Aetna Network Relations Consultant in Jacksonville, Florida

Req ID: 45900BR

POSITION SUMMARY

The Network Account Manager position requires contract negotiations in the Orlando Market and have local market knowledge of the industry as well as the ability to develop strong relationships with network providers and internal business partners. Position requires managed-care contracting experience, strong analytical skills, and ability to work cross-functionally to meet company goals and initiatives.

Fundamental Components:

Negotiates contracts for physician and ancillary providers according to pre-determined internal guidelines and financial standards.

Works cross-functionally to execute network strategies.

Maintains accountability for specific medical cost initiatives.

Completes the necessary steps to ensure that contracts are loaded into systems accurately and timely and manages implementation of new contracts with departments involved.

BACKGROUND/EXPERIENCE desired:

Candidate must have a minimum of 2-5 years of functional experience in Provider Relations and/or Network Management. Candidate has strong experience in contract management, compliance, reimbursement methodologies, provider-data management, credentialing and claims reconciliation processes.

EDUCATION

The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.

FUNCTIONAL EXPERIENCES

Functional - Network Management/Contract negotiation/1-3 Years

Functional - Network Management/Physician recruiting - medical/1-3 Years

Functional - Network Management/Provider relations/1-3 Years

TECHNOLOGY EXPERIENCES

Technical - Desktop Tools/Microsoft Word/1-3 Years/End User

Technical - Desktop Tools/Adobe Acrobat Suite v5/1-3 Years/End User

Technical - Desktop Tools/Microsoft Outlook/1-3 Years/End User

Technical - Desktop Tools/Microsoft PowerPoint/1-3 Years/End User

REQUIRED SKILLS

Leadership/Collaborating for Results/FOUNDATION

Service/Improving constituent-focused Processes/FOUNDATION

Sales/Negotiating collaboratively/ADVANCED

DESIRED SKILLS

Leadership/Developing and Executing Strategy/FOUNDATION

Benefits Management/Interacting with Medical Professionals/ADVANCED

Telework Specifications:

Looking for a Central Florida based candidate to work as a Full-time Telework employee with some local travelling within the local Orlando Market.

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.

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