Aetna Contract Negotiator in Cincinnati, Ohio

Req ID: 43328BR

POSITION SUMMARY

Negotiates, re-negotiates and executes physician and/or provider contracts in accordance with company standards in order to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals. Position will have a special focus on hospital-based providers and ambulatory surgery centers.

Fundamental Components:

Accountable for all aspects of physician and ambulatory surgery center recruitment and contracting as well as ad/hoc network contracting, as assigned. Responsible for re-negotiating or negotiating solo, complex group, hospital-based and large entity physician contracts in support of network quality, availability and financial goals. Participates in the strategic recruitment of physicians and ambulatory surgery centers satisfying specific network goals and objectives. Provides network development, maintenance and refinement activities and strategies in support of cross-market network management units. Partners across the organization to garner support for network contracting activities to ensure all aspects of operational implementation are completed on a timely and accurate basis.

BACKGROUND/EXPERIENCE desired:

Mastery of provider and facility contracts, contracting options, PADU guidelines as well as provider configurations. Communication Skills - Strong written and verbal communication skills. In-depth knowledge of the managed care industry and practices, as well as a strong understanding of Aetna competitor strategies. Solid negotiating and decision-making skills.

EDUCATION

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

FUNCTIONAL EXPERIENCES

Functional - Network Management/Contract negotiation/3-5 Years

Functional - Network Management/Provider relations/3-5 Years

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

TECHNOLOGY EXPERIENCES

Technical - Aetna Applications/Strategic Contracts Manager/1-3 Years/End User

Technical - Aetna Applications/Enterprise Provider Database System/1-3 Years/Power User

REQUIRED SKILLS

Benefits Management/Interacting with Medical Professionals/ADVANCED

Sales/Managing Competitive Networks/ADVANCED

Sales/Negotiating collaboratively/ADVANCED

DESIRED SKILLS

General Business/Demonstrating Business and Industry Acumen/ADVANCED

General Business/Turning Data into Information/ADVANCED

Technology/Selecting and Applying Technology Solutions/FOUNDATION

ADDITIONAL JOB INFORMATION

This is a fast paced dynamic role.

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.

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