Aetna Network Manager in Dallas, Texas
Req ID: 54253BR
Plan Sponsor Insights (PSI) is searching for an experienced network professional to support our customers in managing their network performance and strategies. This position will be part of a cross functional team of clinicians and analysts that provide consultative information and create custom solutions for commercial Plan Sponsors.
The primary responsibilities of this position include identifying specific network strategies to manage medical cost and trend. This is a unique opportunity to work directly with plan sponsors, account management, local/ national network, clinicians and analysts to create customized network strategies for our customers. The individual in this position will be responsible for creating strong relationships with local and national network teams, maintaining an in-depth knowledge of Aetna network strategies and performance and reviewing data to inform recommendations. The successful candidate will serve as a subject matter expert on network related performance including contracting methodologies, network competitiveness and value based designs. This is a customer facing position requiring the ability to communicate complex networking arrangements and delivery performance results to a wide variety of audiences. This position requires the ability to independently manage all network-related, customer- specific health plan performance and identify root causes, identify solutions and present meaningful analysis.
Strong communication skills: Able to articulate (verbally and written) complex business results, issues and strategies in a clear, concise and confident manner to all levels and positions of an organization (internal and external). - Business/Industry Knowledge: Minimum of 7-10 years of direct industry experience negotiating provider contracts and/or provider relations. Strong understanding of health care network product spectrum and contracting methodologies including advanced knowledge of value based designs. Must have strong knowledge of claim coding (CPT/DRG, etc.), provider networks, benefit designs, healthcare products/funding, medical management programs and financial acumen. - Relationship management: Demonstrated relationship management skills at the senior level; capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously. - Strategic Thinking: Must have demonstrated ability to think strategically in an independent manner and out of the box versus accepting the status quo. - Technical Skills: Must possess strong technical skills in Microsoft Office Applications (Excel, Word, PowerPoint) as well as experience using analytic/reporting applications
Strong communication, critical thinking, problem resolution and interpersonal skills.
5-7 years related experience and comprehensive level of negotiating skills with successful track record negotiating contracts with individual or complex provider systems or groups.
Proven working knowledge of provider financial issues and competitor strategies, complex contracting options, financial/contracting arrangements and regulatory requirements.
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
Functional - Network Management/Provider relations/7-10 Years
Functional - Network Management/Contract negotiation/7-10 Years
Functional - Network Management/Physician recruiting - medical/7-10 Years
Technical - Desktop Tools/Microsoft PowerPoint/4-6 Years/End User
Technical - Aetna Applications/Strategic Contracts Manager/4-6 Years/Power User
General Business/Demonstrating Business and Industry Acumen/ADVANCED
Leadership/Developing and Executing Strategy/ADVANCED
ADDITIONAL JOB INFORMATION
The Plan Sponsor Insights (PSI) team provides customer level consultative analytics and reporting for Aetnas commercial business segments. Working on the PSI team provides the opportunity for exposure to senior levels of management within Aetna as well as to customers and consultants. The work environment supports and thrives on out-of-the box thinking and creative talent. Our team is highly valued by our internal partners as well as the customers they serve.
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 candidates'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
Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.