Project Manager

Aetna Inc. Tampa, FL
Job Description

POSITION SUMMARY

Accountable for and manages the development, implementation and ongoing maintenance of project(s) in support of our third party audits and client engagements. Accountable for defining scope and meeting project deliverables, turn around times, audit closure/ corrective action plans, engagement resolution following on-site client audit. Project scope typically impacts one of the following: process, system, function, and/or products.

Fundamental Components:

The Audit Project Manager will facilitate and manage audit on-site or virtual third party audit claim reviews supporting our contractual client requirements. The ideal candidate will understand the relationship of a client's third party audit firm and process improvements, possessing a thorough knowledge of claim processing and audit techniques to drive closure to each audit engagement. Requirements include, drafting and issuing official organizational responses to identified client or audit firm concerns or opportunities and collaboration with internal departments to drive resolution and necessary corrective measures when appropriate at the conclusion of the audit.

BACKGROUND/EXPERIENCE desired:

3-5 years related work/audit/client experience.

Proven track record meeting project dates, production and qualitymetrics

1-2- years claim processing and adjustment experience

2-3 years healthcare audit experience

Excellent verbal and written communication skills

EDUCATION

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

LICENSES AND CERTIFICATIONS

Quality Assurance/ is desired

Audit/ is desired

Insurance/ is desired

Risk Management/ is desired

FUNCTIONAL EXPERIENCES

Functional - Quality Assurance//1-3 Years

REQUIRED SKILLS

Service/Working Across Boundaries/FOUNDATION

Leadership/Collaborating for Results/FOUNDATION

General Business/Demonstrating Business and Industry Acumen/FOUNDATION

DESIRED SKILLS

General Business/Applying Reasoned Judgment/ADVANCED

Leadership/Fostering a Global Perspective/FOUNDATION

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.