Aetna Manager- Medical Underwriting in Blue Bell, Pennsylvania
Req ID: 36856BR
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
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 via all types of pricing methodologies (manual, experience, blended, alternate, etc.) and funding arrangements with knowledge of the Aetna systems supporting those products and rating methodologies. Minimum of 3-5 years of experience preferred. Strong reporting and analytical skills Current/previous experience in a leadership, management and/or training capacity Solid technical skills/abilities to learn and work with various systems as part of the role
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
Alternative work locations:
Atlanta,GA 30328---1100 Abernathy Rd, NE Bldg 500
Hartford, CT - 151 Farmington Avenue, Rogers Bldg
Overland Park, KS 66210 - 9401 Indian Creek Parkway
ADDITIONAL JOB INFORMATION
Solid knowledge of other benefit programs (life, disability, dental, medical, etc.) and financials thereof.
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.
Click here to review the benefits associated with this position.
Job Function: Underwriting