Aetna Contract Coordinator in W. Sacramento, California

Req ID: 41846BR

This is an office based role in West Sacramento, CA.

POSITION SUMMARY

Primarily serves as the subject matter expert in support of the local markets and Network Access Business regarding Provider disputes related to PPO contract interpretation and PPO rates. To minimize risk, avoid adverse cost implications and ensure compliance with companys policies and procedures.

Fundamental components include but are not limited to:

-Conducts research and resolution of legal disputes from clients, providers and attorneys.

-Maintains contract files and is the liaison for special projects, internal audit, core provider service organization and other functional areas for contract copies and information.

-Ensures contract compliance and adherence with Aetnas 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.

-Communicates effectively when responding to senior management, local market management and negotiators.

-Applies well-developed and effective planning techniques in managing the day-to-day operations and balancing priorities.

BACKGROUND/EXPERIENCE

-Bachelors degree desired or equivalent work experience is required

-Contract interpretation skills are preferred

-Ability to explain contract policy parameters is required

-Can interact effectively with all levels within and across organization

-Knowledge of managed care business, regulatory/legal requirements, products, strategy and objectives is preferred

-Prioritizes tasks effectively and should be well organized

EDUCATION

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

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.

Job Function: Health Care