Aetna Sr Dir, Network Mgmt in Houston, Texas
Req ID: 48331BR
This position sits in our Aetna office in Phoenix, AZ.
A senior level position responsible for negotiating the most complex and challenging contractual relationships with
providers. Works cross-functionally within the region to ensure consistency with all contracting strategies. Maintains
overall accountability for medical cost management within a defined market or geographical area.
Formulates the overall network strategy used to manage medical costs for a predefined geographic area.
Partners with Medical Economics team to assess effectiveness of tactical plan in managing costs.
Negotiates complex, competitive provider contracts with significant financial implications and manages relationships
with key providers and health systems.
Responsible for contract negotiations involving all provider types including at-risk arrangements, IPA/PHO, hospital,
and large physician groups.
Manages providers' compensation and pricing development activities for defined geographic area.
Designs, develops, manages, and/or implements strategic network configurations.
Supervises day-to-day operations of network management teams including all Provider Relations and contract
negotiating staff. Responsible for hiring, training and firing local/regional staff.
Provides network strategy support to sales and marketing along with assistance on community relations related items
Understands regulatory environment and ensures contractual compliance with federal and state requirements. (*)
Must possess a successful track record negotiating large hospital system contracts.
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
ADDITIONAL JOB INFORMATION:
In-depth knowledge of managed care business, regulatory /legal requirements, products, programs, strategy and
Comprehensive understanding of hospital and physician financial issues and how to leverage technology to achieve
quality and cost improvements for both payers and providers.
Solid leadership skills including staff development.
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.our
Job Function: Health Care