Highly visible hands-on position supporting Aetna and joint venture Medicare MAPD and standalone PDP plans with subject-matter-expertise of pharmacy (Part D) benefits and administration. Support the Part D Product team on a daily basis with clear and accurate administrative guidance and abilities of internal legacy and Caremark PBM adjudication systems.
* Provide hands on knowledge and experience regarding ability to administer and adjudicate Part D plans/claims based upon unique product design
* Ability and knowledge to draft detailed business requirements for legacy internal systems and/or work with PBM vendor to share detailed business requirements
* Experienced hands-on user acceptance testing, including test plan design and execution
* Resolve gaps between existing and required administration/adjudication abilities through systems enhancements and/or workarounds to provide effective solutioning
* Support product implementation and system builds related to Part D benefit features
* Actively understand competitor administrative functionality and determine options to remain competitive
* Effectively communicate and negotiate priorities to assure Part D systems enhancements are budgeted/resourced consistent with business needs
* Must be well organized, self-starter, independent and motivated to support health plan partners
* Should be articulate and well versed in Part D pharmacy benefits - both Individual and Group
* Must have prior insurance and/or pharmacy benefit management (PBM) experience
* Must be proficient with Microsoft Office (Excel, PowerPoint, Outlook - minimum)
* Must have good decision-making skills - understand calculated risk
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
Marketing/Product development/1-3 Years
General Management/Product development/4-6 Years
Leadership/Lead a major product launch/1-3 Years
Information Technology/Testing/1-3 Years
Desktop Tools/Microsoft Word/4-6 Years/End User
Desktop Tools/Microsoft Outlook/4-6 Years/End User
Desktop Tools/Microsoft PowerPoint/4-6 Years/End User
Technical Experience/Technical Focus/4-6 Years/End User
General Business/Consulting for Solutions/ADVANCED
General Business/Ensuring Project Discipline/ADVANCED
Leadership/Collaborating for Results/ADVANCED
General Business/Demonstrating Business and Industry Acumen/ADVANCED
Leadership/Driving a Culture of Compliance/FOUNDATION
Service/Improving constituent-focused Processes/ADVANCED
Option to work-at-home part or full-time commensurate with experience and ability to demonstrate independence and self-starter work ethic.
ADDITIONAL JOB INFORMATION
Aetna Medicare is a leader in the Medicare industry and our diverse corporate structure provides an unique opportunity to access professionals with distinct experiences and perspectives nationally. Aetna offers competitive salary, benefits and an opportunity to expand your knowledge and experience in ways few corporations in this industry can compare.