Aetna Network Relations Consultant in South Portland, Maine

Req ID: 45881BR

POSITION SUMMARY

Facility and Provider facing, solutions-oriented position to deliver extraordinary service to our healthcare partners. Project management of Provider Network operational functions including Medicare and Commercial requirements.

Fundamental Components:

Responsible for collaborating and providing excellent service for our Hospital, Facility and Provider relationships

Majority of the role is resolving any and all Provider Partner issues including credentialing and claims issues

Project management for internal audits and compliance reviews encompasses a significant component of the job expectations

Will work across all departments for a solution solving approach to meet Provider needs

BACKGROUND/EXPERIENCE desired:

Professional relationship building skills

Ability to multi-task in a fast paced environment

Ability to project manage operational functions

1-5 years industry experience or proven customer service relations

Working knowledge of healthcare preferred

Analytical/data driven decision-making skills

Strong analytical and written/oral communication skills.

EDUCATION

The highest level of education desired for candidates in this position is a Associate's degree or equivalent experience.

LICENSES AND CERTIFICATIONS

Customer Service/Associate Customer Service Specialist is desired

Information Management/ is desired

Office Support/ is desired

Healthcare Management/ is desired

FUNCTIONAL EXPERIENCES

Functional - Customer Service/Customer Service - Member Services - Traditional products/1-3 Years

Functional - Administration / Operations/Data Entry/1-3 Years

Functional - Project Management/Intra-department project management/1-3 Years

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

Functional - Network Management/Provider data services/1-3 Years

TECHNOLOGY EXPERIENCES

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

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

REQUIRED SKILLS

Service/Providing Solutions to Constituent Needs/ADVANCED

Benefits Management/Interacting with Medical Professionals/ADVANCED

ADDITIONAL JOB INFORMATION

Positive work environment

Ability to grow and learn the healthcare industry

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