Aetna Insurance Jobs – Senior Consultant

Job Description:

At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

Job Responsibilities:

• Provides consultation on the design, testing and enhancement of information product including technical assistance and product development support to external and internal customers.
• Researches, manipulates and prepares complex data to document program activities and reports on its results.
• Provides oversight to data quality and provides feedback to various areas in order to improve service delivery and enhancement to design efforts.
• Develops a consultative relationship with internal/external customers.
• May lead or act as a business technical expert with the planning, development and validation of master or detail test plans and strategies.
• Performs ongoing research, and support tasks for existing systems.
• Leads or acts as a business technical expert in the design of new applications or enhancements including integration of solutions.
• Provides Leadership/Coaching/Mentoring; may be a mentor to others.
• Directs the implementation of program specific information through education, technology, organizational methods and procedures.
• Influences enhancements to business processes and system infrastructure to improve data quality availability and access.
• Manages customer contact and participates in internal and external health industry development efforts (e.g., performance measurements).
• Analyzes complex data for trends, highlights in-depth interpretations and provides in-depth root cause analysis.
• Consults with client on a regular basis to ensure progress is in line with customer’s expectations and to obtain additional information as needed.
• Translates complex data into constructive data and information and makes recommendations.
• Defines, identifies, develops and implements information products to support strategic business and operational planning.
• Illustrates complex information in a clear concise manner.
• Develops and conducts presentations and consultations to existing and prospective customers and internal business areas.
• Provides workgroup support on projects.
• Educates customer on the value, use and interpretation of information product.
• Influences changes/enhancements to business processes, policies, and system infrastructure to improve information quality, availability and access.

Job Requirements:

• 6+ Months Working experience reading and understanding claims.
• Working knowledge of reading and reviewing claim and coding types.
• 6+ Months Excel.
• 6+ Months QNXT.
• Excellent verbal and written communication skills.
• Remedy (Ticket Tracking) experience is a plus.
• MS Office (Word, Access DB and Info Path etc.)
• MS SQL experience is a plus.
• Extensive experience with databases as well interpretation and manipulation of related data.
• Healthcare background.
• 3-5+ years of data interpretation and analysis experience.
• Bachelor’s degree, technical certification or equivalent work experience.
• Associate’s degree or equivalent experience

Job Details:

Company: Aetna

Vacancy Type:  Full Time

Job Location: Phoenix, AZ, US

Application Deadline: N/A

Apply Here

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