Hartford, Connecticut

Job Description
The Aetna Special Investigations Unit (SIU) is responsible for the detection, investigation, and prevention of all suspected cases of healthcare fraud. The Senior Project Lead position resides within our Systems & Reporting team. The team is accountable for financial reporting, application development, investigative reporting support and analytic techniques to uncover patterns of fraud, waste or abuse within claims data. We are looking for a data-driven individual that can analyze big data and create a story through data aggregation and reporting.

Job responsibilities include:
- Project oversight including initiation, identification and completion of key deliverable to ensure all business objectives are met.
- Analyze and interpret data to present to internal and external customers
- Knowledge of analytics tools to analyze large data sets to identify trends, spikes or anomalies within the data
- Create and communicate messages based on available data from real-time analyses, including preparing easy-to-understand charts, tables, graphs, and other related documents for diverse audiences
- Understand data nuances; improve data quality
- Present to internal/external customers and business partners
- Influence changes or enhancements to business processes, policies, and system infrastructure to improve information quality, availability and access

Required Qualifications
The ideal candidate would have:
- Solid understanding of medical and pharmaceutical claim data
- Intermediate or Advanced SAS and SQL coding experience
- Advanced experience in Excel
- 5+ years of healthcare data interpretation and analysis experience
- 5+ years of project/program/process management experience
- Ability to find creative solutions, make sound decisions & recommendations
- Ability to work in a team environment & independently manage workload/deliverables

Preferred Qualifications
- Experience as a business developer in Tableau or Power BI to create and maintain internal dashboards, trends and metrics
- MS Access

Education
Bachelor's degree or equivalent work experience

Business Overview
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. See Job Description

Hartford, Connecticut

Continue serving and work with a purpose

As a CVS Health colleague, you'll find career opportunities across the organization and at every stage of your career. More important, your work will have an impactful purpose on someone's life, including your own. Learn more about how you can continue serving on your next mission at CVS Health.

Careers for Veterans and Military Spouses

 

"The military has an ethos that is grounded in purpose-driven service that’s bigger than the individual. The same holds true for us at CVS Health. You can talk to colleagues in any part of our business and they will be able to articulate our company’s purpose. Working here provides an opportunity for service members and military spouses to continue to serve, just in a civvies."

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