Aetna Duals Strategy & Market Performance in New York, New York
Req ID: 49576BR
** LOCATION NOTICE: This position is a telework role that requires travel to NYC/Hartford. You must live close to a major airport with direct flights into NYC/Hartford as a requirement for this position if you do not live within driving distance to these offices.
Own strategy in consultation with the markets and Medicare and Medicaid network strategy to develop overarching and market specific duals strategy including network and growth
-Own strategy in consultation with the markets, and Medicare/Medicaid network strategy to develop overarching and market specific duals strategy including network and growth
-Liaison with market and Medicaid operations regarding provider data management
-Lead individual market with implementation, ongoing operational performance management, market execution, annual implementation
-Host monthly market-based performance management processes
-Coordinate activities among and between markets and segments supports to enhance consistency, leverage best practices, be proactive in planning, etc.
-Own implementation of operating model across new markets, support transition to new operating model in existing markets, identify opportunities for improvement, support model of care implementation efforts, etc.
-Identify new/different providers based on clinical and demographic characteristics of membership
-Create strategy on VBC arrangements
-Liaison with MSO, Medicaid central and market functions, Medicare and Medicaid markets, other enterprise functions supporting dual eligibles.
-DSNP SME capabilities within new markets
Strong communication, critical thinking, problem resolution and interpersonal skills.
7+ years related experience and expert level negotiation skills with successful track record negotiating contracts with large or complex provider systems.
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/Network market leadership/4-6 Years
Functional - Network Management/Contract negotiation/4-6 Years
Functional - Network Management/Provider relations/4-6 Years
Technical - Desktop Tools/Microsoft PowerPoint/4-6 Years/End User
Technical - Desktop Tools/Microsoft Word/7-10 Years/Power User
Leadership/Developing and Executing Strategy/ADVANCED
Sales/Managing Competitive Networks/MASTERY
Finance/Delivering Profit and Performance/ADVANCED
Part-Time Telework (ex: 2 days office-based, 3 days telework)
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.
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