Aetna Contract Negotiator - National Build Team in Sunrise, Florida

Req ID: 41977BR

This is an exciting opportunity to join Aetna Medicaid on the National Build Team as a Contract Negotiator, operating on a national scale.

Position Summary:

Negotiates, re-negotiates and executes physician and/or provider contracts in accordance with company standards in order to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals. Develops 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. Among the success factors inherent in this position: - Candidate must be able to manage priorities effectively and multi-task in a fast-paced work environment - Candidate must be able to maintain a high level of quality while often working on aggressive time frames. - Candidate should have a broad background in the healthcare industry and be able to work productively with internal professionals in multiple departments, including Legal, Claims Operations, Database Management, Finance, and Health Services. - Candidate should have strong communications skills, both written and oral, and be comfortable speaking with healthcare providers, including administrators and clinicians. - Candidate should have experience dealing with multiple healthcare provider types, including hospitals, physicians, ancillary providers, and vendors. - Candidate should have experience negotiating provider contract language. - Candidate should have functional understanding of multiple reimbursement methodologies used in healthcare provider contracts

This role is open to any location, not location specific, office based is an option as well.

Fundamental Components:

The position includes: Analysis of profitability of provider contracts, sustainability, and member access to existing network of participating providers. Development of strategies to improve member access to participating providers. Development of strategies, contracts, and rate methodologies to improve profitability. Negotiation of provider agreements with provider management staff, including senior level administration. Direct interaction with a number of multi-disciplinary units within Aetna Medicaid, including Finance, Health Services, Actuarial, Legal, Claims Operations, Provider Relations, Appeals, Database Management, Quality Improvement, and Compliance. Maintaining a strong working relationship with the provider community, developing and cultivating an atmosphere of mutual trust. Helping providers to get their issues resolved as needed.

BACKGROUND/EXPERIENCE desired:

The successful candidate: Must have 4-6 years of network development/management experience or comparable healthcare background. Should have at least a Bachelors degree, preferably in Business, Healthcare, or a similar field. Significant industry experience will be considered in lieu of a Bachelors degree. Experience negotiating contract terms and rates with varied provider entities.

EDUCATION

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

FUNCTIONAL EXPERIENCES

Functional - Network Management/Contract negotiation/4-6 Years

Functional - Network Management/Physician recruiting - medical/4-6 Years

Functional - Network Management/Provider relations/4-6 Years

TECHNOLOGY EXPERIENCES

Technical - Desktop Tools/Microsoft PowerPoint/4-6 Years/End User

Technical - Desktop Tools/Microsoft PowerPoint/4-6 Years/End User

Technical - Desktop Tools/Microsoft SharePoint/4-6 Years/End User

REQUIRED SKILLS

General Business/Demonstrating Business and Industry Acumen/ADVANCED

Leadership/Collaborating for Results/ADVANCED

Sales/Negotiating collaboratively/ADVANCED

DESIRED SKILLS

Leadership/Developing and Executing Strategy/ADVANCED

Sales/Managing Competitive Networks/ADVANCED

Service/Demonstrating Service Discipline/ADVANCED

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