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Medical Economics Senior Consultant

Primary Location: Phoenix, Arizona
Additional Locations: AZ-Phoenix, FL-Ft. Lauderdale, FL-Miami, FL-Sunrise
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Description:

Partner with business leadership by providing strategic insight using medical cost analytics. Responsible for the development and implementation of models to support future savings estimates, as well as actual achieved savings. Collaborate with the Actuarial department to understand drivers of emerging trends and potential impacts on future health care costs.



Fundamental Components:
Works cross-functionally within the Medicaid Business Unit toward achieving
operational targets. Develops and presents actionable recommendations to
management based on analysis. Presents highly complex information in a way
that multiple levels within an organization can understand and utilize to
make appropriate decisions to meet business objectives. Assists in
development/mentoring of less experienced team members. May assist in
providing direction of day to day activities. Leads the design, development,
and distribution of database tools and applications to efficiently measure,
monitor, and forecast medical cost structure.


Background Experience:
Strong analytical ability, creativity in solving problems, and familiarity with advanced financial and healthcare concepts
Understanding of key
medical insurance concepts and terminology, such as pricing methodology in
various settings (IP, OP, Lab, etc), utilization management, case management,
IBNR, etc., particularly as they relate to Medicaid
Demonstrated ability to consult directly with senior level
business partners, using analytics and experience to support the financial and operational goals of the business
Ability to clearly articulate complex ideas in meetings, presentations, email, and through the work product itself
Bachelor's Degree in
business, finance, math preferred or equivalent
work experience in the healthcare industry
Strong PC application skills (MS Office, SQL, Tableau)




Required Skills:
General Business - Consulting for Solutions, Finance - Delivering Profit and Performance, General Business - Turning Data into Information

Desired Skills:
Finance - Profit and Quality Vigilance, General Business - Demonstrating Business and Industry Acumen, General Business - Ensuring Project Discipline

Functional Skills:
Information Management - Medical economics, Information Management - Provides analysis and support for planning and forecasting of medical costs, Information Management - Researches overpayments and prepares projects for recovery, Information Management - Solutions consulting and decision support

Technology Experience:
Database - Intuit QuickBase, Database - Microsoft SQL Server, Desktop Tool - TE Microsoft Excel

Potential Telework Position:
Yes

Percent of Travel Required:
0 - 10%

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.

Click To Review Our Benefits (PDF)

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