Aetna Network Manager in Albany, New York
Req ID: 52185BR
Negotiates/assists with competitive and complex contractual relationships with providers for Work Comp and Auto products according to pre-determined internal guidelines and financial standards. Works cross-functionally to execute network strategies and assist regional network management team.
Effectively negotiates/assists with complex competitive contractual relationships with providers according to prescribed guidelines in support of national and regional network strategies, to ensure Work Comp and Auto products are included. Manages provider compensation/pricing, contract language, and development activities. Responsible for understanding and managing medical cost issues and initiates appropriate action. Provides guidance with comprehension of applicable federal and state regulations. Acts as WC/Auto SME for Contractors, supporting ancillary, hospital and physician group contracting. Assists with the design, development, management, and/or implementation of strategic network configurations
Must possess a successful track record negotiating large hospital system contracts. Must possess a strong knowledge of the Workers' Compensation and Auto industries Must understand a Managed Care Organization. Must have strong leadership skills and ability to manage multiple projects. Must have knowledge of CPD, SCM, SFE, EPDB and MCPS. Must have strong communication, critical thinking, problem resolution and interpersonal skills.
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
Functional - Network Management/Contract negotiation/4-6 Years
Functional - Network Management/Provider relations/1-3 Years
Functional - Products-Other/Workers Compensation/1-3 Years
Technical - Aetna Applications/Enterprise Provider Database System/1-3 Years/End User
Technical - Desktop Tools/Microsoft Outlook/1-3 Years/End User
Technical - Desktop Tools/Microsoft Word/1-3 Years/End User
Technical - Aetna Applications/Strategic Contracts Manager/1-3 Years/End User
General Business/Demonstrating Business and Industry Acumen/ADVANCED
Leadership/Developing and Executing Strategy/ADVANCED
Finance/Delivering Profit and Performance/FOUNDATION
ADDITIONAL JOB INFORMATION
Works cross-functionally to execute network strategies
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.
Job Function: Health Care