Aetna Provider Network Account Manager in Richmond, Virginia
Req ID: 41988BR
Exciting opportunity in Aetnas growing Joint Venture area for a Provider Network Account Manager who will be responsible for various internal activities related to the Provider Network department, including interacting with internal business partners leading to the achievement of provider database integrity and provider relations for Aetnas Joint Venture partners.
Design, develop, contract, maintain and enhance relationships with facilities, physicians and ancillary providers which serve as contractual networks for Aetnas Joint Ventures. Also responsible for developing strong relationships with network providers and internal business partners leading to the achievement of provider satisfaction, medical cost targets, network growth and/or efficiency targets.
Executes strategic components of the JV Provider Network business plan.
Responsible for collaborating cross-functionally on more complex issues to ensure provider needs are met and outstanding issues are resolved,. i.e. provider service efficiencies, provider service improvement initiatives, identifies opportunities for process improvement.
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.
Coordinates with segment constituents on medical cost and membership growth and network fortification initiatives.
Communicates with external constituents to effectively engage the provider community and demonstrate the Aetna
Negotiate contracts and other understandings on behalf of the company.
Manages various fee schedules, VBC, medical cost drivers and executes specific initiatives to support financial and medical cost
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 a course of action and ultimately drive to implementation.
Consistently monitors Aetna service capabilities to collaboratively ensure that provider constituents needs are met.
Seeks to optimize provider interaction and provides recommendations based on balance of provider needs and
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
Proven ability to synthesize and translate competitive intelligence into decision-making process.
2-5 years industry experience. (Aetnas system and Managed Care Industry)
Knowledge of SCM & EDPD required
Working knowledge of provider business operations (PRL)
Analytical/data driven decision-making skills
Strong analytical & written/oral comm. skills
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
Functional - Sales & Service/Account Management/
General Business/Demonstrating Business and Industry Acumen/FOUNDATION
General Business/Turning Data into Information/ADVANCED
Position will be located in Northern, VA.
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