Aetna Network Manager in Louisville, Kentucky
Req ID: 43957BR
Negotiates, competitive and complex contractual relationships with providers according to pre-determined internal
guidelines and financial standards. Works cross-functionally to execute network strategies. Maintains accountability for specific medical cost initiatives.
Effectively negotiates complex, competitive contractual relationships with providers according to prescribed guidelines
in support of national and regional network strategies
Manages provider compensation/reimbursement and pricing development activities
Responsible for understanding and managing medical cost issues and initiating appropriate action. Provides sales
and marketing support, community relations and guidance with comprehension of applicable federal and state regulations
Assist and facilitate business intent reviews
Initiate legal reviews as needed; ensure all required reviews completed by appropriate functional areas
Regional owner of Strategic Contact Manager and rate wizard
Must possess a successful track record negotiating large hospital system contracts. Bachelor's degree required with MBA/Masters degree preferred.
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
Functional - Network Management/Contract negotiation/1-3 Years
Functional - Network Management/Network market leadership/1-3 Years
Technical - Aetna Applications/Strategic Contracts Manager/1-3 Years/End User
Technical - Aetna Applications/Enterprise Provider Credentialing/1-3 Years/End User
Benefits Management/Interacting with Medical Professionals/MASTERY
Sales/Managing Competitive Networks/MASTERY
Finance/Delivering Profit and Performance/FOUNDATION
Finance/Servicing Customers Profitably/MASTERY
Leadership/Developing and Executing Strategy/ADVANCED
This is for Cincinnati/Kentucky market and could be located in Cincinnati Office or New Albany, OH office.
ADDITIONAL JOB INFORMATION
This is a rewarding, fast paced role in a dynamic organization.
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