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Aetna is now a CVS Health Company

Analytic Consultant - Risk Adjustment and Encounter Data

Primary Location: Woodland Hills, CA
Additional Locations: CA-Santa Ana, CA-Woodland Hills
Applies initial experience from strategy consulting, analytics, or data engineering to contribute to the product ownership of analytics initiatives.

Fundamental Components:
  • Consults with internal clients to identify opportunities to implement data science solutions to business problems at a basic level.
  • Proficient at transforming data into actionable insight through data visualization.
  • Demonstrates familiarity with most areas of mathematical analysis methods, statistical analyses, and predictive and descriptive modeling and in-depth specialization in some areas.
  • Demonstrates familiarity with strategy consulting concepts.
  • Presents recommendations to manager of team.
  • Collaborates with one or more business partners to understand their problems and goals, develop predictive modeling, statistical analysis, data reports and performance metrics.
  • Consults on the creation of analytics solutions that effectively weigh business and technical tradeoffs using a basic understanding of business strategy as well as relevant big data environment topics.
  • Acts as an analytics product owner translating business needs into analytics projects and actions.
  • Leads development of analytics solutions with low complexity and risk.

Background Experience:
Health plan receives over 5 million encounter data records annually (full 837s). Position would work within the Medicare and ACA risk adjustment areas to support analytics of this data. Analysis would include data integrity, HCC coding value and opportunities for value creation. Product analysis to support provider strategies and engagement.
  • Strong knowledge of advanced analytics tools and languages to analyze large data sets from multiple data sources.
  • Experience analyzing medial claim data to finding trends and opportunities
  • Demonstrates proficiency in most areas of mathematical analysis methods, machine learning, statistical analyses, and predictive modeling and in-depth specialization in some areas.
  • Experience in SAS, SQL, Tableau or other programming languages required
  • 2 years of business experience leading analyses and initiatives with track record of business impact.
  • 1 year experience programming using R, Hadoop, or Python preferred
  • 2 years experience strategy consulting or on strategy teams in large companies
  • Minimum 3 years total business experience
  • Anticipates and prevents problems and roadblocks before they occur.
  • Healthcare sector and/or California HMO delivery system experience preferred
  • Demonstrates strong ability to communicate technical concepts and implications to business partners.
  • Bachelor’s degree in quantitative field, or an equivalent combination of formal education and experience.
  • Master's degree in quantitative field or MBA strongly preferred

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. 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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