Network Performance ManagerPrimary Location: Plymouth, Minnesota
Additional Locations: CO-Denver, MN-Plymouth, NY-Buffalo Apply
The dedication of talented and caring health care professional drives the delivery of high quality, cost effective products and services. They make it possible for members to get the right health care treatment for their needs and for Aetna to keep its competitive edge.
Overall accountability for the growth of our hospital vertical strategy. Responsibilities include 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 provider 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 utilizes 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. Ensures success full delivery of what was requested. Educates internal and external parties as needed to ensure compliance with policies and parameters, plan design, compensation process, technology, performance measurement techniques, policies, and procedures.
Manages the development and execution of an 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 execute specific cost initiatives to support business objectives and to identify trends and enlist assistance in problem resolution. Consult 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.
7+ years' experience with business segment specific policy, benefits, plan design and language and contract interpretation.
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.
Bachelor’s Degree or equivalent combination of education and experience. Additional Job Information:
Support the growth of our hospital vertical strategy by designing,developing, negotiating, maintaining and enhancing relationships with facilities, physicians and ancillary providers ; foster growthof managed care products; and enhance profitability of Meritain Health and Aetna.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 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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