Aetna Network Relations Spec in Charleston, West Virginia

Req ID: 56511BR

POSITION SUMMARY

Internally supports and contributes to positive provider relationships by handling routine provider service inquiries and problems regarding policies and procedures, plan design, credentialing process or status. Supports the maintenance of contract or demographic data.

Fundamental Components:

  • Triages routine provider issues and internal inquiries.

  • Educates providers on portals, protocols, policies, procedures, and services to enhance overall provider experience.

  • May assist with or perform standard provider recruitment or contracting or re-contracting functions and discussions

*Performs credentialing support as needed.

BACKGROUND/EXPERIENCE desired:

Excellent Interpersonal Skills.

Organized.

Team player.

EDUCATION

The highest level of education desired for candidates in this position is a Associate's degree or equivalent experience.

FUNCTIONAL EXPERIENCES

Functional - Claims/Claim processing - Medical or Hospital- HMO/1-3 Years

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

TECHNOLOGY EXPERIENCES

Technical - Desktop Tools/Microsoft Exchange/1-3 Years/End User

ADDITIONAL JOB INFORMATION

This is an excellent role in which to learn the critical aspects of the day-to-day operations activities, to serve internal and external customers.

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 candidates'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

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.