Aetna Network Relations Consultant in South Portland, Maine
Req ID: 45881BR
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.
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
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.
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 - 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
Technical - Desktop Tools/Microsoft Outlook/1-3 Years/End User
Technical - Desktop Tools/Microsoft PowerPoint/1-3 Years/End User
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