Medicare Audit Senior ConsultantPrimary Location: Hartford, Connecticut
Additional Locations: CT-Hartford Apply
organizational compliance with National Network Delegation policies and
process, evaluates the performance of risk and/or delegated provider
relationships, identifies compliance issues and closes performance gaps.
Performs Medicare assessments of delegates to verify compliance with Aetna
standards and regulatory requirements by utilizing the prescribed due
diligence, contracting, and reporting tools.
Support the effectiveness of delegation risk management and
motivated to achieve department goals. Able to work in a fast pace, deadline
driven environment. Past experience includes any/all of the following:
auditing, quality assurance, compliance, and Medicare Minimum of 2-4 years of
Audit, Compliance, or related business experience. Advanced skill level with MS
Excel, Word and Outlook. Proficient skill level with MS Visio and MS Access is
preferred Able to travel up to 20%. Additional Job Information: Join a growing team with numerous opportunities to
grow and develop. Support the expansion of our Medicare Delegation Oversight
program. Ability to collaborate with and learn from SME's in areas such as
Medicare Compliance, Legal, and Network. Strengthen written and verbal communication
skills through delivery of reports and participation in Committees/meetings.
Develop and utilize ABX Six Sigma/Lean skills as we rebuild the framework,
processes, and controls for this organization. Learn to assess the risk of the
delegate population, analyze data and trends, and manage delegate compliance
with standards and regulatory requirements. Required Skills: General Business - Applying Reasoned Judgment, Leadership - Driving a Culture of Compliance, Technology - Selecting and Applying Technology Solutions Desired Skills: General Business - Communicating for Impact, Leadership - Creating Accountability, Leadership - Developing and Executing Strategy Functional Skills: Communication - Communication Delivery - Public Speaking, General Management - Data analysis & interpretation, General Management - Project management (non-IT), Management - Management - Process and quality improvement, Project Management - Time Management Technology Experience: Database - Microsoft Access, Desktop Tool - Microsoft PowerPoint, Desktop Tool - Microsoft Visio, Desktop Tool - TE Microsoft Excel 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 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.
Jobs for you
Recently Viewed Jobs
You do not have any recently viewed jobs
Your Saved Jobs
You do not have any saved jobs
Sign up for Job Alerts
Join our Talent Community
At Aetna, we are pioneering a total approach to health and wellness and we need talented candidates like you to join our team. Become a member of our talent community to be the first to know about career initiatives that match your skills and interests as they become available, in addition to details on upcoming events, networking opportunities, and news about Aetna.
Join Our Talent Community
Sign up to receive information about job openings that are tailored to your skills and interests. Plus, get the latest career news from Aetna.