Aetna Senior Network Manager in Columbus, Ohio
Req ID: 52395BR
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..
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.
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.
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 - 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
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
General Business/Demonstrating Business and Industry Acumen/ADVANCED
General Business/Turning Data into Information/MASTERY
Sales/Managing Competitive Networks/MASTERY
Benefits Management/Interacting with Medical Professionals/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