Medical Economics AnalystPrimary Location: Plano, Texas
Additional Locations: CA-Walnut Creek, CT-Hartford, GA-Atlanta, NC-Cary, PA-Cranberry, TX-Plano Apply
|We are seeking an analytical professional to join our Medical Economics - Medical Expense Review (MER) team. The primary goals of this team are to develop, interpret and favorably impact local market medical cost trend and provide analysis and network actions leading to medical cost improvement. This position will provide consultative support and medical cost based analysis of markets and network initiatives.|
57903Fundamental Components: Analyze and research medical costs drivers. Support the development of scoreable action items by identifying outlier cost issues. Consult with network and clinical management on opportunities to improve company’s discount position and strategic cost and utilization initiatives. Perform drill-down analysis to identify medical cost trend drivers; advise network of contracting opportunities to mitigate future trends. Own, track and document all aspects of related work from beginning to end of a project. Background Experience: Applicants must have relevant analytical financial experience. An understanding of the healthcare industry is preferred. Familiarity with key managed care functions including provider contracting, benefit design, medical management as well as knowledge of business functions and impact on financials (underwriting, sales, product development, network management) is also strongly preferred. Minimum of 1-2 years’ experience in the managed care industry with knowledge of provider contracting, provider reimbursement, patient management, product and benefits design. Advanced skills in Excel, MS-Access and Web-based query tools (MCM, data warehouse) preferred. Ability to learn new technologies. Strong analytical ability and familiarity with advanced financial and healthcare concepts. Demonstrates critical thinking and expresses ideas clearly, concisely and logically from a cross functional perspective. Ability to manage conflicting priorities and multiple projects concurrently. Demonstrates initiative, innovation and leadership in achieving results. Potential Telework Position: Yes Percent of Travel Required: 0 - 10%
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.