Aetna Network Manager - 44558BR in Chicago, Illinois

Req ID: 44558BR

POSITION SUMMARY

This position is a Corporate role supporting local market. The role will be responsible for implementing Medicare Advantage value based contracting.

Fundamental Components:

Exhibit and have deep knowledge of Medicare requirements and use that knowledge to implement and improve network design,

performance and quality and ensure compliance with CMS requirements.

Understand and be able to describe both operational and financial deal components.

Designing and implementing innovative provider contract structures and payment models.

Identifying and developing initiatives to address training and implementation of contracting strategies.

Negotiating to build effective long term provider partnerships.

BACKGROUND/EXPERIENCE desired:

Comprehensive understanding of hospital and physician financial issues and how to leverage technology to achieve quality and cost improvements.

Must possess a successful track record negotiating value based contracts.

In-depth knowledge of managed care business and/or healthcare environment.

Strong knowledge of regulatory/legal requirements, products, programs, strategy and objectives.

EDUCATION

The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.

LICENSES AND CERTIFICATIONS

Healthcare Management/ is desired

Leadership/ is desired

Managed Care/ is desired

Project Management/ is desired

FUNCTIONAL EXPERIENCES

Functional - Network Management/Contract negotiation/4-6 Years

Functional - Network Management/Network market leadership/1-3 Years

Functional - Network Management/Provider relations/1-3 Years

Functional - Leadership/Act as company spokesperson to external constituents/1-3 Years

Functional - Leadership/Lead significant enterprise-wide initiative/1-3 Years

TECHNOLOGY EXPERIENCES

Technical - Desktop Tools/Microsoft Word/4-6 Years/End User

Technical - Desktop Tools/Microsoft PowerPoint/4-6 Years/End User

REQUIRED SKILLS

Leadership/Developing and Executing Strategy/ADVANCED

Finance/Profit and Quality Vigilance/FOUNDATION

Sales/Negotiating collaboratively/MASTERY

DESIRED SKILLS

General Business/Demonstrating Business and Industry Acumen/ADVANCED

Service/Creating a Differentiated Service Experience/ADVANCED

Leadership/Driving a Culture of Compliance/ADVANCED

ADDITIONAL JOB INFORMATION

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.

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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.

Job Function: Health Care