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Network Performance and Strategy Liaison

Primary Location: Dallas, Texas
Additional Locations: TX-Austin, TX-Dallas, TX-Houston, TX-San Antonio
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Description:
Plan Sponsor Insights (PSI) is searching for an experienced network professional to support our customers in managing their network performance and strategies. This position will be part of a cross functional team of clinicians and analysts that provide consultative information and create custom solutions for commercial Plan Sponsors.


Fundamental 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


Additional Job Information:
The Plan Sponsor Insights (PSI) team provides customer level consultative analytics and reporting for Aetna’s commercial business segments. Working on the PSI team provides the opportunity for exposure to senior levels of management within Aetna as well as to customers and consultants. The work environment supports and thrives on out-of-the box thinking and creative talent. Our team is highly valued by our internal partners as well as the customers they serve.

Required Skills:
General Business - Consulting for Solutions, General Business - Demonstrating Business and Industry Acumen, General Business - Turning Data into Information

Desired Skills:
Leadership - Collaborating for Results

Functional Skills:
Network Management - Contract negotiation, Network Management - Provider relations

Technology Experience:
Desktop Tool - Microsoft PowerPoint, Desktop Tool - TE Microsoft Excel

Potential Telework Position:
Yes

Percent of Travel Required:
10 - 25%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

Benefit Eligibility:
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Candidate Privacy Information:
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

Click To Review Our Benefits (PDF)

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