Aetna Network Manager (41734BR) in Tampa, Florida

Req ID: 41734BR

POSITION SUMMARY:

Negotiates, competitive and complex contractual relationships with providers according to pre-determined internal guidelines and financial standards. Works cross-functionally to execute network strategies. Maintains accountability for specific medical cost initiatives.

Fundamental Components:

-Position will be responsible for large hospital and very complex provider relationships maintaining and negotiating healthcare contracts including fee or service and value based payment structures

-Manages the most complex provider compensation/reimbursement and pricing development activities including value based payment models

-Understands medical cost issues and how to develop action plans

-Negotiates complex contract language and Initiates legal reviews as needed; ensure all required reviews completed by appropriate functional areas

-Facilitates resolution of complex provider issues

BACKGROUND/EXPERIENCE desired:

Must possess a successful track record of managing hospital system and complex provider contracts.

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/7-10 Years

Functional - Network Management/Network market leadership/4-6 Years

Functional - Network Management/Provider relations/7-10 Years

TECHNOLOGY EXPERIENCES

Technical - Desktop Tools/Microsoft Outlook/7-10 Years/Power User

Technical - Desktop Tools/Microsoft Word/7-10 Years/Power User

REQUIRED SKILLS

Sales/Negotiating collaboratively/MASTERY

Service/Creating a Differentiated Service Experience/ADVANCED

Service/Demonstrating Service Discipline/ADVANCED

DESIRED SKILLS

Benefits Management/Interacting with Medical Professionals/MASTERY

Finance/Servicing Customers Profitably/MASTERY

Technology/Leveraging Technology/ADVANCED

ADDITIONAL JOB INFORMATION

This is a local market position to be located in the Tampa office in a supportive fast paced environment.

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