• Appeal and Grievance Learning Consultant


    Job #1903280435

  • Job Description

    Creates implements and evaluates training tools and programs to support the development of the skills and competencies Aetna employees require to effectively process Medicaid appeals, complaints and grievances.Uses a variety of educational media and a systematic instructional design methodology to design and develop sophisticated, complex and/or segment-wide, state-of-the-art training programs for designated Aetna audiences; assesses and reports on the effectiveness of training programs; supports the skill development of Aetna's learning community.-Consults with organizational leaders and work groups to develop complex, specialized learning strategies to improve appeal, complaint and grievance performance.-Conducts performance analysis to determine the expectations and gaps for the intended audiences.-Uses formal instructional design methodology to design and develop sophisticated, complex and/or segment-wide, performance-based training and educational tools.-Develops and conducts follow-up assessments to determine the effectiveness of training programs. ---Works in partnership as appropriate with external vendors to deliver state-of-the-art, technology-based training tools and programs that meet the needs of multiple, diverse audiences and integrate effectively into Aetna's architecture.-Communicates regularly with local/regional training delivery staff to manage the rollout of training materials and gather feedback on program effectiveness.-Incorporates feedback gathered from participants and other relevant audiences to improve training, processes and products.-Effectively manages curriculum, reporting and other relevant administrative requirements through the Aetna Learning Center.-Works under the direction of Aetna's Medicaid Appeal and Grievance Department to develop and implement segment-wide learning standards, tools, templates and reporting requirements.-Supports the development of skills within Aetna's learning community by managing and participating in the design, development and delivery of state-of-the-art learning methodologies and practices.

    Required Qualifications

    Educational background in instructional design methodologies, adult learning principles and/or performance consulting.5-7 years experience in a corporate training or related function.

    COVID Requirements

    COVID-19 Vaccination Requirement

    CVS Health requires its Colleagues in certain positions to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.

    • If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 10 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 45 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.

    • If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 10 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.

    Preferred Qualifications

    Superior knowledge and application of performance-based instructional design methodologies, adult learning principles and educational media.


    Bachelor's degree required; Masters preferred.

    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.