Skip to main content

A new day in healthcare. Together, CVS Health and Aetna help people on their path to better health.

Medicare Performance Management Lead Business Consultant (58809BR)

Primary Location: Hartford, Connecticut
Additional Locations: AZ-Phoenix, CA-Los Angeles, CA-San Francisco, CO-Denver, CT-Hartford, IL-Chicago, OR-Portland, PA-Philadelphia, PA-Pittsburgh, TX-Dallas, TX-San Antonio, UT-Salt Lake City, WA-Seattle
This position is open across the US and not location specific - willing to consider applicants in all locations, not just where it is listed below. Proximity to listed cities is preferred.

The Medicare Performance Management Lead Business Consultant will facilitate and support implementation of the business units management process and operating model. This role will assist the Medicare Advantage market facing General Manager most directly, in supporting the development and execution of the market strategies, including the development of market level Medicare Advantage product and network strategies, execution of pricing commitments, and management process to ensure development and execution of the plan. Continuously improve management practices to enable collaboration and shared accountability for success. Role will report to the Head of Medicare Performance Management.

Fundamental Components:
The ideal candidate will not only manage business processes, but also actively influence local market performance but help to shape and drive the markets bid strategy. The role will be an analyst of Medicare business performance, meaning that the role is expected to review both financial and medical economic information on their own, so as to be a self-guiding individual that can point to issues that need to be addressed and focused on. Helps to communicate focus activities on diagnosis i.e. unit cost / utilization / provider collab / revenue management. Drives execution of pricing commitments and corrective action plans. Creates a metrics driven management process that allows the segment to understand measured performance. to deliver on the strategic objectives, cost containment activity, growth objectives, and new initiatives to identify and pursue opportunities for further alignment across the Medicare Advantage market and segment leadership teams.The Lead Business Consultant role will be a liaison between senior management and local market leaders Identifies and leads process Improvement opportunities relating to Medicare Advantage Manages process for identification of areas to prioritize for performance improvement Reviews Key Performance Metrics, Helps to establish targets Brings segment/product priorities to the market for local execution.

Supports Local Market General Manager
Develop a project management framework for driving accountability
Developing monthly Quick Strike agenda and facilitate meeting and follow-ups
Management process such as Pricing Commitments, market visits, deep dives, performance/ scorecard and takeaways that align to execution of Strategy
Identifying, prioritizing and driving alignment opportunities across markets
Enables operating model for partnership with local General Managers, Director of Operations, CFOs, Medical Directors, Network Managers, Medical Economics, and Pricing Actuaries

Must have experience in the Medicare line of business
Experience in project management is preferred.
10+ years experience with several of the following methodologies: management consulting, project consulting, business process consulting, financial strategic analysis, mergers and acquisitions, strategic business planning, and/or risk management consulting.
Experience with enterprise-wide and/or cross-functional large scale initiatives with high degree of complexity.
Demonstrated experience successfully implementing change in complex organizations.
Demonstrated superior business process, project management and organizational redesign experience.
Demonstrated leadership with relevant initiatives: Business process, enterprise business project management/consulting, financial strategic planning and analysis, mergers and acquisitions, strategic planning, risk management.
Demonstrated relationship management skills at the senior level; capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously.

The highest level of education desired for candidates in this position is a Master's degree.

Management/Management - Medicare/7-10 Years
Finance/Financial analysis - P&L support/7-10 Years
Project Management/Plan management/7-10 Years
Management/Management - Process and quality improvement/7-10 Years

Database/SQL Server/1-3 Years/End User
Desktop Tools/Microsoft PowerPoint/1-3 Years/End User
Database/Hyperion Essbase/1-3 Years/End User
Database/Microsoft Access/1-3 Years/End User

Finance/Creating Profitable Partnerships/ADVANCED
Leadership/Collaborating for Results/MASTERY
Leadership/Developing and Executing Strategy/MASTERY

General Business/Communicating for Impact/MASTERY
Leadership/Engaging and Developing People/ADVANCED

This is an exciting opportunity to join a leadership team at one of the most compassionate and fastest growing companies in the Health Insurance Industry.

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 candidates'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.


Potential Telework Position:

Percent of Travel Required:
10 - 25%

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

Candidate Privacy Information:

Click To Review Our Benefits (PDF)


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.