Manager - Health Services

About the role

This role is responsible for operationalizing Aetna Clinical Policy Bulletins (CPBs) and Aetna Payment Policies into precise, testable coding logic that drives claims adjudication across lines of business. It serves as a critical control point to ensure accurate translation of clinical policy into claims editing configurations, aligned with regulatory, reimbursement, and organizational standards.

Responsibilities

• Operationalize Aetna Clinical Policy Bulletins (CPBs) and Aetna Payment Policies into precise, testable coding logic that drives claims adjudication across lines of business.
• Serve as a critical control point to ensure accurate translation of clinical policy into claims editing configurations, aligned with regulatory, reimbursement, and organizational standards.
• Ensure decisions are clinically appropriate, compliant, and consistently applied with full audit traceability, protecting policy integrity, claim accuracy, and enterprise compliance.
• Prioritize and work in a fast-paced, deadline-oriented environment.
• Exhibit strong analytical, critical thinking, and problem-solving capabilities.
• Experience with Microsoft Office applications (Excel, Word, Outlook).
• Excellent written and verbal communication skills with ability to clearly articulate complex concepts.
• Work in a team-oriented, collaborative environment.

Requirements

• 2+ years of experience in healthcare claims administration, coding, or configuration.
• Clinical Coding Certification (CPC, CIC, CCS, RHIT, or similar certification).
• If not already a certified coder, candidate must obtain within first year of employment.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.
• Extensive knowledge of CPT, HCPCS, ICD-10 coding.