Aetna Senior Network Manager in Columbus, Ohio

Req ID: 52395BR

POSITION SUMMARY

Work collaboratively with local health plans, territories, and business segment on Medicare related network activities including compliance, operational and contracting initiatives. Individual needs to be experienced in the government sector including Medicare and/or Medicaid. Individual should be versed in the various payment methodologies used for contracting different provider types including capitation, risk and other innovative models..

Fundamental Components:

Work collaboratively with local health plans, territories, and business segment on Medicare related network activities including compliance, operational and contracting initiatives. Individual needs to be experienced in the government sector including Medicare and/or Medicaid. Individual should be versed in the various payment methodologies used for contracting different provider types including capitation, risk and other innovative models.

BACKGROUND/EXPERIENCE desired:

Strong communication, critical thinking, problem resolution and interpersonal skills.

7+ years related experience and expert level negotiation skills with successful track record negotiating contracts with large or complex provider systems.

Proven working knowledge of provider financial issues and competitor strategies, complex contracting options, financial/contracting arrangements and regulatory requirements.

Proven knowledge and experience in Government Programs including Medicare and Medicaid.

EDUCATION

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

FUNCTIONAL EXPERIENCES

Functional - Network Management/Contract negotiation/7-10 Years

Functional - Network Management/Provider relations/7-10 Years

Functional - Project Management/Cross-functional project management/7-10 Years

Functional - Leadership/Lead significant enterprise-wide initiative/4-6 Years

Functional - Products-Medical/Individual Medicare Advantage Plan/4-6 Years

TECHNOLOGY EXPERIENCES

Technical - Desktop Tools/Microsoft PowerPoint/4-6 Years/Power User

Technical - Aetna Applications/Strategic Contracts Manager/4-6 Years/Power User

Technical - Database/Microsoft Access/4-6 Years/End User

REQUIRED SKILLS

General Business/Demonstrating Business and Industry Acumen/ADVANCED

General Business/Turning Data into Information/MASTERY

Sales/Managing Competitive Networks/MASTERY

DESIRED SKILLS

Benefits Management/Interacting with Medical Professionals/MASTERY

Sales/Negotiating collaboratively/MASTERY

ADDITIONAL JOB INFORMATION

The role will provide the successful candidate an opportunity to work in the growing Network and Medicare segment. They will also have an opportunity to work on a wide array of varying initiatives and projects in support of local market growth.

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