Aetna Network Manager in Champaign, Illinois
Req ID: 51711BR
Negotiates competitive and complex contractual relationships with providers while adhering to internal guidelines and financial standards. Works cross-functionally to execute network strategies. Maintains accountability for specific medical cost initiatives.
Fundamental Components include but are not limited to: (denotes essential functions) 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 () Act as SME for PRL/Recruiters supporting ancillary and large physician group contracting (*) Assist with the design, development, management, and/or implementation of strategic network configurations Comprehensive understanding of hospital and physician financial issues and how to leverage technology to achieve quality and cost improvements for both payers and providers. In-depth knowledge of managed care business, regulatory /legal requirements, products, programs, strategy and objectives.
Must possess a successful track record negotiating large hospital system contracts.
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
Functional - Network Management/Contract negotiation/7-10 Years
Functional - Products-Medical/All Aetna Standard Plans/1-3 Years
Functional - Leadership//
Technical - Aetna Applications/Strategic Contracts Manager/1-3 Years/
Finance/Delivering Profit and Performance
General Business/Demonstrating Business and Industry Acumen
Benefits Management/Interacting with Medical Professionals
Leadership/Developing and Executing Strategy
Leadership/Driving a Culture of Compliance
Possible WAH potential.
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.
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