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Medical Economics Analyst

Primary Location: Phoenix, AZ
Additional Locations: AZ-Phoenix
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Description:
The Medical Economics Consultant retrieves, organizes and performs analysis on data, is actively involved in decision making process to provide results against plan objectives.

Fundamental Components:
Analyzes basic types of capitated and fee-for-service provider contracts and presents results against budgets and benchmarks, performs variance analysis. Produces ad hoc reports to satisfy information needs across products/segments and markets. Develops provider compensation and fee schedules. Utilizes, maintains and develops pricing models and medical cost tracking tools. Provides analysis and support for planning and forecasting of medical costs including the development of gross medical trend estimates. Identifies overpayments and prepares projects for recovery. Determines general strategy presentation of hospital charge master reports to implement rate adjustments. Works cross-functionally within the region and supports achievement of regional operating plan targets. Provides network cost support to sales and marketing in the "Request for Proposal" process.

Background Experience:
Bachelor's Degree in business, finance, math, or related field preferred, or 3 to 5 years equivalent work experience in the healthcare industry. Ability to manage conflicting priorities and multiple projects concurrently. Strong analytical ability and familiarity with advanced financial and healthcare concepts. Advanced software and programming skills will be required, particularly SQL and Excel.

Additional Job Information:
A highly motivated candidate will have opportunities to develop knowledge of the Medicaid segment, to work with pharmacy and medical claim data, to interact with health plan leadership, and to enhance technical skills.

Required Skills:
Finance - Delivering Profit and Performance, General Business - Communicating for Impact, General Business - Consulting for Solutions

Functional Skills:
General Management - Data analysis & interpretation, General Management - Data tools: building & utilization, Information Management - Medical economics

Technology Experience:
Database - Microsoft SQL Server, Desktop Tool - TE Microsoft Excel, Development Language - Microsoft TSQL/OSQL

Potential Telework Position:
No

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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