Aetna Network Manager in Los Angeles, California

Req ID: 53435BR

POSITION SUMMARY

Provider recruitment and management for the workers' compensation and auto products to support our clients' market needs. Focus is on initial recruitment, renegotiations, group management and fostering of provider relationships to enhance our workers' compensation and auto product offerings. Emphasis is on meeting and exceeding our clients' network expectations.

Fundamental Components:

Provider engagement to maximize contractual network offerings.

Support of team colleagues' provider activity.

Market analysis related to provider dynamics and network components

Contract language and rate discussions with provider representatives

Documenting network support and development activity for Account Managers and clients

Respond to special projects / initiatives to support the network for workers' compensation / auto products

Participate and lead Aetna culture related activities

Support MCO and market driven network offerings

Respond to Account Management / Sales with provider network solutions

BACKGROUND/EXPERIENCE desired:

Strong written and verbal communications and the ability to describe aspects of provider network dynamics.

3+ years related provider network experience.

Comprehensive level of provider negotiating skills with documented, successful track record

Ability to provide examples of critical thinking, problem resolution and interpersonal skills.

Provider negotiating background with individuals or complex provider systems or groups.

Proven working knowledge of provider financial issues, rate methodologies and complex contracting options.

Understanding of financial/contracting arrangements and various regulatory requirements.

EDUCATION

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

LICENSES AND CERTIFICATIONS

Communications/ is desired

FUNCTIONAL EXPERIENCES

Functional - Communications/Provider communications/4-6 Years

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

TECHNOLOGY EXPERIENCES

Technical - Database

REQUIRED SKILLS

General Business/Demonstrating Business and Industry Acumen/ADVANCED

Benefits Management/Interacting with Medical Professionals/MASTERY

Sales/Managing Competitive Networks/MASTERY

DESIRED SKILLS

General Business/Turning Data into Information/ADVANCED

Service/Creating a Differentiated Service Experience/ADVANCED

Technology/Selecting and Applying Technology Solutions/ADVANCED

Telework Specifications:

Part-Time Telework (ex: 2 days office-based, 3 days telework) is an option or in the office.

ADDITIONAL JOB INFORMATION

We are looking for a self-motivated individual who can make a provider network difference for our workers' compensation and auto clients. Be part of a team who uses the word "family" and is passionate about supporting our Account Managers with quantifiable network activity.

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