Aetna Network Relations Consultant in Louisville, Kentucky
Req ID: 43958BR
Develops strong relationships with network providers and internal business partners leading to the achievement of provider satisfaction, medical cost targets, network grown and/or efficiency targets.
** This role will be located in our Louisville, KY office.
Executes strategic components of the HCD business plan for the market. Coordinates with constituents on medical cost and membership growth and network fortification initiatives. Communicates with external constituents and effectively engages the provider community, demonstrating the Aetna value proposition Negotiate contracts on behalf of the company. Manages medical cost drivers, executes specific medical cost initiatives to support financial, medical cost objectives. Proactively identifies new trends and products within Aetna and the industry and works to raise awareness throughout the organization in order to gain consensus on action and drive to implementation. Consistently monitors Aetna service capabilities to collaboratively ensure that provider constituents needs are met. Seeks to optimize provider interaction, provides recommendations based on provider needs and Aetnas objectives. Responsible for developing and maintaining relationships with physician and business leadership of key physician groups, ancillary providers, and delivery systems. Interacts with large, high profile physician groups, IPAs, PHOs and hospital systems to facilitate solutions that are mutually beneficial for both providers and the organization. Collaborates cross-functionally on more complex issues to ensure provider needs are met and outstanding issues are resolved. Collaborates with internal team members on the implementation of large, high profile physician groups, IPAs, PHOs and hospital systems to ensure a positive business relationship.
Proven ability to synthesize and translate competitive intelligence into decision-making process.
2-5 years industry experience. (Medical Cost Drivers and Managed Care Industry)
Working knowledge of provider business operations (PRL)
Analytical/data driven decision-making skills
Strong analytical and written/oral communication skills.
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
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
Functional - Information Management/Utilizes and maintains pricing models and medical cost tracking tools/1-3 Years
Technical - Aetna Applications/Strategic Contracts Manager/1-3 Years/End User
Technical - Aetna Applications/Enterprise Provider Database System/1-3 Years/End User
Benefits Management/Interacting with Medical Professionals/ADVANCED
General Business/Turning Data into Information/ADVANCED
Leadership/Developing and Executing Strategy/FOUNDATION
Sales/Managing Competitive Networks/FOUNDATION
Service/Providing Solutions to Constituent Needs/ADVANCED
Located in Cincinnati, OH or New Albany, OH Office.
ADDITIONAL JOB INFORMATION
This is a rewarding, fast paced role in a dynamic organization.
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