Aetna Network Consultant in Dubai, United Arab Emirates
Req ID: 41235BR
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.
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.
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.
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