Aetna Network Account Manager in Pittsburgh, Pennsylvania

Req ID: 45555BR

**Telework Specifications:

Flexible telework / office-based schedule (must live near Pittsburgh, PA or WV)

Full-Time Telework (WAH)*

POSITION SUMMARY

Design, develop, contract, maintain and enhance relationships with facilities, physicians and ancillary providers which serve as contractual networks of care for members; foster growth of managed care products; and enhance profitability of Aetna.

Fundamental Components:

Responsible for developing and maintaining relationships with physician and business leadership of key physician groups, ancillary providers, and delivery systems. Interacts with large, high profile physician groups, IPAs, PHOs and hospital systems to facilitate solutions that are mutually beneficial for both providers and the organization. Collaborates cross-functionally on more complex issues to ensure provider needs are met and outstanding issues are resolved. i.e. provider service efficiencies, provider service improvement initiatives, identifies opportunities for process improvement. Collaborates with internal team members on the implementation of large, high profile physician groups, IPAs, PHOs and hospital systems to ensure a positive business relationship. Communicates with external constituents to effectively engage the provider community and demonstrate the Aetna value proposition. Negotiate contracts and other understandings on behalf of the company. Manages medical cost drivers and executes specific medical cost initiatives to support financial and medical cost objectives.

BACKGROUND/EXPERIENCE desired:

Seeking a candidate with 2-5 years managed care insurance industry experience. Strong servicing background with all provider types (e.g. physicians, hospitals and ancillary). Possess strong analytical and written/oral communication skills.

EDUCATION

The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.

FUNCTIONAL EXPERIENCES

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

Functional - Network Management/Credentialing/1-3 Years

Functional - Network Management/Physician recruiting - medical/1-3 Years

Functional - Network Management/Contract negotiation/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 - Aetna Applications/Enterprise Provider Database System/1-3 Years/End User

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

REQUIRED SKILLS

Benefits Management/Interacting with Medical Professionals/ADVANCED

Leadership/Collaborating for Results/FOUNDATION

Service/Providing Solutions to Constituent Needs/ADVANCED

DESIRED SKILLS

Leadership/Developing and Executing Strategy/FOUNDATION

Leadership/Driving a Culture of Compliance/ADVANCED

Leadership/Driving Strategic and Organizational Agility/FOUNDATION

**Telework Specifications:

Flexible telework / office-based schedule (must live near Pittsburgh, PA or WV)

Full-Time Telework (WAH)*

ADDITIONAL JOB INFORMATION

This is an entry level position with opportunity for advancement within the department as well as within Aetna. The position offers a competitive salary and opportunity for bonus potential.

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