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Manager, Medical Underwriting - Atlanta, GA #3756817

Company: Aetna

Date: 08/13/2017

Category: Computer Software

City: Atlanta, GA

Req ID: 44714BR


POSITION SUMMARY


Aetna is looking for Manager, Medical Underwriting for one of their growing new business teams in the AFA. 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.


Fundamental 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


BACKGROUND/EXPERIENCE desired:


*Extensive pricing experience via all types of pricing methodologies (manual, experience, blended, alternate, etc.)


*Funding arrangements with knowledge of the Aetna systems supporting products and rating methodologies, preferred.


*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.


EDUCATION


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


REQUIRED SKILLS


Technology/Leveraging Technology/ADVANCED


Leadership/Driving a Culture of Compliance/ADVANCED


Leadership/Driving Strategic and Organizational Agility/ADVANCED


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: Underwriting


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