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Job Information

Aetna Network Manager (Performance and Strategy) in Washington, District Of Columbia

Req ID: 61211BR

Job Description

PlanSponsor Insights (PSI) is searching for an experienced network professional tosupport our customers in managing their network performance and strategies.This position will be part of a cross functional team of clinicians andanalysts that provide consultative information and create custom solutions forcommercial Plan Sponsors.

Fundamental Components included but are not limited to:

The primary responsibilities ofthis position include identifying specific network strategies to manage medicalcost and trend. This is a unique opportunity to work directly with plansponsors, account management, local/ national network, clinicians and analyststo create customized network strategies for our customers. The individual inthis position will be responsible for creating strong relationships with localand national network teams, maintaining an in-depth knowledge of Aetna networkstrategies and performance and reviewing data to inform recommendations.

The successful candidate willserve as a subject matter expert on network related performance includingcontracting methodologies, network competitiveness and value based designs.This is a customer facing position requiring the ability to communicate complexnetworking arrangements and delivery performance results to a wide variety ofaudiences.

This position requires theability to independently manage all network-related, customer- specific healthplan performance and identify root causes, identify solutions and presentmeaningful analysis.

Qualifications Requirements and Preferences:

  • Strong communication skills: Able toarticulate (verbally and written) complex business results, issues andstrategies in a clear, concise and confident manner to all levels and positionsof an organization (internal and external).

    • Business/Industry Knowledge: Minimum of7-10 years of direct industry experience negotiating provider contracts and/orprovider relations. Strong understandingof health care network product spectrum and contracting methodologies includingadvanced knowledge of value based designs. Must have strong knowledge of claim coding (CPT/DRG, etc.), providernetworks, benefit designs, healthcare products/funding, medical managementprograms and financial acumen.

    • Relationship management: Demonstrated relationship management skills at the senior level;capacity to quickly build and maintain credible relationships at varying levelsof the organization simultaneously.

    • Strategic Thinking: Must have demonstrated ability to think strategically in an independentmanner and ‘out of the box versus accepting the status quo.

    • Technical Skills: Must possess strong technical skills in Microsoft OfficeApplications (Excel, Word, PowerPoint) as well as experience usinganalytic/reporting applications.

    Education and CertificationRequirements

• Collegedegree.

• Mastersdegree preferred, but not required.

• Additional Information (situationalcompetencies, skills, work location requirements, etc.)

• Criticalthinking skills.

• Timemanagement skills.

• Organizationalskills.

• Negotiation/influencingskills.

• Relationshipand change management skills.

• Analyticaland planning skills.

• Oraland written communication skills.

• Abilityto work in a team environment

Additional Job Information:

Additional Candidate Info

The Plan Sponsor Insights (PSI) teamprovides customer level consultative analytics and reporting for Aetna scommercial business segments. Working on the PSI team provides the opportunityfor exposure to senior levels of management within Aetna as well as tocustomers and consultants. The work environment supports and thrives onout-of-the box thinking and creative talent. Our team is highly valued by our internal partners as well as thecustomers they serve.

Benefit Eligibility

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

Job Function: Health Care

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.