Aetna Sr Dir, Network Mgmt in Blue Bell, Pennsylvania
Req ID: 37734BR
A senior level leadership position responsible for negotiating the most complex and challenging contractual and collaborative relationships with providers. Works cross-functionally within the region to ensure consistency with all contracting strategies. Maintains overall accountability for medical cost management within a defined market or geographical area.
Formulates the overall network strategy used to manage medical costs for a predefined geographic area.
Partners with Medical Economics team to assess effectiveness of tactical plan in managing costs.
Negotiates complex, competitive provider contracts with significant financial implications and manages relationships with key providers and health systems.
Responsible for contract negotiations involving all provider types including at-risk arrangements, IPA/PHO, hospital, and large physician groups.
Manages providers' compensation and pricing development activities for defined geographic area.
Designs, develops, manages, and/or implements strategic network configurations.
Supervises day-to-day operations of network management teams including all Provider Relations and contract negotiating staff. Responsible for hiring, training and firing local/regional staff.
Provides network strategy support to sales, marketing and product along with assistance on community relations related items when required.
Understands regulatory environment and ensures contractual compliance with federal and state requirements.
Must possess a successful track record negotiating large health system and clinically integrated network collaboration and contracts, have value based and healthcare transformation experience.
Ideal candidate has management experience and has demonstrated strong leadership during dynamic evolving times.
Bachelor's degree or equivalent experience.
Functional - Network Management/Network market leadership/1-3 Years
Functional - Management/Management - Multifunctional management: < 25 employees/4-6 Years
Functional - Network Management/Contract negotiation/4-6 Years
General Business/Demonstrating Business and Industry Acumen/MASTERY
Leadership/Creating a World Class Workforce/MASTERY
Leadership/Developing and Executing Strategy/MASTERY
Leadership/Engaging and Developing People/MASTERY
Sales/Managing Competitive Networks/MASTERY
Sales/Selling Products and Services/MASTERY
ADDITIONAL JOB INFORMATION
Join one of Aetna's most dynamic markets and leading territories.
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 here to review the benefits associated with this position.
Job Function: Health Care