Network Performance and Strategy LiaisonPrimary Location: Dallas, Texas
Additional Locations: TX-Austin, TX-Dallas, TX-Houston, TX-San Antonio Apply
61725Fundamental Components: 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.
Background Experience: Core Competencies:
- 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.
Education and Certification Requirements
- College degree.
- Masters degree preferred, but not required.
- Appropriate licensure or certification by discipline preferred.
Additional Information (situational competencies, skills, work location requirements, etc.)
- Critical thinking skills.
- Time management skills.
- Organizational skills.
- Negotiation/influencing skills.
- Relationship and change management skills.
- Analytical and planning skills.
- Oral and written communication skills.
- Ability to work in a team environment
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