Aetna Network Relations Consultant in Orlando, Florida
Req ID: 62627BR
This position will act as the primary resource for assigned key physicians/ancillaries for contracting activity and maintaining positive relationships. This role will also assist with complex issues regarding policies and procedures, plan design, contract language, service, claims or compensation issues, and provider education needs.
Fundamental Components included but are not limited to:
• Negotiates contracts for physician and ancillary providers according to pre-determined internal guidelines and financial standards. • Works cross-functionally to execute network strategies. • Maintains accountability for specific medical cost initiatives. • Completes the necessary steps to ensure that contracts are loaded into systems accurately and timely and manages implementation of new contracts with departments involved.
Qualifications Requirements and Preferences:
Strong communication, critical thinking, problem resolution and interpersonal skills. 3+ years' related experience, proven and proficient negotiating skills. Proven working knowledge of industry standards, products, financial/contracting arrangements and regulatory requirements. Bachelor s Degree or equivalent combination of education and experience.
Claim - Claims Administration - cost management, Management - Management - Network Management, Network Management - Contract negotiation, Network Management - Physician recruiting - medical, Network Management - Provider relations
Desktop Tool - Adobe Acrobat Suite v5, Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft PowerPoint, Desktop Tool - Microsoft Word
Leadership - Collaborating for Results, Sales - Negotiating Collaboratively, Service - Handling Service Challenges, Service - Providing Solutions to Constituent Needs, Service - Working Across Boundaries
General Business - Turning Data into Information, Sales - Managing Competitive Networks, Service - Managing Organizational Dynamics
Additional Job Information:
Opportunity to work independently in a fast-paced environment with potential for career growth.
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Job Function: Healthcare
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.