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Plan Builder

Primary Location: Plymouth, MN
Additional Locations: FL-Tampa, IN-Evansville, MI-Lansing, MN-Plymouth, NY-Amherst
Responsible for directing all aspects of product plan implementation. Partners with key stakeholders (i.e., sales/service staff, consultants, plan sponsors and other internal business units) to proactively identify and address critical implementation issues ensuring customer expectations are consistently satisfied or exceeded and ensuring Consumer Fund Services profit objectives.

Fundamental Components:
  • Reviews benefit provisions to ensure compliance with state and federal mandates. Evaluation process may also include assessment of summary plan descriptions and other related documents prepared internally or externally by clients.
  • Uses business knowledge and experience to make plan design and pricing recommendations when working with prospective customers.
  • Evaluates impact of client requested exceptions and develops reasonable alternatives to satisfy client’s needs while minimizing impact on Meritain’s system and operations; Identifies, communicates and tracks cost sensitive items not included as part of the standard process and highlights them for consideration in the determination of rate adjustments or renewal activity.
  • Collaborates on review, analysis and development of recommendations for the design of complex account and benefit structures based on customers’ objectives and Meritain’s system.
  • Executes system setup and mapping of client level benefits to align with industry coding (ICD 10, Place of service, Healthcare Reform, etc.)
  • Solicits and assesses internal and external customer feedback to enhance continuous quality improvement on the implementation process (ie. System tools, resources, etc.)
  • Facilitating client call to review benefits

Background Experience:
  • Healthcare industry experience (Customer Service, Claims, and or Plan Build preferred)
  • Detail oriented
  • Highly organized
  • Good communication skills

Additional Job Information:
  • The person placed in this role will have an opportunity to work directly with internal and external partners to translate client intent to systematic administration of their plan benefits.
  • This person should be highly organized and able to quickly prioritize multiple assignments with high quality results.
  • This person should have good communication skills with the ability to express complex concepts in a clear and concise manner.
  • This person should have a high attention to detail and accuracy while focusing on overall project deliverables.
  • This person should have the ability to remain flexible yet focused during stressful situations.
  • This person should possess good analytical and problem solving skills.

Required Skills:
General Business - Communicating for Impact, General Business - Consulting for Solutions, General Business - Ensuring Project Discipline, Leadership - Collaborating for Results, Leadership - Driving a Culture of Compliance

Potential Telework Position:

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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