Aetna Network Account Manager in Jackson, Mississippi

Req ID: 44204BR

POSITION SUMMARY

Negotiate, renegotiate and execute provider contracts in Alabama and Mississippi in accordance with company standards in order to maintain and enhance provider networks while meeting or exceeding accessibility, quality and financial goals for commercial and Medicare. Develops strong relationships with network providers and internal business partners leading to the achievement of provider satisfaction, medical cost targets, network growth and/or efficiency targets.

Fundamental Components:

  • Recruits and negotiates contracts with providers on behalf of the company for commercial and Medicare.

  • Responsible for developing and maintaining relationships with providers and business leadership of key provider groups.

  • Interacts with networks key physician groups, integrated delivery systems and hospitals to facilitate solutions that are mutually beneficial for providers and company.

  • Collaborates cross-functionally on complex issues to ensure provider needs are met and issues resolved.

  • Manages medical cost drivers and executes specific medical cost initiatives to support financial and medical cost objectives.

  • Consistently monitors Aetna's service capabilities to collaboratively ensure that provider constituents needs are met within the company standards.

  • Must be able to multi task and work as a team.

    BACKGROUND/EXPERIENCE desired:

    Proven ability to synthesize and translate competitive intelligence into decision-making process.

    Multi-functional experience

    2-5 years provider relations and contracting experience

    Working knowledge of provider business operations

    Analytical/data driven decision-making skills

    Strong analytical and written/oral presentation/communication skills.

    Strong project management capabilities

    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/Physician recruiting - medical/1-3 Years

    Functional - Network Management/Contract negotiation/1-3 Years

    Functional - Network Management/Credentialing/1-3 Years

    TECHNOLOGY EXPERIENCES

    Technical - Desktop Tools/Microsoft Outlook/1-3 Years/End User

    Technical - Desktop Tools/Microsoft Word/1-3 Years/End User

    Technical - Desktop Tools/TE Microsoft Excel/1-3 Years/End User

    REQUIRED SKILLS

    Benefits Management/Interacting with Medical Professionals/ADVANCED

    General Business/Demonstrating Business and Industry Acumen/FOUNDATION

    Service/Providing Solutions to Constituent Needs/ADVANCED

    DESIRED SKILLS

    General Business/Turning Data into Information/ADVANCED

    Leadership/Collaborating for Results/FOUNDATION

    Service/Improving constituent-focused Processes/FOUNDATION

    Telework Specifications:

    Telework is a requirement for this position because there is no physical office in Alabama or Mississippi where this position will be working. The position must be based in either Alabama or Mississippi.

    ADDITIONAL JOB INFORMATION

    New opportunity to expand and grow the Alabama and Mississippi markets for Medicare and commercial business.

    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