Bethesda, MD, United States
Req ID: 57130BR
Participate in multi-discipline team to develop innovative provider contracts that result in improved quality of care and cost for both commercial and Medicare Advantage lines of business. Apply rigorous analysis and financial discipline to evaluating opportunities and projecting outcomes.
-Partner with clinical, legal, infomatics and business partners to develop new VBC programs -Anticipate short and long term implication of programs including their interaction -Apply past program successes and failures to new program design -Mine data to look for opportunities that would benefit from value based programs and design program to tap into opportunity -Develop expected program benefit and ROI -Partner with legal to develop financial section of contract -Develop financial guidelines for contract parameters -Develop training materials
Bachelor's degree along with 10 years experience
Prior experience with provider contracts
Experience with Medicare Advantage preferred
Must have strong leadership qualities
Actuarial credentials are strongly preferred
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Actuarial/Fellow, Society of Actuaries is desired
Functional - Actuarial/Modeling & tool development/More Than 10 Years
Functional - Actuarial/Financial actuarial analysis/More Than 10 Years
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.
Job Function: Actuarial
Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.
Website : http://www.aetna.com
Aetna Inc. operates as a diversified health care benefits company in the United States. The company operates in three segments: Health Care, Group Insurance, and Large Case Pensions. The Health Care segment provides medical, pharmacy benefit management, dental, behavioral health, and vision plans on an insured basis, and an employer-funded or administrative basis. This segment also provides Medicare and Medicaid products and services, as well as other medical products, such as medical management and data analytics services, medical stop loss insurance, workers' compensation administrative services, and products that provide access to its provider networks in select markets. This segment offers its products and services to multi-site national, mid-sized, and small employers, as well as individual customers. The Group Insurance segment provides life insurance products comprising group term life insurance, voluntary spouse and dependent term life insurance, group universal life, and accidental death and dismemberment insurance; disability insurance products; and long-term care insurance products, which offer benefits to cover the cost of care in private home settings, adult day care, assisted living, or nursing facilities. This segment provides insurance products principally to employers that sponsor its products for the benefit of their employees and their employees dependents. The Large Case Pensions segment manages various retirement products, including pension and annuity products for tax-qualified pension plans. The companys customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups, and expatriates. Aetna Inc. was founded in 1853 and is headquartered in Hartford, Connecticut.