Aetna VBC Senior Program Manager in Bowling Green, Kentucky
Req ID: 55156BR
He/she is responsible for coordinating all types of account servicing in order to implement and maintain provider operations according to value-based-contract (VBC) arrangements. This includes setup and on-going maintenance of tech / care management solutions, organizing consultative services and guidance from subject matter experts as needed, as well as back office functions such as billing, claims and appeals processing. He/she will interact with providers on a regular basis to handle provider requests and concerns while managing routine servicing operations to realize the terms of the VBC and responding to ad-hoc requests / issues raised by providers and Engagement Managers. He/she works to ensure that the providers / ACOs are functioning successfully and the VBC arrangement is working to improve quality of care while reducing costs.
** The person in this role must be located in KY as this is a Provider-facing position.
Manages a cross-functional team of various Aetna, client and external resources to implement and maintain ongoing account services in VBC arrangements with combinations of financial, product, technology, clinical, and operational elements, ranging from infrastructure / network installation for provider solutions, ongoing maintenance of provider solutions (e.g., tech / population health services), payments / appeals processes, report generation, and compliance
Establishes and maintains relationships across ACS and Aetna organizations to use as support for these provider servicing activities
Manages servicing operations on a routine basis, including setting cadence for regular task activities, as well as responding to live direction requests from Engagement Managers
Regularly interfaces with provider to facilitate implementation / maintenance of provider servicing activities and to respond to provider requests / concerns
Ensures adherence to compliance policies and procedures throughout provider account operations, proactively identifying risks and escalating to leadership as appropriate
Responsible for ensuring that provider account services contribute to ACS objective of improving quality of care while reducing costs
8+ years of hospital system and/or health insurance industry experience, ACO / managed-care experience preferred
8+ years of client management
5+ years of project management experience in a health plan, health system or provider organization
Proven ability to interact with, influence and collaborate with clients at all levels
Experience managing matrixed staff with ability to leverage non-directs to complete tasks.
Proven track record managing complex projects and or programs that resulted in cost savings.
Knowledge of healthcare and insurance industry.
Good interpersonal and communication skills and ability to form strong client relationships.
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
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ADDITIONAL JOB INFORMATION
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.
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Job Function: Management
Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.