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Medical Economics Consultant

Primary Location: Hartford, CT
Additional Locations: CT-Hartford
This position is responsible for providing analytical support for Aetna’s value based contracts. Candidate will work collaboratively with business units across the Company providing medical cost and outcomes focused analytical research, financial modeling and business decision support reporting. The team is engaged in all aspects of the analytic lifecycle from contract negotiation through reconciliation & settlement, including report development and financial consulting support for provider partners.

Fundamental Components:
Provide analytical consulting in support of Aetna’s value based contracting strategy. Provide analytical support for value based contract negotiations. Provide on-going analytical support for active value based contracts. Perform financial reconciliations as part of value based contracts. Create actionable financial projections, decision support models, and financial reporting for new and evolving products, programs and initiatives. Develop innovative analytics, insights and solutions for medical cost drivers and network design/provider reimbursement issues. Identify medical cost savings opportunities for provider partners to pursue.

Background Experience:
3-6 years demonstrated leadership and project management experience. Ability to manage conflicting priorities and multiple projects concurrently. Strong analytical ability and familiarity with advanced financial and healthcare concepts. Expertise in multiple areas of provider contracting/reimbursement, analysis, modeling & reporting. Extensive & diverse knowledge of healthcare data, metrics & coding structures. Able to make sound decisions to drive solutions.

Required Skills:
General Business - Applying Reasoned Judgment, General Business - Turning Data into Information, Leadership - Collaborating for Results

Desired Skills:
General Business - Communicating for Impact, General Business - Demonstrating Business and Industry Acumen, Technology - Leveraging Technology

Functional Skills:
Information Management - Provides analysis and support for planning and forecasting of medical costs, Information Management - Utilizes and maintains pricing models and medical cost tracking tools, Medical Management - Medical Management - Medical Economics, Network Management - Contract negotiation

Technology Experience:
Aetna Application - Enterprise Data Warehouse, Database - Microsoft Access, Desktop Tool - TE Microsoft Excel

Clinical Licensure:

Potential Telework Position:

Percent of Travel Required:
0 - 10%

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

Benefit Eligibility:
Benefit eligibility may vary by 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 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.


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