As a Senior Consultant, you will review laws and regulations pertaining to Aetna Commercial business practices. The Senior Consultant will act as the Business Area Consultant for Claim and Call Policies to determine if the laws need to be documented in e.Policies for Claim and Call staff.
While the business is accountable for implementing the laws, the Senior Consultant is responsible for ensuring the documentation of that implementation and any required processing instructions in e.Policies.
As part of the e.Policies legislation team, you will be responsible for reviewing laws for a set of states. The Senior Consultant participates in workgroup calls pertaining to the laws and with the business areas as they determine how to implement the laws. Assisting with the documentation of the business area's implementation and obtaining business area signoff are critical to ensure correct documentation and publishing in e.Policies.
The position requires working collaboratively in inter-departmental settings to accomplish tasks and goals. This position also requires attention to detail, a focus on documentation, and the ability to handle multiple projects simultaneously.
Additional Responsibilities include:
- Completing assessments for all state laws for the states assigned
- Researching and responding to questions pertaining to state laws
- Utilizing strong written and verbal communication skillsets to ensure a strong end result
- Ensuring all deadlines are met and any issues are escalated to management as appropriate
- 4-6+ years of experience working with claims including claims processing, claims policy, or related experience
- Strong written and verbal communication skills
- Experience with Aetna commercial business practices
- Experience presenting in front of large groups of people
Associate's degree or equivalent experience
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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