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SAI Management

Primary Location: Seattle, Washington
Additional Locations: ID-Boise, OR-Portland, WA-Seattle
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Description:

Position Summary:

Responsible for identifying, executing and monitoring trendmitigating initiatives across local network and medical management operations for the PNW market.

Project Management responsibility for the end to end processrelated to opportunity ideation and discovery, validation and analytics supporting all commercial and Medicare business segments.

Collaborates with Network, Medical Management, MEU , Financeand Actuarial teams in the PNW to convert insights into data that is actionable.

Job Responsibilities:

Educates business and technical resources on purpose andvalue of quality and cost metrics and assists in interpretation to solveproblems and improve outcomes

Monitors market level metrics and performance forutilization, market level medical cost, premiums, financial results, etc. toidentify trends

Coordinates tracking and execution of trend mitigating actionitems in collaboration with Network Management, Medical Management and MedicalEconomics Unit (MEU)

Responsible for supporting the network leader through thenetwork strategy development process by leveraging network design tools

Provides insights to Network Management team to help inform network strategy based on insights and observations

Supports Medical Economics Review process on behalf of Local Network team

Ability to effectively communicate and negotiate across thebusiness and in the external health care environment.

Provides leadership in negotiation support and ability toinfluence sound business decisions based on data, results and informationderived from industry trends, research findings, and Aetna-specific reports and analyses

Background/Desired Experience:

5+ years’ experience in healthcare analytics role.

Deep knowledge of health care industry, policy, researchdesign, statistical analyses, predictive modeling, provider reimbursementmethods, case-mix and risk adjustment methods and tools

Demonstrated experience developing analysis, presentationsand support material to successfully implement strategy or change initiatives.

Demonstrated relationship management skills at peer levelswithin an organization and external constituents

Advanced technical, analytic and consultative skills,extensive knowledge of health care data and information systems, as well as anunderstanding of health care benefits, health care financing and health caredelivery systems

Advanced proficiency in excel and power point

Education:

The highest level of education desired for candidates inthis position is a Bachelor's degree or equivalent experience.

Additional Job Information:
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.







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

Click To Review Our Benefits (PDF)

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