Aetna Network Consultant in Dubai, United Arab Emirates

Req ID: 41235BR

Position Summary

Design, develop, contract, maintain and enhance relationships with medical facilities and vendors in the Middle East which serve as contractual networks of care for members; and enhance profitability of Aetna Global Benefits.

Fundamental Components

  • Contracting with new medical providers in the MEA region ,negotiates new service codes as well as the renewal of contracts in accordance with applicable Aetna guidelines and instructions

  • Negotiates volume rebates, upfront / early payment discount, with medical providers.

  • Supports global network initiatives

  • Turns data into information through ROW network analysis

  • Educates providers and Aetna staff, including:assessing needs, designing and developing training and educational materials

  • Coordinates distribution of product/educational materials

  • Implements network development and refinement strategies

  • Conducts and manages continuous review of provider networks to assure appropriate network composition

  • Monitors multi-year contract rate changes, and consult with colleagues to ensure new rates are loaded appropriately

  • Identifies areas of improvement, makes recommendations, designs processes, implements and follow up until completion.

Background/Experience Desired

  • 3-5 years of relevant experience in medical network management with Providers in the GCC

  • Experience managing vendors/Third Party Administrators is desirable

  • Familiarity with contract language a plus

  • Demonstrated organizational and communication skills required

    Education and Certification Requirements

  • Bachelor s degree or equivalent work experience.

Additional Information

  • Strong analytical skills (Excel Skills a must)

  • Sound knowledge of the GCC healthcare and insurance market, legislation and regulations.

  • Ability to anticipate customer needs and requirements, as well as to facilitate and negotiate using tact and diplomacy.

  • Ability to communicate effectively with Providers, Members, and Staff & Upper Management in both an oral and written format.

Job Function: Health Care