Aetna Manager, Medical Underwriting (Small Group AFA) in Overland Park, Kansas
Req ID: 49201BR
Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe #WeJoinYou! We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come. Aetna s seeking a leader who wants to be part of this change on the Small Group Aetna Funding Advantage (AFA) team. This is a growing team. Come join the team to support Aetna's ability to achieve its financial and strategic goals through effective underwriting. Underwriting support primarily includes identifying, evaluating, and managing risk in order to maximize revenue, membership and earnings. As the Manager of Medical Underwriting you will help lead the team in the following components.
*Develops, documents and implements medical underwriting policy consistent with plan objectives
*Establishes procedures and develops workflow to ensure quality service and timely response to customers
*Develops and maintains contacts with professional associations and authorities in the medical field to facilitate the development of underwriting policy and standards
*Selects, trains and develops medical underwriting staff
*Conducts performance audits to assure correct interpretation and application of policy
*Underwrites complex medical questionnaires and/or medical records
*Assesses risks and makes sound underwriting decisions based on established criteria and/or medical judgments *Communicates with customers regarding the underwriting process
*Reviews all appeals and advises management of unusual situations
*Participates in analyzing trends in claim experience and recommends areas of underwriting criteria for review and modification
*May manage additional functions as part of overall functional responsibilities
*Participates in projects that have significant business-wide implications
*Engages in underwriting decisions with significant benefit implications
*Extensive pricing experience (5+yrs) via all types of pricing methodologies (manual, experience, blended, alternate, etc.) in medical underwriting.
*Solid knowledge of other benefit programs (life, disability, dental, medical, etc.) and financials thereof.
*Minimum of 3 - 5 years of medical underwriting experience with small group experience.
Previous management/leadership experience strongly preferred.Funding arrangements with knowledge of the Aetna systems supporting products and rating methodologies, is a plus.
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
Leadership/Driving a Culture of Compliance/ADVANCED
Leadership/Driving Strategic and Organizational Agility/ADVANCED
ADDITIONAL JOB INFORMATION
Interested in an Underwriting opportunity at Aetna? Join one of our upcoming virtual office hours with an Underwriting recruiter! Register here: http://aet.na/2FrGtmxAetna 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: Underwriting