Aetna Business Consultant in Fresno, California

Req ID: 52493BR


Bi-lingual Spanish liaison for integrated provider/ member engagement strategies (1) externally in the field, including end to end planning & execution member meetings, community & provider related activities strategically in collaboration with sales to ensure retention & return on investment is maximized; secures and manages services supporting local member activities with providers, community organizations, retailers, vendors, etc. (2) internally directs and facilitates consistent multi-disciplinary work groups to proactively address member issues

Documents project plans for leadership tracking, including operational processes & improvements, initiative planning, and outcomes

Supports external vendors, internal team members and/or matrixed staff as required for operational initiatives by transferring knowledge, best practices, methodology and tools. May be responsible for concurrent initiatives as team lead and/or team member, based on resource requirements. Also supports quality assurance of operations, member, provider & sales materials for compliance submissions as needed.

Fundamental Components:

  • Supports solutions development for Medicare operational issues impacting Star Ratings

  • Manages strategic project plans for key stakeholders (members, providers, sales, leadership)

  • Proactively identifies opportunities for process improvements and documents change rationale and business impact

  • Communicates detailed, concise results via written & verbal methods to empower stakeholders (members, providers, & internal depts.) in decision making regarding initiative opportunities

  • Conducts thorough operational business & external member/provider value analysis to determine selection, prioritization positioning and approach to maximize Medicare membership growth & retention in California

  • Drives or guides engagement using a disciplined repeatable methodology. Designs, develops interventions and facilitates work sessions, and follow-up. Develops and delivers all required analysis, reporting and presentation materials (*)

    Gathers, analyzes and synthesizes business intelligence to drive achievement of strategic business objectives (*) for growth & retention in assigned geographies

    Facilitates diverse internal and external networks, as appropriate, for data gathering and best practice identification (*)


  • 5+ years experience with one or more of the following in a Medicare health plan or related community, provider or clinical environment: sales account management, strategic analysis, marketing planning and execution, customer/member service, leadership/executive level projects, and/or strategic business planning

  • Experience with health plan project management initiatives & outcomes tracking moderate degree of complexity.

  • Operational experience in one or more relevant healthcare discipline such as customer service, sales, marketing, quality, business development, & provider engagement

    Demonstrated superior business process, project management and organizational redesign experience for membership growth and retention

    Demonstrated relationship management skills internal and external; capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously.


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


    Sales/California Health and Life Insurance License is required.


    Functional - Project Management/Project Manager/4-6 Years

    Functional - Sales & Service/Sales administration, support, reporting/1-3 Years

    Functional - Marketing/Communications/1-3 Years

    Functional - Customer Service/Customer service - transaction based environment/1-3 Years


    Technical - Aetna Applications/Aetna Directory Assistance/1-3 Years

    TechnicalExperience/TechnicalFocus/1-3 Years/Power User

    Technical - Desktop Tools/Microsoft Outlook/4-6 Years/End User

    Technical - Desktop Tools/Microsoft PowerPoint/4-6 Years/End User


    General Business/Communicating for Impact/ADVANCED

    General Business/Demonstrating Business and Industry Acumen/ADVANCED

    General Business/Ensuring Project Discipline/ADVANCED


    General Business/Applying Reasoned Judgment/MASTERY

    General Business/Consulting for Solutions/ADVANCED

    General Business/Maximizing Work Practices/ADVANCED

    Telework Specifications:

    Option for telework will be evaluated after 6-12 months in the position

    Not guaranteed & based on business need at time of evaluation


    Opportunity to support member advocacy and health plan initiatives improving the quality of lives of seniors in general and Hispanic market expansion/retention for Aetna in California

    An unprecedented opportunity to initiate, evaluate & implement robust, integrated healthcare improvement programs in the communities we serve

    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: Management