaborating with underwriting to prepare competitive quotes for targeted prospects. - Creates open enrollment strategy with producer and plan sponsor to maximize enrollment. BACKGROUND/EXPERIENCE desired: 10+ years of sales experience in the managed care field. EDUCATION The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. FUNCTIONAL EXPERIENCES Functional - Sales & Service/Strategy development/7-10 Years Functional - Sales & Service/Self insured/stop loss products/7-10 Years Functional - Sales & Service/Complex negotiations/7-10 Years Functional - Sales & Service/Individual sales/7-10 Years REQUIRED SKILLS Finance/Creating Profitable Customers/MASTERY General Business/Consulting for Solutions/MASTERY General Business/Managing Sales Relationships/MASTERY DESIRED SKILLS Leadership/Collaborating for Results/ADVANCED Leadership/Developing and Executing Strategy/MASTERY Sales/Strategic Prospecting/MASTERY ADDITIONAL JOB INFORMATION 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
Aetna McLean, VA, USA
Apr 18, 2018
Req ID: 49585BR POSITION SUMMARY Develop and maintain medical product portfolios for Aetnas commercial business through a consultative, forward thinking approach with the local markets. Conduct competitive & market analysis, incorporate consumer insights, understand/apply benefit mandates and collaborate with market leadership to formulate market specific portfolio strategy and plan designs that maximize competitive advantage, sales and earnings. Fundamental Components: * Partner with the market and develop a market specific product strategy targeted at driving achievement of market and enterprise goals * Design product portfolio to maximize competitive advantage, sales and earnings * Create data driven recommendations and drive consensus on product simplification strategy * Lead market discussions to drive consensus on portfolio needs and timing * Articulate product and market expertise to all stakeholders in strategy and planning sessions, and day to day interactions * Demonstrate expertise on federal and state specific EHB rules and regulations, including all state-specific rules pertaining to HCR and product in assigned states * Demonstrate a thorough understanding of Aetna products/services/benefits/system capabilities * Effectively measure and communicate product performance; ensure we capitalize on greatest opportunity to maximum sales and earnings * Enable product innovation by vetting new product concepts, facilitating dialogue to generate new ideas and raising those ideas for formal concept evaluation BACKGROUND/EXPERIENCE desired: 6+ years of related industry experience. EDUCATION The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. FUNCTIONAL EXPERIENCES Functional - Products-Medical/All Aetna Standard Plans/4-6 Years Functional - Leadership/Act as company spokesperson to external constituents/4-6 Years REQUIRED SKILLS Leadership/Driving a Culture of Compliance/FOUNDATION Leadership/Anticipating and Innovating/ADVANCED General Business/Communicating for Impact/ADVANCED ADDITIONAL JOB INFORMATION 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: Marketing
Aetna McLean, VA, USA
Apr 18, 2018
Req ID: 45381BR POSITION SUMMARY Understand and manage the product development life cycle, product strategy and design, end-to-end impact analysis, project planning, and go-to market execution. Fundamental Components: * Interact with local product managers and matrix partners to develop and operationalize new product ideas, solutions, and programs * Conduct end-to-end impact analysis, develop and manage project plans, and direct project team in support of product rollouts * Gather and analyze external and internal information used to support product business case development Understanding of Benefits * Demonstrate a basic understanding of Aetna products/services/benefits/system capabilities Business Acumen * Interface with internal and external partners and resources to ensure robust end-to-end impact analysis and successful completion of all projects * Understand the business, markets supported, and industry trends and use that knowledge to execute BACKGROUND/EXPERIENCE desired: 3-5 years related work experience. EDUCATION The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. FUNCTIONAL EXPERIENCES Functional - Products-Medical/All Aetna Standard Plans/1-3 Years Functional - Project Management/Project Manager/1-3 Years REQUIRED SKILLS General Business/Communicating for Impact/ADVANCED Sales/Creating Innovative Products/ADVANCED Sales/Knowing Markets/FOUNDATION ADDITIONAL JOB INFORMATION 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: Marketing
Aetna McLean, VA, USA
Apr 18, 2018
Req ID: 48476BR POSITION SUMMARY Develop and maintain medical product portfolios for Aetnas commercial business through a consultative, forward thinking approach with the local markets. Conduct competitive & market analysis, incorporate consumer insights, understand/apply benefit mandates and collaborate with market leadership to formulate market specific portfolio strategy and plan designs that maximize competitive advantage, sales and earnings. Fundamental Components: * Partner with the market and develop a market specific product strategy targeted at driving achievement of market and enterprise goals * Design product portfolio to maximize competitive advantage, sales and earnings * Create data driven recommendations and drive consensus on product simplification strategy * Lead market discussions to drive consensus on portfolio needs and timing * Articulate product and market expertise to all stakeholders in strategy and planning sessions, and day to day interactions * Demonstrate expertise on federal and state specific EHB rules and regulations, including all state-specific rules pertaining to HCR and product in assigned states * Demonstrate a thorough understanding of Aetna products/services/benefits/system capabilities * Effectively measure and communicate product performance; ensure we capitalize on greatest opportunity to maximum sales and earnings * Enable product innovation by vetting new product concepts, facilitating dialogue to generate new ideas and raising those ideas for formal concept evaluation BACKGROUND/EXPERIENCE desired: 6+ years of related industry experience. Consultative, forward thinking, strong negotiator * Strong communication and presentation skills * Prior experience in medical product development and a detailed understanding of medical benefits required along with a financial understanding of profit, pricing and margin and how that is incorporated into the product strategy EDUCATION The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. FUNCTIONAL EXPERIENCES Functional - Products-Medical/All Aetna Standard Plans/1-3 Years Functional - Leadership/Act as company spokesperson to external constituents/1-3 Years REQUIRED SKILLS General Business/Communicating for Impact/ADVANCED Leadership/Collaborating for Results/ADVANCED Sales/Knowing Markets/ADVANCED ADDITIONAL JOB INFORMATION 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: Marketing
Aetna McLean, VA, USA
Apr 18, 2018
Req ID: 49666BR POSITION SUMMARY The Product Implementation Manager/Associate position will be responsible for CMS bid submission and implementation of Individual Medicare products to downstream systems with a focus on quality assurance, ensuring end-to-end that what we implement is consistent with our product filings. *For business continuity, we would prefer candidates on the west coast for this position.* Fundamental Components:Support and assist local market expansion application submission as needed. Ensure SAE/SAR HPMS activities are completed timely. Understand and communicate CMS regulation changes impact to benefit design and system set up. Ensure all CMS bid submission activities are on time and accurate with respect to CMS requirements, corporate systems requirements, and strategic initiatives. Ensure accuracy of benefit data in bid submission, member materials, sales/marketing materials and internal/external websites. Work with local market and operational partners to implement new plans and benefits internally and externally (vendor set up, claims adjudication, system setup, etc.) Other product implementation activities and assignments as needed.BACKGROUND/EXPERIENCE desired:5+ years related cross-functional, project management experience. 3 - 5+ years CMS Bid submission experience, including PBP software setup, PBP entry and HPMS submission, Desk Review and NAMBA. Highly organized and detail oriented with proof-reading and quality control skills. Have strong interpersonal skills and the ability to work independently and in a team environment. Must demonstrate strong project management skills: multi-tasking priorities and facilitating/executing multiple marketing programs. Strong written and verbal communication skills. Proven ability to collaborate across boundaries. Intermediate analytic skills. EDUCATION The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. FUNCTIONAL EXPERIENCES Functional - Management/Management - Medicare/1-3 Years Functional - Project Management/Cross-functional project management/1-3 Years Telework Specifications: Full-Time Telework (WAH) ADDITIONAL JOB INFORMATION 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-MR1 Job Function: Marketing
Aetna Sandy, UT, USA
Apr 18, 2018
Req ID: 49149BR POSITION SUMMARY This position will partner with the business to identify key drivers of member satisfaction, obtain access to specific data elements, research, cleanse, model and visualize the data. Then use the data to build predictive models, which will be tested, enhanced and implemented. Once implemented, trends will be collected from the models and visualized for the business. Fundamental Components:Partner with business to identify key drivers and data elements.Conduct research to identify, cleanse and model the data.Build predictive models using the modeled data.Develop and implement QA testing protocols and business testing on the models.Develop tools to measure and visualize the results.Partner with the business to evaluate the models and enhance.Use the data to identify trends and communicate to the business.Be comfortable researching, cleansing, modeling and visualizing data.Demonstrated ability to interact with business staff to draw out their requirements.Work with minimal direction.BACKGROUND/EXPERIENCE desired:Knowledge of health care data, metrics, systems and standards.Experience building predictive models.Demonstrated ability to research, capture, cleanse, model and visualize data.Able to make sound decisions and recommendations to drive business solutions.Ability to communicate statistical and technical ideas and results to non-technical clients in written and verbal form.Well-versed in statistical model building and concepts, decision trees and classification rules, segmentation and cluster analysis.Advanced SQL and SAS programming abilities in data warehouse or big data analytics environment, including use of statistical analysis techniques or business intelligence application development.Strong problem solving skills and critical thinking ability.Understanding of relational databases, data systems, data warehouses and Big Data.Strong reporting skills using Excel, Access, Word, Tableau and/or PowerPoint.Strong understanding of customers' strategies, information needs programs, processes and products. EDUCATION The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. FUNCTIONAL EXPERIENCES Information Management/Data acquisition, data management, programming and documentation/4-6 Years Information Management/Decision trees and classification rules/1-3 Years Information Management/Statistical model building and concepts/1-3 Years Information Management/predictive modeling/1-3 Years Information Management/Informatics - regression analysis/1-3 Years TECHNOLOGY EXPERIENCES Reporting Tools/SAS/4-6 Years/ Development Languages/SQL/4-6 Years/ REQUIRED SKILLS General Business/Ensuring Project Discipline/FOUNDATION Leadership/Collaborating for Results/FOUNDATION Technology/Leveraging Technology/ADVANCED DESIRED SKILLS Benefits Management/Promoting Health Information Technology/FOUNDATION General Business/Communicating for Impact/FOUNDATION Technology/Promoting Emerging Technology/FOUNDATION Telework Specifications: Also available in Blue Bell, PA, Jacksonville FL, Fresno, CA, New Albany, OH, Albany, NY, Allentown, PA, Arlington, TX, Bismarck, ND, Cranberry, PA, Harrisburg, PA, Highpoint, NC, San Antonio, TX, Sandy UT, Scottsdale, AZ. ADDITIONAL JOB INFORMATION Opportunity to work on innovative project building predictive models, using key data analytic skills. Work will include partnering with business, developing an understanding of health care and creating new tools for the company. Project will require research and creativity. 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: Health Care
Aetna Sandy, UT, USA
Apr 18, 2018
Req ID: 49585BR POSITION SUMMARY Develop and maintain medical product portfolios for Aetnas commercial business through a consultative, forward thinking approach with the local markets. Conduct competitive & market analysis, incorporate consumer insights, understand/apply benefit mandates and collaborate with market leadership to formulate market specific portfolio strategy and plan designs that maximize competitive advantage, sales and earnings. Fundamental Components: * Partner with the market and develop a market specific product strategy targeted at driving achievement of market and enterprise goals * Design product portfolio to maximize competitive advantage, sales and earnings * Create data driven recommendations and drive consensus on product simplification strategy * Lead market discussions to drive consensus on portfolio needs and timing * Articulate product and market expertise to all stakeholders in strategy and planning sessions, and day to day interactions * Demonstrate expertise on federal and state specific EHB rules and regulations, including all state-specific rules pertaining to HCR and product in assigned states * Demonstrate a thorough understanding of Aetna products/services/benefits/system capabilities * Effectively measure and communicate product performance; ensure we capitalize on greatest opportunity to maximum sales and earnings * Enable product innovation by vetting new product concepts, facilitating dialogue to generate new ideas and raising those ideas for formal concept evaluation BACKGROUND/EXPERIENCE desired: 6+ years of related industry experience. EDUCATION The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. FUNCTIONAL EXPERIENCES Functional - Products-Medical/All Aetna Standard Plans/4-6 Years Functional - Leadership/Act as company spokesperson to external constituents/4-6 Years REQUIRED SKILLS Leadership/Driving a Culture of Compliance/FOUNDATION Leadership/Anticipating and Innovating/ADVANCED General Business/Communicating for Impact/ADVANCED ADDITIONAL JOB INFORMATION 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: Marketing
Aetna Salt Lake City, UT, USA
Apr 18, 2018
Req ID: 49803BR POSITION SUMMARY The ideal candidate has a passion for technology and is excited to join a team that has a varied portfolio of application and product support. We are seeking a Sr Middleware Engineer to install, implement and support enterprise application technologies and participate in the design, delivery, optimization and scalability of the products and services supported by Integrated Middleware/Application Technology and Transactional Management Engineering with an emphasis on supporting the roadmap for next generation infrastructure. *Note: Interested candidates must be legally eligible to work for any US employer & not require visa transfer or sponsorship now or in the future. Fundamental Components: Assess, engineer, develop, design and support new products that provide capabilities for advanced tooling, and application support. Work with engineering Leads to strategize and develop solutions addressing technical and business needs, understand and address end-to-end requirements and infrastructure. Engineer, design, automate, implement and support prototypes, using open source and vendor solutions. Collaborate with other technology teams and architects to define and develop cross-function technology stack interactions. Design code, instrument and document processes. Provide leadership, able to engage cross organizationally to promote change and carve out new technology and software not previously deployed. Participate in the development and execution of project plans and timelines. Perform infrastructure software installs and upgrades. Build infrastructure environments for development, integration, QA, Stress and production application server environments and support application deployments. Assists and conducts configuration & testing/certification of infrastructure products, customer support and upgrades. Creates necessary documentation for install and testing processes. Monitor overall capacity / performance of application server environments, tune infrastructure components for optimal performance for both system and application goals. Monitor product usage to insure efficiency, reliability and adherence to license agreements. Input, planning and support for disaster recovery for the infrastructure tier. BACKGROUND/EXPERIENCE desired: Aptitude/engineering competencies Administration/exposure to Middleware Platform Administration, FileNet, Axway, Sterling File Gateway, MQ exposure on one or more: Linux, AIX, Windows, Cloud - Experience in diagnostic/troubleshooting vendor software and enterprise environments. - Navigate effortlessly across multiple organizations Automation capabilities, scripting exposure a plus - Analytical, creative, and innovative approach to solving difficult problems. EDUCATION The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. ADDITIONAL JOB INFORMATION If you are interested in joining a dynamic, agile team supporting enterprise software and each other, embrace change, are enthusiastic about learning new technologies, please consider posting for this position. 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: Information Technology
Aetna Sandy, UT, USA
Apr 18, 2018
Req ID: 49926BR This role is office based in Sugar Land, TX The following hours are required:8:00-4:30 CST 3 days/wk. and 11:30 pm to 8:00 pm CST 2 days/wk POSITION SUMMARY The Health Coach Consultant utilizes a collaborative process of assessment, planning, implementation and evaluation, to engage, educate, and promote/influence members decisions related to life style changes to achieve and maintain optimal health status. Requires an RN with unrestricted active license. -Responsible for managing patients in a telephonic educational disease management program. Fundamental components include but are not limited to: Screens members to identify needed medical services, modifiable risk factors and educational needs and identifies or refers cases for other services. -Intervenes to positively effect healthcare outcomes. -Conducts individualized holistic clinical assessments of members care needs and develops a personalized disease-specific action plan. -Promotes communication, both internally and externally, to enhance effectiveness of medical management services (member, family and health care team members respectively). -Reinforces appropriate self-care teaching and monitoring, provides up-to-date health care information to help facilitate the members understanding of his/her health conditions. -Helps member actively and knowledgeably participate with their provider in their own health care decision-making. -Evaluates the members progress in meeting established goals and revises the care plan accordingly. -Ensures accurate and complete documentation of required information to meet risk management, regulatory and accreditation requirements. BACKGROUND/EXPERIENCE An RN license is required Managed Care experience preferred Previous coaching experience preferred 3-5 years of clinical experience required EDUCATION The minimum level of education desired for candidates in this position is a Associate's degree or equivalent experience. LICENSES AND CERTIFICATIONS Nursing/Registered Nurse is required FUNCTIONAL EXPERIENCES Functional - Nursing/Medical-Surgical Care/1-3 Years Functional - Nursing/Disease management/1-3 Years TECHNOLOGY EXPERIENCES Technical - Computer Operations/System and Console Operations/1-3 Years/End User Technical - Desktop Tools/Microsoft Word/1-3 Years/End User Technical - Desktop Tools/Microsoft PowerPoint/1-3 Years/End User Technical - Desktop Tools/Microsoft Outlook/1-3 Years/End User REQUIRED SKILLS Benefits Management/Maximizing Healthcare Quality/FOUNDATION Benefits Management/Understanding Clinical Impacts/ADVANCED Leadership/Driving Change/ADVANCED DESIRED SKILLS General Business/Turning Data into Information/ADVANCED Leadership/Collaborating for Results/ADVANCED ADDITIONAL JOB INFORMATION Registered Nurse with 5 years of clinical experience -Disease Management, Case Management or Managed Care experience preferred -Excellent verbal and written communication skills required to provide patient education -Proficiency in use of computer applications and typing skills (>35 wpm) highly recommended -A commitment to Excellence and Accountability -Integrity -Ability to be flexible and adapt to changing processes and schedule requirements -Ability to work with multiple screens is desired - This is a call center environment, majority of time is spent speaking telephonically with members. -Bilingual in Spanish a plus, not required -Willingness for flexible hours desired. -Work hours for the 1st 18 months after orientation will be from 8:00-4:30 CST 3 days/wk. and 11:30 pm to 8:00 pm CST 2 days/wk. 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: Health Care
Aetna Sugar Land, TX, USA
Apr 18, 2018
Req ID: 49487BR POSITION SUMMARY In the HEDIS outreach coordinator position, you will perform provider and member outreach, data analysis, medical record abstraction and data entry to support continuous quality improvement in Healthcare Effectiveness Data and Information Set (HEDIS) rates. Facilitates provider and member outreach to ensure member receipt of important clinical services to improve member health outcomes. Supports efficient medical record retrieval for HEDIS medical record review and HEDIS supplemental data collection activities. Fundamental Components include, but are not limited to: Identifies potential resources and initiates collaboration with providers to improve member health outcomes and HEDIS measures. Makes outbound calls to members to provide reminders and assistance in obtaining services to avoid delays in treatment and improve member health outcomes. Develops and distributes educational information to members and providers in accordance with the HEDIS outreach work plan. Assists in the development and standardization of outreach documentation and manages the data flow process to complete HEDIS documentation. Documents member participation in outreach activities in accordance with abstraction and audit standards. Conducts HEDIS provider chart request calls and mailings. May develop and maintain member incentive programs to support HEDIS initiatives. May identify opportunities to partner with community organizations on special events and presentations (i.e., health fairs and community events). Works with internal staff to schedule, organize, and staff these events. Records and documents all member and provider outreach activity. Performs other duties as required. BACKGROUND/EXPERIENCE desired: Minimum 1 year experience with Healthcare Effectiveness Data and Information Set (HEDIS) data collection and quality improvement activities Minimum 3 years' recent experience working in a health care setting (e.g. managed care, provider office, hospital, clinic, pharmacy, etc.). Strong communication skills and experience speaking with medical providers. Ability to work independently. Experience working in a professional, corporate office setting Ability to use standard corporate software packages and Microsoft applications (Outlook, Work, Excel, PowerPoint, etc.) EDUCATION The minimum level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. Telework Specifications: Telework 2 days a week, Office 3 days a week - see notes below on location preferences (requires discussion) ADDITIONAL JOB INFORMATION 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. 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: Quality Management
Aetna San Antonio, TX, USA
Apr 18, 2018
Req ID: 50003BR This position will sit in our San Antonio, TX office. Open to internals, but must be local to the area. POSITION SUMMARY The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Requires an RN with unrestricted active license. The hours for this position are 8am-6pm CT, Mon-Fri, with some flexibility. Fundamental Components: The Nurse Case Manager, utilizing advanced clinical judgment and critical thinking skills, is responsible for telephonically assessing, planning, implementing and coordinating all case management activities with members to evaluate appropriate physical and behavioral healthcare and social services for the member. Through assessment and member-centered care planning, direct provider coordination/collaboration, and coordination of psychosocial services, the Case Manager promotes effective utilization of available resources, optimal member functioning, and cost-effective outcomes. In doing this, the Case Manager develops a proactive course of action to address issues to enhance the short and long term outcomes as well as opportunities to enhance a members overall wellness through integration. Background/Experience:Minimum of 5 years clinical experience required (Med/Surg preferred) Minimum of 1 year case management or home health experience strongly preferred Bilingual (Spanish) preferred EDUCATION The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. LICENSES AND CERTIFICATIONS Nursing/Registered Nurse is Required Nursing/Certified Case Manager (CCM) is preferred FUNCTIONAL EXPERIENCES Functional - Nursing/Medical-Surgical Care/4-6 Years Functional - Nursing/Case Management/1-3 Years Functional - Nursing/Discharge Planning/1-3 Years TECHNOLOGY EXPERIENCES Technical - Aetna Applications/Aetna Strategic Data Warehouse/1-3 Years/End User Technical - Aetna Applications/Aetna Total clinical View/1-3 Years/End User Technical - Desktop Tools/Microsoft Outlook/1-3 Years/End User Technical - Desktop Tools/Microsoft Word/1-3 Years/End User REQUIRED SKILLS Benefits Management/Maximizing Healthcare Quality/FOUNDATION Benefits Management/Understanding Clinical Impacts/FOUNDATION Leadership/Collaborating for Results/ADVANCED DESIRED SKILLS General Business/Applying Reasoned Judgment/ADVANCED Leadership/Driving a Culture of Compliance/FOUNDATION Technology/Leveraging Technology/FOUNDATION ADDITIONAL JOB INFORMATION 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: Health Care
Aetna San Antonio, TX, USA
Apr 18, 2018
Req ID: 49149BR POSITION SUMMARY This position will partner with the business to identify key drivers of member satisfaction, obtain access to specific data elements, research, cleanse, model and visualize the data. Then use the data to build predictive models, which will be tested, enhanced and implemented. Once implemented, trends will be collected from the models and visualized for the business. Fundamental Components:Partner with business to identify key drivers and data elements.Conduct research to identify, cleanse and model the data.Build predictive models using the modeled data.Develop and implement QA testing protocols and business testing on the models.Develop tools to measure and visualize the results.Partner with the business to evaluate the models and enhance.Use the data to identify trends and communicate to the business.Be comfortable researching, cleansing, modeling and visualizing data.Demonstrated ability to interact with business staff to draw out their requirements.Work with minimal direction.BACKGROUND/EXPERIENCE desired:Knowledge of health care data, metrics, systems and standards.Experience building predictive models.Demonstrated ability to research, capture, cleanse, model and visualize data.Able to make sound decisions and recommendations to drive business solutions.Ability to communicate statistical and technical ideas and results to non-technical clients in written and verbal form.Well-versed in statistical model building and concepts, decision trees and classification rules, segmentation and cluster analysis.Advanced SQL and SAS programming abilities in data warehouse or big data analytics environment, including use of statistical analysis techniques or business intelligence application development.Strong problem solving skills and critical thinking ability.Understanding of relational databases, data systems, data warehouses and Big Data.Strong reporting skills using Excel, Access, Word, Tableau and/or PowerPoint.Strong understanding of customers' strategies, information needs programs, processes and products. EDUCATION The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. FUNCTIONAL EXPERIENCES Information Management/Data acquisition, data management, programming and documentation/4-6 Years Information Management/Decision trees and classification rules/1-3 Years Information Management/Statistical model building and concepts/1-3 Years Information Management/predictive modeling/1-3 Years Information Management/Informatics - regression analysis/1-3 Years TECHNOLOGY EXPERIENCES Reporting Tools/SAS/4-6 Years/ Development Languages/SQL/4-6 Years/ REQUIRED SKILLS General Business/Ensuring Project Discipline/FOUNDATION Leadership/Collaborating for Results/FOUNDATION Technology/Leveraging Technology/ADVANCED DESIRED SKILLS Benefits Management/Promoting Health Information Technology/FOUNDATION General Business/Communicating for Impact/FOUNDATION Technology/Promoting Emerging Technology/FOUNDATION Telework Specifications: Also available in Blue Bell, PA, Jacksonville FL, Fresno, CA, New Albany, OH, Albany, NY, Allentown, PA, Arlington, TX, Bismarck, ND, Cranberry, PA, Harrisburg, PA, Highpoint, NC, San Antonio, TX, Sandy UT, Scottsdale, AZ. ADDITIONAL JOB INFORMATION Opportunity to work on innovative project building predictive models, using key data analytic skills. Work will include partnering with business, developing an understanding of health care and creating new tools for the company. Project will require research and creativity. 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: Health Care
Aetna San Antonio, TX, USA
Apr 18, 2018
Req ID: 46696BR POSITION SUMMARY The main goal of this role is to help design technical solutions leveraging Salesforce capabilities that will deliver accelerated value towards achieving strategic business goals with clear focus on success metrics and ROI. This role reports into the Salesforce Center of Excellence Director. The ideal candidate is a change agent with consulting experience who will work with key business area stakeholders, the CoE team and our IT Partners to understand business processes and design, prototype, help develop enhancements, capabilities, process automation and customers insights that are aligned with the project vision, while mitigating risk. Salesforce Certifications required. The candidate must demonstrate in depth technical knowledge of Salesforce and its capabilities, track record of major solution design architecture contributions in a large enterprise, leadership skills to drive change, analytical and problem solving way of thought, project management skills and enthusiastic personality. Fundamental Components: Duties and Responsibilities: Ambassador of the CoE, change agent and champion of Salesforce to promote best practices that can transform and empower Aetnas businesses using Salesforce. Responsible for connecting business goals and challenges and for the overall design of the application solution on Salesforce.com. Leads Discovery Workshops with key stakeholders to understand Aetnas strategic business goals, needs, processes and current use of the platform, and any other customer centric data and processes not currently on SFDC. Analyzes and maps business areas strategic goals, processes and success metrics with Salesforce capabilities. Demonstrates Salesforce and extended AppExchange apps that can fit our needs. Explains complex technology concepts in in simple language. Partners with Aetnas SMEs across IT, Data Governance, Innovation Lab and other areas to design solutions that will deliver maximum value across the enterprise. Designs solutions with maximum usability while minimizing complex code and customization. Delivers detailed design proof-of-concepts, wireframes, prototypes, in PPT and sandbox, as needed. Creates documentation of technical design, support plan and enable best practices and governance measures. This role works as a team member of the CoE to deliver the complete solution for our customers, partnering with our Platform Manager and IT Partners to oversee build, testing and deployment. Writes user stories and acceptance criteria for complex Agile deployments. Project manage solution scope, timelines, quality and cost and escalates issues for resolution and to mitigate risk. Drives communications with all key stakeholders including delivering project updates and gathering project sign offs from CoE Lead and key stakeholders and maintains alignment Partners with Customer Success team to design end-user training materials and go-live support. Stay current on Salesforce releases, new features, product roadmaps and applications available from 3rd parties on the Salesforce AppExchange. BACKGROUND/EXPERIENCE desired: Qualifications: Salesforce Certifications required to be considered for this position: Administrator Must have 5+ years of direct experience in all aspects of developing and implementing CRM or salesforce platform applications. Strong understanding of key SFDC architectural concepts and how they influence design. Change management experience. Demonstrate ability to influence stakeh EDUCATION The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. ADDITIONAL JOB INFORMATION Preferred Skills: Salesforce Certifications Preferred: Sales Cloud and/or Service Cloud Consultant or Analyst Consultant or other SFDC specialization. Experience developing solutions using Apex and VisualForce Experience in implementation projects using Agile methods and practices Education: Bachelors degree in Engineering, Computer Science, or similar MBA preferred 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: Information Technology
Aetna Houston, TX, USA
Apr 18, 2018
Req ID: 46696BR POSITION SUMMARY The main goal of this role is to help design technical solutions leveraging Salesforce capabilities that will deliver accelerated value towards achieving strategic business goals with clear focus on success metrics and ROI. This role reports into the Salesforce Center of Excellence Director. The ideal candidate is a change agent with consulting experience who will work with key business area stakeholders, the CoE team and our IT Partners to understand business processes and design, prototype, help develop enhancements, capabilities, process automation and customers insights that are aligned with the project vision, while mitigating risk. Salesforce Certifications required. The candidate must demonstrate in depth technical knowledge of Salesforce and its capabilities, track record of major solution design architecture contributions in a large enterprise, leadership skills to drive change, analytical and problem solving way of thought, project management skills and enthusiastic personality. Fundamental Components: Duties and Responsibilities: Ambassador of the CoE, change agent and champion of Salesforce to promote best practices that can transform and empower Aetnas businesses using Salesforce. Responsible for connecting business goals and challenges and for the overall design of the application solution on Salesforce.com. Leads Discovery Workshops with key stakeholders to understand Aetnas strategic business goals, needs, processes and current use of the platform, and any other customer centric data and processes not currently on SFDC. Analyzes and maps business areas strategic goals, processes and success metrics with Salesforce capabilities. Demonstrates Salesforce and extended AppExchange apps that can fit our needs. Explains complex technology concepts in in simple language. Partners with Aetnas SMEs across IT, Data Governance, Innovation Lab and other areas to design solutions that will deliver maximum value across the enterprise. Designs solutions with maximum usability while minimizing complex code and customization. Delivers detailed design proof-of-concepts, wireframes, prototypes, in PPT and sandbox, as needed. Creates documentation of technical design, support plan and enable best practices and governance measures. This role works as a team member of the CoE to deliver the complete solution for our customers, partnering with our Platform Manager and IT Partners to oversee build, testing and deployment. Writes user stories and acceptance criteria for complex Agile deployments. Project manage solution scope, timelines, quality and cost and escalates issues for resolution and to mitigate risk. Drives communications with all key stakeholders including delivering project updates and gathering project sign offs from CoE Lead and key stakeholders and maintains alignment Partners with Customer Success team to design end-user training materials and go-live support. Stay current on Salesforce releases, new features, product roadmaps and applications available from 3rd parties on the Salesforce AppExchange. BACKGROUND/EXPERIENCE desired: Qualifications: Salesforce Certifications required to be considered for this position: Administrator Must have 5+ years of direct experience in all aspects of developing and implementing CRM or salesforce platform applications. Strong understanding of key SFDC architectural concepts and how they influence design. Change management experience. Demonstrate ability to influence stakeh EDUCATION The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. ADDITIONAL JOB INFORMATION Preferred Skills: Salesforce Certifications Preferred: Sales Cloud and/or Service Cloud Consultant or Analyst Consultant or other SFDC specialization. Experience developing solutions using Apex and VisualForce Experience in implementation projects using Agile methods and practices Education: Bachelors degree in Engineering, Computer Science, or similar MBA preferred 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: Information Technology
Aetna Dallas, TX, USA
Apr 18, 2018
Req ID: 49149BR POSITION SUMMARY This position will partner with the business to identify key drivers of member satisfaction, obtain access to specific data elements, research, cleanse, model and visualize the data. Then use the data to build predictive models, which will be tested, enhanced and implemented. Once implemented, trends will be collected from the models and visualized for the business. Fundamental Components:Partner with business to identify key drivers and data elements.Conduct research to identify, cleanse and model the data.Build predictive models using the modeled data.Develop and implement QA testing protocols and business testing on the models.Develop tools to measure and visualize the results.Partner with the business to evaluate the models and enhance.Use the data to identify trends and communicate to the business.Be comfortable researching, cleansing, modeling and visualizing data.Demonstrated ability to interact with business staff to draw out their requirements.Work with minimal direction.BACKGROUND/EXPERIENCE desired:Knowledge of health care data, metrics, systems and standards.Experience building predictive models.Demonstrated ability to research, capture, cleanse, model and visualize data.Able to make sound decisions and recommendations to drive business solutions.Ability to communicate statistical and technical ideas and results to non-technical clients in written and verbal form.Well-versed in statistical model building and concepts, decision trees and classification rules, segmentation and cluster analysis.Advanced SQL and SAS programming abilities in data warehouse or big data analytics environment, including use of statistical analysis techniques or business intelligence application development.Strong problem solving skills and critical thinking ability.Understanding of relational databases, data systems, data warehouses and Big Data.Strong reporting skills using Excel, Access, Word, Tableau and/or PowerPoint.Strong understanding of customers' strategies, information needs programs, processes and products. EDUCATION The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. FUNCTIONAL EXPERIENCES Information Management/Data acquisition, data management, programming and documentation/4-6 Years Information Management/Decision trees and classification rules/1-3 Years Information Management/Statistical model building and concepts/1-3 Years Information Management/predictive modeling/1-3 Years Information Management/Informatics - regression analysis/1-3 Years TECHNOLOGY EXPERIENCES Reporting Tools/SAS/4-6 Years/ Development Languages/SQL/4-6 Years/ REQUIRED SKILLS General Business/Ensuring Project Discipline/FOUNDATION Leadership/Collaborating for Results/FOUNDATION Technology/Leveraging Technology/ADVANCED DESIRED SKILLS Benefits Management/Promoting Health Information Technology/FOUNDATION General Business/Communicating for Impact/FOUNDATION Technology/Promoting Emerging Technology/FOUNDATION Telework Specifications: Also available in Blue Bell, PA, Jacksonville FL, Fresno, CA, New Albany, OH, Albany, NY, Allentown, PA, Arlington, TX, Bismarck, ND, Cranberry, PA, Harrisburg, PA, Highpoint, NC, San Antonio, TX, Sandy UT, Scottsdale, AZ. ADDITIONAL JOB INFORMATION Opportunity to work on innovative project building predictive models, using key data analytic skills. Work will include partnering with business, developing an understanding of health care and creating new tools for the company. Project will require research and creativity. 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: Health Care
Aetna Arlington, TX, USA
Apr 18, 2018
Req ID: 46696BR POSITION SUMMARY The main goal of this role is to help design technical solutions leveraging Salesforce capabilities that will deliver accelerated value towards achieving strategic business goals with clear focus on success metrics and ROI. This role reports into the Salesforce Center of Excellence Director. The ideal candidate is a change agent with consulting experience who will work with key business area stakeholders, the CoE team and our IT Partners to understand business processes and design, prototype, help develop enhancements, capabilities, process automation and customers insights that are aligned with the project vision, while mitigating risk. Salesforce Certifications required. The candidate must demonstrate in depth technical knowledge of Salesforce and its capabilities, track record of major solution design architecture contributions in a large enterprise, leadership skills to drive change, analytical and problem solving way of thought, project management skills and enthusiastic personality. Fundamental Components: Duties and Responsibilities: Ambassador of the CoE, change agent and champion of Salesforce to promote best practices that can transform and empower Aetnas businesses using Salesforce. Responsible for connecting business goals and challenges and for the overall design of the application solution on Salesforce.com. Leads Discovery Workshops with key stakeholders to understand Aetnas strategic business goals, needs, processes and current use of the platform, and any other customer centric data and processes not currently on SFDC. Analyzes and maps business areas strategic goals, processes and success metrics with Salesforce capabilities. Demonstrates Salesforce and extended AppExchange apps that can fit our needs. Explains complex technology concepts in in simple language. Partners with Aetnas SMEs across IT, Data Governance, Innovation Lab and other areas to design solutions that will deliver maximum value across the enterprise. Designs solutions with maximum usability while minimizing complex code and customization. Delivers detailed design proof-of-concepts, wireframes, prototypes, in PPT and sandbox, as needed. Creates documentation of technical design, support plan and enable best practices and governance measures. This role works as a team member of the CoE to deliver the complete solution for our customers, partnering with our Platform Manager and IT Partners to oversee build, testing and deployment. Writes user stories and acceptance criteria for complex Agile deployments. Project manage solution scope, timelines, quality and cost and escalates issues for resolution and to mitigate risk. Drives communications with all key stakeholders including delivering project updates and gathering project sign offs from CoE Lead and key stakeholders and maintains alignment Partners with Customer Success team to design end-user training materials and go-live support. Stay current on Salesforce releases, new features, product roadmaps and applications available from 3rd parties on the Salesforce AppExchange. BACKGROUND/EXPERIENCE desired: Qualifications: Salesforce Certifications required to be considered for this position: Administrator Must have 5+ years of direct experience in all aspects of developing and implementing CRM or salesforce platform applications. Strong understanding of key SFDC architectural concepts and how they influence design. Change management experience. Demonstrate ability to influence stakeh EDUCATION The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. ADDITIONAL JOB INFORMATION Preferred Skills: Salesforce Certifications Preferred: Sales Cloud and/or Service Cloud Consultant or Analyst Consultant or other SFDC specialization. Experience developing solutions using Apex and VisualForce Experience in implementation projects using Agile methods and practices Education: Bachelors degree in Engineering, Computer Science, or similar MBA preferred 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: Information Technology
Aetna Austin, TX, USA