Aetna Dir, Network Management - 39020BR in Tampa, Florida
Req ID: 39020BR
Negotiates, competitive and complex contractual relationships (Participation and Value-based agreements) with large health systems and large physician groups to be able to meet strategy and customer needs in the future. Works cross-functionally to execute network strategies with a sense of urgency to deliver results. Maintains accountability for specific medical cost initiatives. Assists in managing and supporting the Tampa / Southwest Florida local network team.
-Position will be responsible for strategic provider relationships which include maintaining and negotiating some of the most complex healthcare contracts in the local market
-Position will have focus on value based agreements with ACOs and other provider entities
-Manages other personnel to maintain a wide geographical area
-Manages and sets strategy for provider compensation/reimbursement and pricing development activities
-Manages medical cost issues and how to develop and execute action plans
-Negotiates contract language and Initiates legal reviews as needed; ensure all required reviews completed by appropriate functional areas
-Facilitates resolution of complex provider issues
-Previous hospital contracting experience is required (Commercial and Medicare)
-Previous value based / risk contracting experience is desired
-Financial analysis experience is desired
-Supervisory experience is desired
-Knowledge of the Tampa/Southwest Florida healthcare marketplace is desired
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
Functional - Network Management/Contract negotiation/More Than 10 Years
Functional - Network Management/Network market leadership/4-6 Years
Functional - Network Management/Provider relations/More Than 10 Years
Technical - Desktop Tools/Microsoft Word/More Than 10 Years/Power User
Technical - Desktop Tools/Microsoft Outlook/More Than 10 Years/Power User
General Business/Turning Data into Information/MASTERY
Leadership/Engaging and Developing People/ADVANCED
Benefits Management/Interacting with Medical Professionals/MASTERY
ADDITIONAL JOB INFORMATION
This is a local market network management position to be located in the Tampa office. This is a very dynamic role with routine travel required in the local market. This position has flexibility to balance work and personal life. The local market team mostly located in Tampa offers a great supportive culture and always delivers results to the overall Florida plan.
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.
Job Function: Health Care