Network Development Contract Negotiator (Physician Hospital Organization) (54144BR)Primary Location: Detroit, Michigan
Additional Locations: MI-Detroit Apply
Overall accountability for structuring and maintaining successful collaborations and for the strategic alignment and operational success of assigned provider relationships with most complex/high value initiatives and/or highest risk and revenue generating provider systems, networks and relationships (i.e. value based).
Optimizes interactions, anticipates needs, and provides recommendations to providers and internal business partners to establish and maintain productive, professional relationships.
Consults on operational design and implementation of the business strategy and executes the strategic vision and tone for the relationship and carries out the operational plan to execute that strategy.
Influences and/or manages internal cross-functional groups and external client relationships and utlizes data in the management of patient populations to ensure that financial, technology, clinical, operational goals, provider satisfaction, cost targets, network growth, and efficiency targets are achieved.
Educates internal and external parties as needed to ensure compliance with contract policies and parameters, plan design, compensation process, technology, performance measurement techniques, policies, and procedures.
Manages the development and execution of annual strategic business plans and meeting with key providers to ensure service levels are meeting expectations.
Collaborates cross-functionally to ensure optimal implementation of large provider systems, monitor and optimize performance including clinical, quality, capabilities, and growth as well as financial goals.
Manages cost drivers and executes specific cost initiatives to support business objectives and to identify trends and enlist assistance in problem resolution.
Consults with providers to improve functionality and enhance solutions, programs, products, services and technology to ensure better outcomes and achievement of program objectives.
Accountable for the collaboration management services being delivered.
Experience with financial models, value-based solutions and overall contracting strategy required
7+ years experience with several of the following methodologies: management consulting, project consulting, strategic analysis and planning, and/or risk management consulting
Working knowledge of business segment specific codes, products, and terminology
7+ years' experience with business segment specific policy, benefits, plan design and language and contract interpretation.
7+ years' experience in hospital contract negotiation
Demonstrated project and client management, strategic planning and proven ability to interact with, influence and collaborate with clients at all levels
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
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ADDITIONAL JOB INFORMATION
Ability to build a competitive Medicaid/Medicare managed care network facilitating membership/revenue growth.
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 candidates'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.
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