Aetna Senior Analyst in Phoenix, Arizona

Req ID: 43381BR

Candidate will work full time from the Phoenix, AZ office. No telework at this time.

POSITION SUMMARY

Creates and executes deliverables as part of a team assigned to a business. This position supports the Medicaid Encounter processes including new plan implementations, system upgrades, and regulatory changes by plan. The Analyst is responsible for defining the reporting requirements based on each state specifics and working with Data Base Analysts to ensure the report requirements are met. Proactively defines, identifies, develops and implements information products to support business strategic and operational planning. Assists in the development of and participates in the presentation to existing and prospective customers and internal business areas.

Fundamental Components:

Prepare, validate, submit, load, and log 837 encounter files and 277, 824, 999, NCPDP response files in accurate and timely manner according to state and federal regulations.

Monitors, reviews, researches, reconciles and balances designated Aetna system activity.

Resolves problems in a timely and effective manner.

Leads or acts as a business technical expert in the design of new applications or enhancements including integration of solutions.

Uses designated systems to obtain information. Understands the impact of actions on system primarily used/maintained. Understands relationships of designated systems.

Analyzes and verifies system results to ensure accuracy, accountability and financial data integrity.

Possesses working knowledge of functions of other units in department Responds to and resolves customer inquiries and complaints (internal as well as external) both verbal and written correspondence within established unit objectives.

BACKGROUND/EXPERIENCE desired:

Bachelor's Degree is REQUIRED.

Medical/Healthcare claims experience would be preferred,

SQL, QNXT experience is preferred.

Analyzes and resolves system error conditions within established unit time frames.

Participates as a member of a project team.

Analyzes and recommends solutions to non-standard requests and requirements from plan sponsors and areas within and outside the area.

EDUCATION

The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.

FUNCTIONAL EXPERIENCES

Functional - Information Technology/Application development/1-3 Years

Functional - Information Management/Data acquisition, data management, programming and documentation/1-3 Years

Functional - Information Technology/Research/1-3 Years

Functional - Claims/Reporting & special services/1-3 Years

Functional - Information Management/Query and Database Access Tools/1-3 Years

TECHNOLOGY EXPERIENCES

Technical - Database/SQL Server/1-3 Years/Power User

Technical - Database/Crystal Analysis/1-3 Years/Power User

Technical - Aetna Applications/QNXT/1-3 Years/End User

REQUIRED SKILLS

General Business/Communicating for Impact/ADVANCED

General Business/Turning Data into Information/ADVANCED

Technology/Leveraging Technology/FOUNDATION

DESIRED SKILLS

General Business/Applying Reasoned Judgment/FOUNDATION

General Business/Maximizing Work Practices/ADVANCED

ADDITIONAL JOB INFORMATION

Strong problem solving and communication skills

SQL Experience a plus

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: Health Care