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SAI Management

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

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

Project Management responsibilityfor the end to end process related to opportunity ideation and discovery,validation and analytics supporting all commercial and Medicare business segments.

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



Fundamental Components:



Educates business and technical
resources on purpose and value of quality and cost metrics and assists in
interpretation to solve problems and improve outcomes




Monitors market level metrics and
performance for utilization, market level medical cost, premiums, financial
results, etc. to identify trends




Coordinates tracking and execution
of trend mitigating action items in collaboration with Network Management,
Medical Management and Medical Economics Unit (MEU)




Responsible for supporting the
network leader through the network 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 the business and in the external health care environment.




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






Background Experience:



5+ years’ experience in healthcare
analytics role.




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




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




Demonstrated relationship
management skills at peer levels within an organization and external
constituents




Advanced technical, analytic and
consultative skills, extensive knowledge of health care data and information
systems, as well as an understanding of health care benefits, health care
financing and health care delivery systems




Advanced proficiency in excel and
power point





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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