Aetna Manager of Physician Contracting (Network Management) in San Antonio, Texas
Req ID: 49450BR
Design, develop, contract, maintain and enhance relationships with facilities, physicians and ancillary providers which serve as contractual networks of care for members and foster growth of managed care products. Negotiates, competitive and complex contractual relationships with providers according to pre-determined internal guidelines and financial standards. Works cross-functionally to execute network strategies. Maintains accountability for specific medical cost initiatives.
Manages a team of direct reports responsible for building, maintaining and enhancing relationships with physicians in multiple markets in South Texas
Effectively negotiates complex, competitive contractual relationships with providers according to prescribed guidelines in support of local, national and regional network strategies.
Identify and collaborate with key physician groups to transition contract to a value based relationship, assist physicians in managing the health of their patient population
Manages provider compensation/reimbursement and pricing development activities.
Responsible for reporting, understanding and managing medical cost issues and initiating appropriate action in partnership with health plan.
Provides sales and marketing support, community relations and guidance with comprehension of applicable federal and state regulations.
Must possess a successful track record managing a team, negotiating large physician agreements and evaluating and identifying strategies to reduce medical cost trend.
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
Functional - Network Management/Network market leadership/1-3 Years
Functional - Network Management/Contract negotiation/4-6 Years
Functional - Network Management/Provider relations/1-3 Years
Technical - Desktop Tools///
Leadership/Engaging and Developing People/ADVANCED
Sales/Managing Competitive Networks/MASTERY
Finance/Delivering Profit and Performance/ADVANCED
General Business/Turning Data into Information/ADVANCED
Leadership/Developing and Executing Strategy/ADVANCED
Can be located in Houston, Austin or San Antonio
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