Aetna Business Analyst in Phoenix, Arizona
Req ID: 41631BR
Reporting to the Manager of Configuration Solutions Reimbursement Administration (CSRA), this position is responsible for executing the activities of the Health Plan Reimbursement Administration (HPRA) department, including, but not limited to, research, analysis, file maintenance, project execution and project closure of assigned health plans.
Extensive knowledge of health care claims, coding, systems, fee schedules and reimbursement methodologies
Excellent written and verbal communication skills
Strong attention to detail, organizational abilities and ability to work independently
Solid computer skills including Word, Excel, ACCESS and SQL
Proficient data query design and analytical skills
Must possess sound knowledge of structured IT application development lifecycles, methodologies inclusive of Use Case tools.
Ability to successfully interact with members, medical professionals and health plan and government representatives.
3+ years Business Analyst experience.
The highest level of education desired for candidates in this position is a Associate's degree or equivalent experience.
Functional - Information Management/Analyzes all types of capitated and fee-for-service provider contracts, performs variance analysis/1-3 Years
Functional - Information Management/Develops provider compensation and fee schedules/1-3 Years
Functional - Information Management/Business information analysis/1-3 Years
Functional - Finance/Audit - system development/1-3 Years
Functional - Administration / Operations/Document production & distribution/1-3 Years
Technical - Aetna Applications/QNXT/1-3 Years/End User
Technical - Database/Microsoft Access/1-3 Years/End User
Technical - Desktop Tools/Microsoft SharePoint/1-3 Years/End User
Technical - Operating Systems/Windows 2003/1-3 Years/End User
General Business/Applying Reasoned Judgment/FOUNDATION
Leadership/Collaborating for Results/FOUNDATION
General Business/Turning Data into Information/ADVANCED
Leadership/Driving a Culture of Compliance/FOUNDATION
Considered only for current internal teleworkers (in any area)
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 candidate'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: Information Technology