Aetna Contract Coordinator in Sandy, Utah
Req ID: 41798BR
Supports Network Managers with contract development and implementation. Serves as subject matter expert on Aetna's Strategic Contract Manager (SCM) system, advising Network Managers on how to best structure deals to ensure they can be administered by SCM and other Aetna systems in accordance with Aenta's policies and procedures. Also works with providers to ensure Aetna's providers databases and directories are accurate.
Collaborates on negotiations and ensures all contracts are reviewed and audited for accuracy; Coordinates all required approvals with appropriate parties
Ensures contract compliance and adherence with Aetna's policies and procedures
Develops and maintains effective working relationships with the Network Manager, local markets and cross-functional areas
Maintains focus on quality in completing internal processes correctly and efficiently
Receives, processes and triages all incoming contracts expeditiously to the appropriate areas
Communicates effectively when responding to Senior Mgmt, Local market mgmt/negotiators
Provides technical expertise for SCM, codified service and compensation schedules and related systems
Coordinates pre-signature business intent reviews (BIR)
Maintains contract files and is the liaison/single-point-of-contact for special projects, internal audit, core, provider service organization and other functional areas for contract copies and information
Supports markets with training needs related to company's policies, procedures, regulatory compliance (HIPAA, AVC, etc.), SCM, and claims adjudication (ACAS/Pricer)
Bachelor's degree desired or equivalent work experience.
Working knowledge of SCM and other Aetna internal systems preferred.
Contract interpretation skills; ability to assess administrative and constituent impact.
Ability to explain contract policy parameters in terms local market network staff can understand.
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
Provider data services/1-3 Years
Provider relations/1-3 Years
Microsoft Outlook/1-3 Years
Microsoft Word/1-3 Years
Creating a Differentiated Service Experience
Ensuring Project Discipline
Working Across Boundaries
ADDITIONAL JOB INFORMATION:
This is a critical network position, central to the development and growth of key provider relationships. The incumbent will gain substantial exposure to how complicated provider deals are developed and administered.
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