Lead complex medical economics analyses supporting Non‑Participating (Non‑Par) pricing, No Surprises Act (NSA) compliance, audits, and strategic initiatives.
Translate highly technical data into clear insights for actuarial, legal, and business stakeholders.
Present key trends, financial performance, tools and analyses with a broad MEU audience.
Analyze, draw conclusions, and communicate the financial impact resulting from changes in Aetna’s network provider agreements.
Ensure pricing defensibility, regulatory compliance, and financial integrity.

Requirements

Bachelor's degree along with 3 - 5 years experience and knowledge of: Complex data collection, modeling & analysis.
Experience working with Excel and Web-based query tools (SQL, BigQuery, etc.).
Prioritizes & manages multiple projects while managing customer expectations and business priorities.
Work collaboratively and build relationships with customers.
Knowledge of: Extensive knowledge of managed care and how provider reimbursement policies relate to the control of medical claims costs.
Full comprehension of provider contracts and the potential impact the regulatory/legislative environment has on reimbursement strategies.
Understanding of internal and external database applications.
Knowledge of market-place delivery (understanding of provider relationships).

Benefits

Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access and many other benefits depending on eligibility.

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

data collectiondata modelingdata analysisfinancial analysispricing analysisregulatory complianceprovider reimbursement policiesprovider contractsExcelSQL

Soft Skills

communicationcollaborationproject managementcustomer relationship managementanalytical thinking