29 days old

Director, Advanced Analytics (Fraud/Waste & Abuse)

Hartford, Connecticut 06156
  • Job Status
    Full Time

Additional Locations: Hartford, CT

POSITION SUMMARY

Critical role leading the Fraud analytics team while partnering with Aetna's Special Investigation Unit (SIU). This individual will provide consultative, advisory services and outcomes for Fraud project driven initiatives (i.e. waste & abuse, payment integrity).

Acts as a key subject matter analytics expert and thought leader for a small team with a purpose driven focus: to uncover fraudulent activity.

 

Fundamental Components:

Consults with internal clients to identify opportunities to implement data science solutions to business problems at an expert level.

Acts as an analytics product owner translating business needs into analytics projects and actions.

Understands and recommends modeling techniques to data scientists.

Ability to structure data analysis, driving analytics insights and analytical solutions to help data scientists determine the best analytical solution.

Understanding key drivers of healthcare business value and being able to translate into business opportunities and frame them as analytical problems. eg How to grow business

Ability to translate business problems into analytical solutions by knowing appropriate models to suggest to data scientists.

Autonomously leads the client relationship with senior business leaders as their single point of contact.

Collaborates with business partners to understand their strategy, problems, and goals.

Works with senior leaders to identify opportunities to implement analytics solutions to business problems.

Presents recommendations to senior staff and internal clients. Seen as the face of the organization.

Mentors junior team members.

Consults on the creation of analytics solutions that effectively weigh business and technical tradeoffs using an expert understanding of business strategy as well as relevant big data environment topics.

Acts as an analytics product owner translating business needs into analytics projects and actions.

Resolves issues and removes barriers that hinder analytics initiatives. Builds contingency plans and executes corrective action on a timely basis to mitigate risks.

Sets priorities and executes strategy for the analytics organization.

Leads development of solutions with high complexity and risk with business area implications.

Requirements

BACKGROUND/EXPERIENCE desired:

Minimum 10 years total healthcare analytics experience, in particular in Fraud (or Payment Integrity or Revenue Management)

5+ years experience strategy consulting or on strategy teams in large companies in Fraud Analytics

5+ years experience programming using R, Hadoop, or Python

5+ years of business experience leading analyses and initiatives with track record of business impact.

5+ years of people management experience Healthcare sector experience preferred

Demonstrates proficiency in most areas of mathematical analysis methods, machine learning, statistical analyses, and predictive modeling and in-depth specialization in some areas.

Experience in SAS or SQL or other programming languages.

Strong knowledge of advanced analytics tools and languages to analyze large data sets from multiple data sources.

Anticipates and prevents problems and roadblocks before they occur.

Demonstrates strong ability to communicate technical concepts and implications to business partners.

 

Education

Master's degree required, PhD preferred.

 

Location

NYC or Hartford

 

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.

 

 

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 to review the benefits associated with this position. 

 

Aetna takes our candidates'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.

 

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Click To Review Our Benefits (PDF)

Categories

Posted: 2018-10-19 Expires: 2018-11-19

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Director, Advanced Analytics (Fraud/Waste & Abuse)

Aetna
Hartford, Connecticut 06156

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