36 jobs found in blue bell

Aetna Description: Responsible for conducting audits of current processes, reports, and procedures to identify process improvements and issue resolutions. Develops and conducts medical management staff training based on outcomes of clinical audits. 65174 Fundamental Components: Provides ongoing and random qualitative and quantitative analysis of the business process, clinical systems, tools, and staff competencies using organizational performance measurements to ensure compliance with government regulations and corporate policy. Reviews and evaluates internal controls are in place to ensure ongoing compliance. Identifies, documents, and reports any transaction errors in a timely manner to ensure prompt resolution. Tracks and trends audit results, providing feedback to management. Recommends corrective action and facilitates the implementation of remedial and process improvement plans. Develops and conducts medical management staff training based on outcomes of clinical audits. Implements training programs to increase role specific consistencies and efficiencies related to process work flows. Measures outcomes of clinical staff training and identifies key findings to ensure effective alignment of training content and method of delivery with business objectives and staff performance requirements. Promotes continuing compliance with accreditation and/or applicable regulatory body requirements including but not limited to: company's ethical, fraud, abuse, and compliance policies and expectations, utilization management policies, procedures and workflows, key accreditation standards, and HIPAA regulatory standards related to use of PHI. Facilitates communication of relevant findings to corporate Compliance Department and/or Corporate Privacy/Security Officer. Performs other duties as required. Background Experience: Excellent verbal and written communication skills. Experience in designing, developing, and instructing training programs. Ability to use standard corporate software packages and corporate applications. Previous (3-5+ years) experience in a managed care clinical operations environment (case management and specialty programs) required. Strong data analysis and report preparation skills. A current clinical license in the state where job duties are performed is required based on the clinical sector supported and may include any of the following: RN.Required Additional Job Information: This is an exciting time to join the Training & Quality Clinician team. We are inspired to make a difference, and we are committed to integrity and clinical excellence. We strive to work together as a team to enhance the quality of services rendered by our staff. Required Skills: Leadership - Collaborating for Results, Leadership - Driving a Culture of Compliance, Technology - Leveraging Technology Desired Skills: General Business - Applying Reasoned Judgment, General Business - Communicating for Impact, General Business - Consulting for Solutions Functional Skills: Nursing - Case Management, Nursing - Discharge Planning, Nursing - Medical-Surgical Care Technology Experience: Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft PowerPoint, Desktop Tool - Microsoft Word, Desktop Tool - TE Microsoft Excel Education: Nursing - Registered Nurse Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: 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.

Merakey is currently seeking Technical Services Analyst to join our Merakey IT division name in our Blue Bell, PA location in Montgomery County. POSITION OVERVIEW As part of End User Support within IT Support Services, the Technical Services Analyst role is to provide 2ndlevel IT support and guidance for all Merakey end user assets. This would include resolving support requests, as well as meeting customer satisfaction and continuous service delivery demands. Responsibilities include but are not limited to the following. Answers and responds to inbound calls, emails, or chats using documented procedures, available tools and supplied script(s) to assess customer's technical support needs and handle/route accordingly to the satisfaction of the customer Verifies all contact information Creates/Updates/Resolves incidents or service requests within supplied IT Service Management System Documents problem definition Documents and logs all contacts and actions into tickets per specified guidelines Files appropriate data (soft and hard copies) Provides direction to customers promoting online self-service and web based solutions Creates temporary "work-around" for immediate customer issues when appropriate Serves as escalation point for computer related service center requests Maintains and deploys Merakey standard computer images Maintains Merakey Asset and Software Inventory Create and maintain hardware and software test scripts Works with IT procurement to purchase hardware and software Work with vendors to resolve technical issues Provides software and system troubleshooting, maintenance, support and resolve remotely, over the phone or at desk side Installs, upgrades and configures applications, software and related hardware (such as desktops, laptops, tablets, related peripherals such as printers, scanners, drives, monitors and video teleconferencing and software such as Windows OS and Office) Provides technical support and training to end-users and internal IT analysts Maintains current knowledge of relevant technology and recommends future growth hardware and software specifications Prepares activity reports as requested by management Communicates recurring issues to management Remains knowledgeable of performance requirements and IT service offerings Adheres to service level agreements with customers and business partners Maintains awareness of and compliance with all Merakey personnel policies Achieves specified performance goals Travel to off-site programs up to 60-75% of the time Participates in special projects as required Additional responsibilities as required MERAKEY IS PROUD TO OFFER THE FOLLOWING BENEFITS Work/Life Balance Competitive Compensation Plans Opportunities for professional growth and advancement Medical, Dental, and Vision Insurance Plans Flexible Spending Accounts Short/Long Term Disability Coverage Life Insurance 403B Retirement Plan (with company matching) Marketplace Savings Program Employee Assistance Program Wellness Programs 24-Hour Nurse Hotline Tuition Reimbursement Generous Paid Time Off (for qualifying positions) Stability that coincides with working for a national leader in education and human services ABOUT MERAKEY Merakey is a leading developmental, behavioral health and education provider offering a breadth of integrated services to individuals and communities across the country. We leverage our size and expertise to develop innovative solutions and new models of care to meet the needs of individuals, their families, public and private healthcare funders and community partner organizations. We recognize that complex needs require a holistic approach. With our experience, expertise and compassion, we empower everyone within our communities to reach their fullest potential. With a rich tradition spanning 50 years with nearly 10,000 employees, Merakey provides care to over 40,000 adults and children throughout Pennsylvania, New Jersey, New York, Maryland, Delaware, Louisiana, Michigan, Texas, California, and Tennessee. For more information on Merakey and our various divisions, please visit: www.merakey.org Merakey is an Equal Opportunity Employer! APPLY TODAY www.merakey.org/careers Requisition # 48614

Merakey is currently seeking a Full Time 37.5 hour Telecom Technician to join Merakey in our IT department based in Harrisburg, PA. POSITION DETAILS The Telecom Technician answers and responds to inbound calls, emails, or chats using documented procedures, available tools and supplied script(s) to assess customer's telephone support needs and handle/route accordingly to the satisfaction of the customer. Responsibilities include but are not limited to the following. Verifies all contact information Creates/Updates/Resolves incidents or service requests within supplied IT Service Management System. Documents problem definition Documents and logs all contacts and actions into tickets per specified guidelines Creates temporary "work-around" for immediate customer issues when appropriate Install and troubleshoot voice/data cabling in commercial/residential sites. Place orders and disconnects of voice circuits. Assists in project planning bid preparation site surveys and coordination and execution. Maintains Merakey phone system inventory. Create and maintain voice mailboxes. Provides software, hardware and cable troubleshooting, maintenance, support and resolve remotely, over the phone or on- site Installs, upgrades and configures phones systems. Maintains current knowledge of relevant technology and recommends future growth hardware and software specifications. Works with IT procurement to purchase hardware and software. Work with vendors to resolve technical issues. Prepares activity reports as requested by management. Communicates recurring issues to management. Remains knowledgeable of performance requirements and IT service offerings Adheres to service level agreements with customers and business partners Maintains awareness of and compliance with all Merakey personnel policies Achieves specified performance goals Travel to off-site programs up to 80% of the time. Assists Network and Technical Service teams with deployment of equipment. Participates in special projects as required Additional responsibilities as required WHAT MERAKEY HAS TO OFFER Work/Life Balance Competitive Compensation Plans Opportunities for professional growth and advancement Medical, Dental, and Vision Insurance Plans Flexible Spending Accounts Short/Long Term Disability Coverage Life Insurance 403B Retirement Plan (with company matching) Marketplace Savings Program Employee Assistance Program Wellness Programs 24-Hour Nurse Hotline Tuition Reimbursement Generous Paid Time Off (for qualifying positions) Stability that coincides with working for a national leader in education and human services  ABOUT MERAKEY Merakey is a leading developmental, behavioral health and education provider offering a breadth of integrated services to individuals and communities across the country. We leverage our size and expertise to develop innovative solutions and new models of care to meet the needs of individuals, their families, public and private healthcare funders and community partner organizations. We recognize that complex needs require a holistic approach. With our experience, expertise and compassion, we empower everyone within our communities to reach their fullest potential. With a rich tradition spanning 50 years with nearly 10,000 employees, Merakey, formerly NHS, provides care to over 40,000 adults and children throughout Pennsylvania, New Jersey, New York, Maryland, Delaware, Virginia, Louisiana, Michigan, California, Ohio and Tennessee. Merakey is an Equal Opportunity Employer! APPLY TODAY www.merakey.org/careers Requisition # 46702  

Position Summary: Merakey is seeking a Senior Director of Recruiting who will be responsible for the overall management and implementation of Merakey's in-house full life cycle staffing department elevating Merakey to an "Employer of Choice." The Sr. Director of Recruiting will lead partnerships with Merakey Service Lines, Operations, and Marketing to deliver "best in class" Staffing Services. The Sr. Director of Recruiting will develop a strategic and proactive approach to supporting Merakey's programs and 10,000+ workforce that are located across multiple states, within a Union and Non-Union environment. This position will be based out of our Blue Bell, PA location and report directly to the Sr. VP of HR.   Duties include, but are not limited to: Works closely with trainers and educators to ensure implantation of company-wide orientation. Facilitate effective talent acquisition discussions with leaders and help them forecast their talent needs in line with business strategy. Responsible for advertising, hiring policies and procedures, candidate sourcing, diversity in applicant pools, recruiting, selection and hiring. Keep abreast of talent acquisition trends and best practices and share knowledge across the organization. Continually looks for opportunities to improve the new hire experience and proactively seeks out new and creative ways of improving the onboarding program. Works along other key members of the HR leadership team to positively impact recruitment and retention. Strives to create a recruiting team with the philosophy of hiring the right "fit". Stays on top of trends and innovations in the Recruiting arena. Ability to grow and develop Recruiting managers and Recruiters within the Department. Proven success building a strong, productive recruiting program. Knowledge of federal, state, and local laws governing employment policies and practices.

Merakey is seeking a Senior IT Project Manager to join our IT Division team in Blue bell, PA . POSITION OVERVIEW The Senior IT Project Manager responsibilities include, but are not limited to the following: Lead the development and implementation of a broad, coordinated set of plans and programs to meet the goals and priorities of the department. Cultivate contacts with client planners or developers -- to obtain information about future client developments in the functional areas and to try to influence those developments in ways favorable to MERAKEY Continuously improve project management toolkits and methodologies used within MERAKEY IT and MERAKEY. Provide expertise and consulting to project managers in the process of project management and in the softer skills of team dynamics, team building and group motivation. Lead planning and/or implementation of projects. May participate in the design and/or testing phases. Facilitate the definition of project missions, goals, tasks, and resource requirements; resolve or assist in the resolution of conflicts within and between projects or functional areas; develop methods to monitor project or area progress; and provide corrective supervision if necessary. Responsibility for assembling the project staff; for their technical or functional development, performance, and/or termination during the project or projects. Manage project budget and resource allocation. Facilitate the definition of service levels and customer requirements. Interact regularly with existing or potential clients to determine their needs and to develop plans for improving delivery. Advocate on behalf of clients and represent clients' needs as appropriate to senior management. Work cross-functionally to solve problems and implement changes. Follow a defined, agreed upon project management methodology. Present oral and written reports defining plans, problems, and resolutions to appropriate levels of management. Conduct training as needed. Other related duties, as assigned. MERAKEY IS PROUD TO OFFER THE FOLLOWING BENEFITS Work/Life Balance Competitive Compensation Plans Opportunities for professional growth and advancement Medical, Dental, and Vision Insurance Plans Flexible Spending Accounts Short/Long Term Disability Coverage Life Insurance 403B Retirement Plan (with company matching) Marketplace Savings Program Employee Assistance Program Wellness Programs 24-Hour Nurse Hotline Tuition Reimbursement Generous Paid Time Off (for qualifying positions) Stability that coincides with working for a national leader in education and human services ABOUT MERAKEY Merakey is a leading developmental, behavioral health and education provider offering a breadth of integrated services to individuals and communities across the country. We leverage our size and expertise to develop innovative solutions and new models of care to meet the needs of individuals, their families, public and private healthcare funders and community partner organizations. We recognize that complex needs require a holistic approach. With our experience, expertise and compassion, we empower everyone within our communities to reach their fullest potential. With a rich tradition spanning 50 years with nearly 10,000 employees, Merakey provides care to over 40,000 adults and children throughout Pennsylvania, New Jersey, New York, Maryland, Delaware, Louisiana, Michigan, Texas, California, Virginia, Ohio and Tennessee. APPLY TODAY at www.merakey.org/careers Requisition 47933 Merakey is an Equal Opportunity Employer

Merakey is currently seeking a Service Center Analyst to join our IT Division in our Blue Bell, PA location in Montgomery County. Pay Rate up to 17.43 per hour POSITION OVERVIEW As part of End User Support within IT Support Services, a Service Center Analyst is responsible for answering telephone calls and emails from Merakey employees that require technical support. Through the use of remote access tools, an analyst identifies the cause of hardware/software issues and guides the user to a successful resolution. All work must be documented in a timely manner in the ticketing system application utilized by IT Support Services. Through these tickets, a Service Center Analyst will be able to monitor the status of unresolved issues and communicate frequent updates with users. This role is considered as the Merakey front line support and the face of IT. Service Center Analysts will solve level 1 technical problem and provide support for all assigned areas. The goal is to make sure that customer value is maintained to the standards set forth by the company. Answers and responds to inbound calls, emails, or chats using documented procedures, available tools and supplied script(s) to assess customer's technical support needs and handle/route accordingly to the satisfaction of the customer Verifies all contact information Creates tickets within supplied IT Service Management System Documents problem definition Documents and logs all contacts and actions into tickets per specified guidelines Files appropriate data (soft and hard copies) Provides direction to customers promoting online self-service and web based solutions Creates temporary "work-around" for immediate customer issues when appropriate Serves as escalation point for eService requests Escalates unresolved customer issues to Technical Services with concise description, actions, and traces as required for escalation Provides customers with existing Service Request status and triages call appropriately Handles RMA issuance and guidance Reset customer passwords Prepares activity reports as requested by management Communicate recurring issues to management Remains knowledgeable of system information, changes and updates Remains knowledgeable of performance requirements and IT service offerings Adheres to service level agreements with customers and business partners Maintains awareness of and compliance with all Merakey personnel policies Achieves specified performance goals Additional responsibilities as required MERAKEY IS PROUD TO OFFER THE FOLLOWING BENEFITS Work/Life Balance Competitive Compensation Plans Opportunities for professional growth and advancement Medical, Dental, and Vision Insurance Plans Flexible Spending Accounts Short/Long Term Disability Coverage Life Insurance 403B Retirement Plan (with company matching) Marketplace Savings Program Employee Assistance Program Wellness Programs 24-Hour Nurse Hotline Tuition Reimbursement Generous Paid Time Off (for qualifying positions) Stability that coincides with working for a national leader in education and human services ABOUT MERAKEY Merakey is a leading developmental, behavioral health and education provider offering a breadth of integrated services to individuals and communities across the country. We leverage our size and expertise to develop innovative solutions and new models of care to meet the needs of individuals, their families, public and private healthcare funders and community partner organizations. We recognize that complex needs require a holistic approach. With our experience, expertise and compassion, we empower everyone within our communities to reach their fullest potential. With a rich tradition spanning 50 years with nearly 10,000 employees, Merakey provides care to over 40,000 adults and children throughout Pennsylvania, New Jersey, New York, Maryland, Delaware, Louisiana, Michigan, Texas, California, and Tennessee. For more information on Merakey and our various divisions, please visit: www.merakey.org Merakey is an Equal Opportunity Employer! APPLY TODAY www.merakey.org/careers Requisition # 47664     it help desk, service desk, first level support, help desk, help desk analyst, help desk representative, help desk support, help desk technician, service desk analyst, technical support, technical support representative  

Merakey is currently seeking a Credentialing Specialist to join our Human Resources department in our Blue Bell, PA location. Working within the Human Resources Center of Excellence , the Credentialing Support Specialist will perform the following functions: Process all new hire application / credentialing documentation for assigned caseload of candidates, ensuring completeness and accuracy of information. Constantly collect and process significant amounts of verification, criminal background and accreditation information, checking for full completeness and accuracy. This may involve verifying the legitimacy of information with universities, licensing agencies, prior employers, etc. Verify that candidate credentials are in compliance with program, State and Federal standards. Effectively communicate with Program Managers/Directors and Staffing Partners on a regular basis regarding process delays due to missing or incomplete information or lack of response from candidate. Report any anticipated delays in credentialing for assigned caseload to Credentialing Manager for assistance and resolution. Other duties as assigned. MERAKEY IS PROUD TO OFFER THE FOLLOWING BENEFITS Work/Life Balance Competitive Compensation Plans Opportunities for professional growth and advancement Medical, Dental, and Vision Insurance Plans Flexible Spending Accounts Short/Long Term Disability Coverage Life Insurance 403B Retirement Plan (with company matching) Marketplace Savings Program Employee Assistance Program Wellness Programs 24-Hour Nurse Hotline Tuition Reimbursement Generous Paid Time Off (for qualifying positions) Stability that coincides with working for a national leader in education and human services ABOUT MERAKEY Merakey is a leading developmental, behavioral health and education provider offering a breadth of integrated services to individuals and communities across the country. We leverage our size and expertise to develop innovative solutions and new models of care to meet the needs of individuals, their families, public and private healthcare funders and community partner organizations. We recognize that complex needs require a holistic approach. With our experience, expertise and compassion, we empower everyone within our communities to reach their fullest potential. With a rich tradition spanning 50 years with nearly 10,000 employees, Merakey provides care to over 40,000 adults and children throughout Pennsylvania, New Jersey, New York, Maryland, Delaware, Louisiana, Michigan, Texas, California, and Tennessee. For more information on Merakey and our various divisions, please visit: www.merakey.org Merakey is an Equal Opportunity Employer! APPLY TODAY www.merakey.org/careers Requisition # 48467 In addition to completing your application, please feel free to email your resume directly to our recruiter at gwendolyn.miller@merakey.org 0719mrk

Aetna Description: The ideal candidate will evaluate professional and outpatient facility claims using specific criteria to determine if the claim is paid correctly. Candidate will focus on industry and company reimbursement and coding concepts to identify opportunities to pursue. 64926 Fundamental Components: Provide policy and coding guidance for initiatives driven by Medical Policy & Program Solutions (MPPS) and Analytics & Behavior Change (ABC) Coordinate and conduct post-payment and root cause analysis to validate payment of professional and outpatient facility claims Provide medical coding subject matter claim expertise to identify claim overpayments. Identify potential waste and abuse by performing audits of claim data and electronic sources. Communicate detailed description of the correct claim handling to internal and external constituents Background Experience: Professional coding certification is required Must be familiar with CMS reimbursement policies, claim editing and industry coding concepts Demonstrate basic knowledge of health insurance claim s processing. Good investigation skills are a plus Excellent verbal and written communication skills Comfortable using various databases and computer systems to research and investigate opportunities Required Skills: General Business - Applying Reasoned Judgment, General Business - Communicating for Impact, General Business - Demonstrating Business and Industry Acumen Desired Skills: Finance - Managing Aetnas Risk, General Business - Consulting for Solutions, General Business - Maximizing Work Practices Functional Skills: Claim - Claims Administration - cost management, Claim - Policies & procedures, Clinical / Medical - FE Clinical coverage & policies, Medical Management - Medical Management - Coding, Project Management - Cost Management Technology Experience: Operating System - Windows Education: Information Technology - Certified Professional Coder (CPC) Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: 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.

Aetna Description: The ideal candidate will evaluate inpatient facility claims using specific criteria before payment is issued. Candidate will focus on inpatient industry and company reimbursement and coding concepts. 64939 Fundamental Components: Provide policy and coding guidance for initiatives driven by Medical Policy & Program Solutions (MPPS) and Analytics & Behavior Change (ABC) Provide inpatient coding subject matter expertise by identifying coding opportunities in particular those involving DRGs and other inpatient pricing concepts. Identify potential waste and abuse by performing audits of inpatient medical records. Demonstrate the ability to assign accurate ICD-10 medical codes for diagnoses and procedures performed in an inpatient setting. Ability to integrate coding and reimbursement understanding with charge master updates Background Experience: Registered Nurse is required Inpatient coding certification is preferred Must be familiar with inpatient facility contracting/pricing methodologies and industry coding concepts Demonstrate basic knowledge of health insurance claim processing Good investigation skills are a plus Excellent verbal and written communication skills Comfortable using various databases and computer systems to research and investigate opportunities Required Skills: Benefits Management - Maximizing Healthcare Quality, General Business - Consulting for Solutions, General Business - Demonstrating Business and Industry Acumen Desired Skills: General Business - Applying Reasoned Judgment, General Business - Communicating for Impact, General Business - Ensuring Project Discipline Functional Skills: Claim - Claims Administration - cost management, Claim - Policies & procedures, Clinical / Medical - Clinical claim review & coding, Clinical / Medical - Hospital administration Technology Experience: Operating System - Windows Education: Nursing - Registered Nurse (RN) Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: 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.

Aetna Description: Provides consultation on the design, testing and enhancement of information product including technical assistance and product development support to external and internal customers. Researches, manipulates and prepares complex data to document program activities and reports on its results. Provides oversight to data quality and provides feedback to various areas in order to improve service delivery and enhancement to design efforts. Develops a consultative relationship with internal/external customers. 64662 Fundamental Components: May lead or act as a business technical expert with the planning, development and validation of master or detail test plans and strategies. Performs ongoing research, and support tasks for existing systems. Leads or acts as a business technical expert in the design of new applications or enhancements including integration of solutions. Provides Leadership/Coaching/Mentoring; may be a mentor to others. Directs the implementation of program specific information through education, technology, organizational methods and procedures. Influences enhancements to business processes and system infrastructure to improve data quality availability and access. Manages customer contact and participates in internal and external health industry development efforts (e.g., performance measurements). Analyzes complex data for trends, highlights in-depth interpretations and provides in-depth root cause analysis. Consults with client on a regular basis to ensure progress is in line with customer's expectations and to obtain additional information as needed. Translates complex data into constructive data and information and makes recommendations. Defines, identifies, develops and implements information products to support strategic business and operational planning. Illustrates complex information in a clear concise manner. Develops and conducts presentations and consultations to existing and prospective customers and internal business areas. Provides workgroup support on projects. Educates customer on the value, use and interpretation of information product. Influences changes/enhancements to business processes, policies, and system infrastructure to improve information quality, availability and access. Evaluates available software and data to deliver better business solutions. Use knowledge, team resources, and data from multiple source systems to perform root cause analysis on complaints. Clearly document root cause drivers and ensure internal customers understand what is causing complaints. Analyze complex data to identify trends and risk mitigation plans. Differentiate between data that is relevant and/or critical and data that is not. Identify opportunities for process improvement and recommend changes to business partners. Drive improvements to work processes and validate that changes were completed as expected. Collaborate on projects throughout the Medicare organization. Background Experience: Excellent verbal and written communication skills. Extensive experience with databases as well interpretation and manipulation of related data. Healthcare background. 3-5 years of data interpretation and analysis experience. Bachelor's degree, technical certification or equivalent work experience. Additional Job Information: Functional Claims Claim Processing Medical Medicare Policies & Procedures Claim Processing- Dental Enrollment Functional Knowledge Medicare Technical IDX Systems Burgess Pricer Strategic Pricer Complaints & Appeals Tracking System NextGen Pegasus EPDB Navigator ATV Microsoft-PowerPoint, Excel, Word Required Skills: General Business - Communicating for Impact, General Business - Demonstrating Business and Industry Acumen, General Business - Ensuring Project Discipline Desired Skills: General Business - Maximizing Work Practices, Leadership - Collaborating for Results, Leadership - Driving Change Functional Skills: Claim - Claim processing - Medical - Medicare Potential Telework Position: Yes Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: 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.

Allied Universal is seeking Professional Security Officers.   Our Security Officers allow us to contribute to our company’s core purpose of providing unparalleled service, systems and solutions to serve, secure and care for the people and businesses of our communities.  Pay Rate: $13.28 Per Hour QUALIFICATIONS/REQUIREMENTS: Be at least 18 years of age with high school diploma or equivalent Possess effective written and oral communication and interpersonal skills with ability to deal with all levels of personnel and the general public in a professional and effective manner Valid guard card/license, as required in the state for which you are applying.  As a condition of employment, employee must successfully complete a background investigation and a drug screen in accordance with all federal, state, and local laws Display exceptional customer service and communication skills Have intermediate computer skills to operate innovative, wireless technology at client specific sites Ability to handle crisis situations at the client site, calmly and efficiently Able to: Work in various environments such as cold weather, rain/snow or heat Occasionally lift or carry up to 40 pounds Climb stairs, ramps, or ladders occasionally during shift Stand or walk on various surfaces for long periods of time Allied Universal provides unparalleled service, systems and solutions to the people and business of our communities, and is North America’s leading security services provider. With over 200,000 employees, Allied Universal delivers high-quality, tailored solutions, which allows clients to focus on their core business. For more information:   www.AUS.com .   We proudly support the Veteran Jobs Mission, a group of over 200 companies that have committed to collectively hiring a total of one million military veterans. EOE/Minorities/Females/Vet/Disability  Allied Universal Services is an Equal Opportunity Employer committed to hiring a diverse workforce.

Allied Universal is seeking Professional Security Officers.   Our Security Officers allow us to contribute to our company’s core purpose of providing unparalleled service, systems and solutions to serve, secure and care for the people and businesses of our communities.  QUALIFICATIONS/REQUIREMENTS: Be at least 18 years of age with high school diploma or equivalent Possess effective written and oral communication and interpersonal skills with ability to deal with all levels of personnel and the general public in a professional and effective manner Valid guard card/license, as required in the state for which you are applying.  As a condition of employment, employee must successfully complete a background investigation and a drug screen in accordance with all federal, state, and local laws Display exceptional customer service and communication skills Have intermediate computer skills to operate innovative, wireless technology at client specific sites Ability to handle crisis situations at the client site, calmly and efficiently Able to: Work in various environments such as cold weather, rain/snow or heat Occasionally lift or carry up to 40 pounds Climb stairs, ramps, or ladders occasionally during shift Stand or walk on various surfaces for long periods of time Allied Universal provides unparalleled service, systems and solutions to the people and business of our communities, and is North America’s leading security services provider. With over 200,000 employees, Allied Universal delivers high-quality, tailored solutions, which allows clients to focus on their core business. For more information:   www.AUS.com .   We proudly support the Veteran Jobs Mission, a group of over 200 companies that have committed to collectively hiring a total of one million military veterans. EOE/Minorities/Females/Vet/Disability  Allied Universal Services is an Equal Opportunity Employer committed to hiring a diverse workforce.

Allied Universal is seeking Professional Security Officers in Blue Bell Pa.   Our Security Officers allow us to contribute to our company’s core purpose of providing unparalleled service, systems and solutions to serve, secure and care for the people and businesses of our communities.  Pay Rate: $13.28 QUALIFICATIONS/REQUIREMENTS: Be at least 18 years of age with high school diploma or equivalent Possess effective written and oral communication and interpersonal skills with ability to deal with all levels of personnel and the general public in a professional and effective manner Valid guard card/license, as required in the state for which you are applying.  As a condition of employment, employee must successfully complete a background investigation and a drug screen in accordance with all federal, state, and local laws Display exceptional customer service and communication skills Have intermediate computer skills to operate innovative, wireless technology at client specific sites Ability to handle crisis situations at the client site, calmly and efficiently Able to: Work in various environments such as cold weather, rain/snow or heat Occasionally lift or carry up to 40 pounds Climb stairs, ramps, or ladders occasionally during shift Stand or walk on various surfaces for long periods of time Allied Universal provides unparalleled service, systems and solutions to the people and business of our communities, and is North America’s leading security services provider. With over 200,000 employees, Allied Universal delivers high-quality, tailored solutions, which allows clients to focus on their core business. For more information:   www.AUS.com .   We proudly support the Veteran Jobs Mission, a group of over 200 companies that have committed to collectively hiring a total of one million military veterans. EOE/Minorities/Females/Vet/Disability  Allied Universal Services is an Equal Opportunity Employer committed to hiring a diverse workforce.

Aetna Description: Lead consultative and analytics point of contact for markets and complex medical economic projects related to Value Based Contracting. Accountabilities include project initiation, identification and completion of key deliverables to ensure all business objectives are met. Responsible for the development and implementation of key medical economics business efforts (e.g. medical cost initiatives, policies/programs and analytical models). Accountable for all financial projections associated with project. 62155 Fundamental Components: Senior team member for analytical modeling and consulting on provider specific negotiations related to Value Based Contracting programs. Role involves independent analysis, coach others and working collaboratively with business units across the company and be part of a team that provides medical cost and outcomes focused analytical research, complex financial modeling and business decision support reporting. This includes both contractual reconciliation and ad hoc consulting supporting. Performs analyses of varied healthcare data to evaluate programs and product solutions using healthcare medical, pharmacy, lab, survey and utilization data. Requires strong communication skills creating an environment of teamwork with internal Aetna and external provider constituents. Participate as subject matter expert in provider negotiations including support for proposals along with reviewing interim reports with markets and providers regarding progress towards goals. Presents complex information in a way that multiple levels within an organization can understand and utilize to make appropriate decisions to meet business objectives. Works collaboratively with other Consultants and Analysts with opportunity for project leadership as well as mentoring others. Motivated and is willing to understand and probe into data. Contributes to a positive environment by working effectively to achieve common goals. Must be skilled in complex financial data collection, modeling & analysis, advanced use of Microsoft Excel, understand relational database concepts and related query tools. Capable of taking project through issue identification, design specifications, data query/programs, financial analysis and resolution/recommendation stages. Background Experience: 5-8 years demonstrated leadership and project management experience. Ability to manage conflicting priorities and multiple projects concurrently. Strong analytical ability and familiarity with advanced financial and healthcare concepts. Advanced software and programming skills will be required in different MEU departments #LI-DI1 Additional Job Information: Medical Economics is charged with managing Aetna's medical costs and ensuring healthcare remains affordable. It is an exciting time to be part of our Value Based Contracting Team with Aetna committed to growing influence of these model beyond 75% of our total market by 2020. These incentive models reward providers partners for efficient and quality care to our members. We are currently seeking a Medical Economics Consultant for our expanding VBC responsibilities. This opportunity will give broad exposure across various areas of healthcare and senior leadership. Required Skills: General Business - Communicating for Impact, General Business - Turning Data into Information, Technology - Leveraging Technology Desired Skills: General Business - Demonstrating Business and Industry Acumen, Leadership - Collaborating for Results, Service - Working Across Boundaries Functional Skills: Communication - Translating & Interpreting, Finance - Financial analysis, Information Management - Business information analysis Technology Experience: Desktop Tool - Microsoft PowerPoint, Desktop Tool - TE Microsoft Excel, Reporting Tool - SAS Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: 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

POSITION REQUIREMENTS Minimum of a bachelor's degree in social work, psychology or another human service field 3-years experience in the Behavioral Health field, which must include a minimum of 1 year experience in a mental health setting and 1 year experience in an IDD setting Must possess or is able to attain all necessary clearances and background checks to work with designated consumers Possess valid PA driver's license with a clean driving record Merakey is currently seeking a DDTT Recovery Coordinator to join our Adult Behavioral Mental Health Community Based Teams DDTT Program , 1730 Walton Road, in Montgomery County, PA.   POSITION OVERVIEW   As a member of the Dual Diagnosis Treatment Team, the Recovery Coordinator is qualified in the human service field and possesses the skills and experience necessary to provide coordination and supportive services to program individuals with BH and IDD diagnoses (dually diagnosed). This is done in collaboration with the rest of the team and under the clinical supervision of the Program Director.   Role Specific Responsibilities include but are not limited to the following: Perform initial intakes Complete all paperwork in a timely and accurate manner Quickly establish therapeutic relationships with the individuals being served Provide case management and coordination with other service delivery systems Participate in on-call schedule on a rotating basis   MERAKEY IS PROUD TO OFFER THE FOLLOWING BENEFITS Work/Life Balance Competitive Compensation Plans Opportunities for professional growth and advancement Medical, Dental, and Vision Insurance Plans Flexible Spending Accounts Short/Long Term Disability Coverage Life Insurance 403B Retirement Plan (with company matching) Marketplace Savings Program Employee Assistance Program Wellness Programs 24-Hour Nurse Hotline Tuition Reimbursement Generous Paid Time Off (for qualifying positions) Stability that coincides with working for a national leader in education and human services   ABOUT MERAKEY'S BEHAVIORAL HEALTH DIVISION Merakey offers a continuum of care in behavioral health (includes mental health and addictive diseases), integrating services in both community and site-based settings. These services provide a wide range of recovery focused treatment, services, and supports for children and adults. Site/Clinic Based Services The Center for Hope Outpatient Parent Child Interaction Therapy (PCIT) Parents and Children Together (PACT) Partial Hospitalization Program (PHP) Psychiatric/Socialization Rehabilitation for Hope Residential Services for Children and Adults Community Based Services Assertive Community Treatment (ACT) and Forensic Assertive Community Treatment (FACT) Behavioral Health Rehabilitation Services (BHRS) Case Management / Recovery Coaching Community Health Liaison (CHL) Community and School Based Behavioral Health (CSBBH) Crisis Intervention Substance Use Disorder Services Dual Diagnosis Treatment Team (DDTT) Family Based Mental Health Services Therapeutic Family Care Foster Care Plus Peer Support Student Assistance Program (SAP) Supported Employment Supports for Permanency (SFP) For more information on each individual service, please visit: https://www.merakey.org/services-behavioral-health.html   ABOUT MERAKEY Merakey is a leading developmental, behavioral health and education provider offering a breadth of integrated services to individuals and communities across the country. We leverage our size and expertise to develop innovative solutions and new models of care to meet the needs of individuals, their families, public and private healthcare funders and community partner organizations. We recognize that complex needs require a holistic approach. With our experience, expertise and compassion, we empower everyone within our communities to reach their fullest potential. With a rich tradition spanning 50 years with nearly 10,000 employees, Merakey provides care to over 40,000 adults and children throughout Pennsylvania, New Jersey, New York, Maryland, Delaware, Louisiana, Michigan, Texas, California, Virginia and Tennessee.   Merakey is an Equal Opportunity Employer!     APPLY TODAY   Requisition Number: 48986   Please complete your online application at: www.merakey.org    

Aetna Description: Full time telework opportunity open to candidates across the country. The Maternity Nurse Case Manager is responsible for telephonically assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical and disability needs of the member to facilitate the members overall wellness and appropriate and timely return to work. In doing this the nurse develops a proactive course of action to address issues presented to enhance the short and long term outcomes as well as opportunities to enhance a members overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies. 64768 Fundamental Components: Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. Reviews prior claims to address potential impact on current case management and eligibility. Assessments include the member's level of work capacity and related restrictions/limitations. Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality. Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management. Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. Background Experience: RN Licensure required -4+ years clinical practice experience in Obstetrical Nursing required -Manager care experience preferred Additional Job Information: Typical office working environment with productivity and quality expectationsWork requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.Ability to multitask, prioritize and effectively adapt to a fast paced changing environmentPosition requires proficiency with computer skills which includes navigating multiple systems and keyboardingEffective communication skills, both verbal and written. Education: Nursing - Registered Nurse Potential Telework Position: Yes Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: 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.

Aetna Description: Full time telework opportunity open to candidates across the country. The Fertility Advocate Nurse Case Manager is responsible for working with members to provide nurse case management from preconception through postpartum to provide education and support through the fertility process, pregnancy and postpartum. The Fertility Advocate Nurse Case Manager is responsible for telephonically assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical and disability needs of the member to facilitate the members overall wellness and appropriate and timely return to work. In doing this the nurse develops a proactive course of action to address issues presented to enhance the short and long term outcomes as well as opportunities to enhance a members overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies. 64767 Fundamental Components: Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. Reviews prior claims to address potential impact on current case management and eligibility. Assessments include the member's level of work capacity and related restrictions/limitations. Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality. Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management. Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. Background Experience: RN Licensure required -4+ years clinical practice experience in Obstetrical Nursing required Beneficial to have experience in fertiity/infertility -Manager care experience preferred Additional Job Information: Typical office working environment with productivity and quality expectationsWork requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.Ability to multitask, prioritize and effectively adapt to a fast paced changing environmentPosition requires proficiency with computer skills which includes navigating multiple systems and keyboardingEffective communication skills, both verbal and written. Education: Nursing - Registered Nurse Potential Telework Position: Yes Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: 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.

Aetna Description: The Supervisor is responsible for oversight of healthcare management staff including the organization and development of high performing teams. Works closely with functional area managers to ensure consistency in clinical interventions supporting our members. Accountable for meeting the financial, operational and quality objectives of the unit. 63825 Fundamental Components: Oversees the implementation of healthcare management services for assigned functional area Implements clinical policies & procedures in accordance with applicable regulatory and accreditation standards (e.g. NCQA, URAC, state and federal standards and mandates as applicable) Serve as a content model expert and mentor to the team regarding practice standards, quality of interventions, problem resolution and critical thinking Ensure implementation and monitoring of best practice approaches and innovations to better address the member's needs across the continuum of care May act as a liaison with other key business areas. May develop/assist in development and/review new training content May collaborate/deliver inter and intra-departmental training sessions Protects the confidentiality of member information and adheres to company policies regarding confidentiality Manages resources responsible for identification of members, development and implementation of care plans, enhancement of medical appropriateness and quality of care and monitoring, evaluating and documenting of care Develop, initiate, monitor and communicate performance expectations Ensures the team's understanding and use of information system capability and functionality May have responsibility for their own case load work May act as a single point of contact for the customer and the Account Team including: participation in customer meetings, implementation and oversight of customer cultural requirements, and support implementation of new customers. Participate in the recruitment and hiring process for staff using clearly defined requirements in terms of education, experience, technical and performance skills Assesses developmental needs and collaborates with others to identify and implement action plans that support the development of high performing teams Establish an environment and work style that promotes the concept of teamwork, cross product integration, and continuum of care thinking that results in strong performance Consistently demonstrates the ability to serve as an model change agent and lead change efforts Create a positive work environment by acknowledging team contributions, soliciting input, and offering personal assistance, when needed Accountable for maintaining compliance with policies and procedures and implements them at the employee level Background Experience: 3 years in clinical area of expertise. (Certain functional areas may require additional clinical experience such as for BH triage and referral Supervision decisions must have 5 years post master's degree clinical experience required.) 2 years DSNP experience is required. 2 years leadership experience is required. Computer literacy and experience familiarity with Microsoft Excel, Word, and web-based applications desired. Ability to work with people in such a manner as to build high morale and group commitment to goals and objectives. Ability to evaluate and interpret data, identify areas of improvement, and focus on interventions to improve outcomes. Ability to communicate effectively with Providers, Members, Staff and other Leaders both in oral and written formats (e.g., may provide support to the sales staff & network staff via onsite customer visits and/or presentations) LICENSE one of the following is required: Registered Nurse (BSN preferred) Active unrestricted State Licensure in applicable functional area. (eg RN, LPC, LCSW) Mental Health/Licensed Clinical Social Worker Mental Health/Licensed Professional Counselor Nursing/Psychiatric and Mental Health Nurse Mental Health/American Psychological Association EDUCATION Master's degree in behavioral health field Additional Job Information: linical experience workingwith the Medicare population is highly desired. Communicates andcollaborates with providers, members, staff, leaders within the enterprise andaccount teams in both written and oral formats. May provide support to salesand network staff via onsite customer visits and/or presentations. Required Skills: Benefits Management - Maximizing Healthcare Quality, Leadership - Anticipating and Innovating, Leadership - Collaborating for Results Desired Skills: General Business - Maximizing Work Practices, Leadership - Collaborating for Results, Leadership - Driving a Culture of Compliance, Leadership - Driving Change Potential Telework Position: Yes Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: 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.

Aetna Description: The care management associate (CMA) role supports medical services including precert intake and sending to clinical, verifying discharges, along with outreach to members. Hiring shift starts at 12:30-9pm. Coverage on Saturday and Holidays may be required on a volunteer basis. 64727 Fundamental Components: Responsible for initial entry of precert cases Screens medical services incoming calls Outgoing calls for entry of appropriate discharge dates and dispositions Identifies triggers for referral to case management or other specialty programs Utilizes ATV and other Aetna systems to enter, build and research and enter information as needed Performs non medical research pertinent to maintain cases Provides support services to team members by answering telephone calls, taking messages, and researching information and assisting in solving problem Making outreach calls to members to explain programs Background Experience: 2-4 years experience as a medical assistant, office assistant, or customer service. High School Diploma or G.E.D. Additional Job Information: Effective communication, telephonic and organization skills.Familiarity with basic medical terminology and concepts used in care management.Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members.Computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word.Ability to effectively participate in a multi-disciplinary team including internal and external participants. Required Skills: Benefits Management - Interacting with Medical Professionals, Service - Demonstrating Service Discipline, Service - Handling Service Challenges Desired Skills: Service - Creating a Differentiated Service Experience, Service - Working Across Boundaries, Technology - Leveraging Technology Functional Skills: Customer Service - Customer service - production environment Potential Telework Position: Yes Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: 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.

Aetna Description: This role is WAH anywhere! Preference for candidates in EST or CST! This position reports to the Director of Specialty Strategy. The Pharmacy Service Manager will be responsible for supporting the overall strategy to manage the Medicare specialty drug spend. This includes ideation, implementation, administration and oversight of clinical programs across the medical and pharmacy platforms to meet Aetna's business requirements. 62384 Fundamental Components: FUNDAMENTAL COMPONENTS: - Analyze key utilization metrics to identify opportunities to manage spend on the medical and pharmacy platform. - Support/Lead the ideation and development of clinical programs to improve management of specialty drugs and enhance cost savings. - Participate in Aetna's cross functional committees to support formulary placement decisions and development of authorization criteria. Aid the annual bid ulary development process. - Serve as a subject matter expert for Pipeline drugs; collaborate with matrix partners to develop utilization management strategies based on trend analysis, competitor positioning, treatment guideline research etc. Support the quarterly and annual utilization forecasting for Specialty drugs. - Maintain knowledge and understanding of specialty medications and specialty medication utilization, clinical information, prescribing patterns and current clinical trials. - Keep abreast of industry trends and regulatory changes in the specialty pharmacy industry and evaluate their effect on pharmacy contracts and services. Make recommendations on program improvements, based on findings and utilization. - Participate in market meetings to review utilization metrics and make recommendations as appropriate. - Serve as a subject matter expert and clinical liaison at internal committees. - Perform other duties as required. Background Experience: BACKGROUND/EXPERIENCE: - Current unrestricted pharmacist license.(Required) - At least 5+ years of pharmacy experience in a Medicare Managed Care environment. (Required) - Experience in Specialty drug management.(Preferred) - Knowledge of clinical programs, specialty drug trends, and formulary designs. (Preferred) - Understanding of medical and pharmacy terminology. (Preferred) - Excellent communication and presentation skills. (Preferred) - Experience working in Matrix Organization, Project Mgmt experience, ability to complete projects independently within established timeframes. (Preferred) Education: Pharmacy - Licensed Pharmacist Potential Telework Position: Yes Percent of Travel Required: 10 - 25% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: 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