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SAI Management

Primary Location: Chicago, Illinois
Additional Locations: IL-Chicago
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Description:

Job Description

Position Summary:

Responsible for identifying, executing and monitoring trendmitigating initiatives across local network and medical management operationsfor the Great Lakes market.

Project Management responsibility for the end to end processrelated to opportunity ideation and discovery, validation and analyticssupporting all commercial and Medicare business segments.

Collaborates with Network, Medical Management, MEU , Financeand Actuarial teams in the Great Lakes to convert insights into data that isactionable.

Job Responsibilities:

Educates business and technical resources on purpose andvalue of quality and cost metrics and assists in interpretation to solveproblems and improve outcomes

Monitors market level metrics and performance forutilization, market level medical cost, premiums, financial results, etc. toidentify trends

Coordinates tracking and execution of trend mitigating actionitems in collaboration with Network Management, Medical Management and MedicalEconomics Unit (MEU)

Responsible for supporting the network leader through thenetwork strategy development process by leveraging network design tools

Provides insights to Network Management team to help informnetwork strategy based on insights and observations

Supports Medical Economics Review process on behalf of LocalNetwork team

Ability to effectively communicate and negotiate across thebusiness and in the external health care environment.

Provides leadership in negotiation support and ability toinfluence sound business decisions based on data, results and informationderived from industry trends, research findings, and Aetna-specific reports andanalyses

Background/DesiredExperience:

5+ years’ experience in healthcare analytics role.

Deep knowledge of health care industry, policy, researchdesign, statistical analyses, predictive modeling, provider reimbursementmethods, case-mix and risk adjustment methods and tools

Demonstrated experience developing analysis, presentationsand support material to successfully implement strategy or change initiatives.

Demonstrated relationship management skills at peer levelswithin an organization and external constituents

Advanced technical, analytic and consultative skills,extensive knowledge of health care data and information systems, as well as anunderstanding of health care benefits, health care financing and health caredelivery systems

Advanced proficiency in excel and power point

Education:

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



Fundamental Components:



Background Experience:



Potential Telework Position:
Yes

Percent of Travel Required:
10 - 25%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

Benefit Eligibility:
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Candidate Privacy Information:
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

Click To Review Our Benefits (PDF)

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