Aetna Engagement Manager (Value-Based Contract) in Washington, District Of Columbia
Req ID: 62947BR
The Engagement Manager will report to the Sr. Dir. Engagement. He/she is responsible for coordinating all types of provider interactions in order to implement and maintain a robust and successful Performance Network /value-based-contract (VBC) with targeted providers in the JV service area. This includes assisting with setup and on-going maintenance of technology / care management engagement and guidance from subject matter experts as needed. He/she will interact with providers on a regular basis to handle provider requests and concerns while managing and engaging the providers in advanced reimbursement and value based solutions necessary to realize the terms of the VBC arrangement. He/she will coordinate cross-functional groups across the JV and the wider Aetna organization to carry out these servicing activities, many of which are not lead by groups within the JV or Aetna organization (e.g., Clinical Transformation, IT, Informatics, etc). He/she works to ensure that the Performance Network providers / VBC arrangements are functioning successfully and the VBC arrangement is working to improve quality of care while reducing costs.
Fundamental Components included but are not limited to:
Manages a cross-functional team of various Aetna, client and external resources to implement and maintain ongoing account services in VBC arrangements with combinations of financial, product, technology, clinical, and operational elements, ranging from infrastructure / network installation for provider solutions, ongoing maintenance of provider solutions (e.g., tech / population health services), payments / appeals processes, report generation, and compliance Establishes and maintains relationships across the JV and Aetna organizations to use as support for these provider servicing activities Manages servicing operations on a routine basis, including setting cadence for regular task activities, as well as responding to live direction requests from Engagement Managers Regularly interfaces with provider to facilitate implementation / maintenance of provider servicing activities and to respond to provider requests / concerns Ensures adherence to compliance policies and procedures throughout provider account operations, proactively identifying risks and escalating to leadership as appropriate Responsible for ensuring that provider account services contribute to the JV objective of improving quality of care while reducing costs
Qualifications Requirements and Preferences:
Proven ability to interact with, influence and collaborate with clients at all levels 5+ years of project management experience in a health plan, health system or provider organization 8+ years of client management 8+ years of hospital system and/or health insurance industry experience, ACO / managed-care experience preferred Experience managing matrixed staff with ability to leverage non-directs to complete tasks. Proven track record managing complex projects and or programs that resulted in cost savings. Good interpersonal and communication skills and ability to form strong client relationships. Knowledge of healthcare and insurance industry. Bachelor's Degree Required
Benefits Management - Maximizing Healthcare Quality, Finance - Creating Profitable Partnerships, Technology - Promoting Emerging Technology
General Business - Turning Data into Information, Service - Managing Organizational Dynamics, Technology - Creating Technology Partnerships
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Job Function: Management
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.
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