Medical Economics Senior Consultant Value Based Contracts

Aetna   •  

Hartford, CT

Industry: Healthcare

  •  

5 - 7 years

Posted 120 days ago

This job is no longer available.

POSITION SUMMARY
This position is responsible for providing analytical support for Aetnas value based contracts. Candidate will work collaboratively with business units across the Company providing medical cost and outcomes focused analytical research, financial modeling and business decision support reporting. The team is engaged in all aspects of the analytic lifecycle from contract negotiation through reconciliation & settlement, including report development and financial consulting support for provider partners.

Fundamental Components:
Provide analytical consulting in support of Aetnas value based contracting strategy. Provide analytical support for value based contract negotiations. Provide on-going analytical support for active value based contracts. Perform financial reconciliations as part of value based contracts. Create actionable financial projections, decision support models, and financial reporting for new and evolving products, programs and initiatives. Develop innovative analytics, insights and solutions for medical cost drivers and network design/provider reimbursement issues. Identify medical cost savings opportunities for provider partners to pursue.

BACKGROUND/EXPERIENCE desired:
5-8 years demonstrated leadership and project management experience.
Ability to manage conflicting priorities and multiple projects concurrently.
Strong analytical ability and familiarity with advanced financial and healthcare concepts.
Expertise in multiple areas of provider contracting/reimbursement, analysis, modeling & reporting.
Extensive & diverse knowledge of healthcare data, metrics & coding structures.
Able to make sound decisions to drive solutions.

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

FUNCTIONAL EXPERIENCES
Functional - Information Management/Medical economics/7-10 Years
Functional - Information Management/Provides analysis and support for planning and forecasting of medical costs/4-6 Years
Functional - Network Management/Contract negotiation/1-3 Years
Functional - Information Management/Utilizes and maintains pricing models and medical cost tracking tools/4-6 Years