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Network Account Manager - Location: NH, but work at home

Company Name:
Aetna
Req ID: 18175BR
POSITION SUMMARY
Develops strong relationships with network providers and internal business partners leading to the achievement of provider satisfaction, medical cost targets, network growth and/or efficiency targets. You will service, maintain and enhance relationships with facilities, physicians and ancillary providers. Foster growth of managed care products; and create value for our constituents. As needed, negotiate competitive and complex contracts with providers according to pre-determined internal guidelines and financial standards. Works cross-functionally to execute network strategies. Working knowledge of the New Hampshire /VT provider marketplace will be important.
Fundamental Components:
Account Manager Responsibilities overseeing/managing your accounts o Executes strategic components of the HCD business plan for each market ( ) o Coordinates with segment constituents on medical cost and membership growth and network fortification initiatives ( ) o Communicates with external constituents to effectively engage the provider community and demonstrate the Aetna value proposition. ( ) o Negotiate contracts and other understandings on behalf of the company ( ) Business Knowledge o Manages medical cost drivers and executes specific medical cost initiatives to support financial and medical cost objectives ( ) o Proactively identifies new trends and products within Aetna and the industry and works to raise awareness throughout the organization in order to gain consensus on a course of action and ultimately drive to implementation ( ) o Consistently monitors Aetna service capabilities to collaboratively ensure that provider constituents needs are met. Seeks to optimize provider interaction and provides recommendations based on balance of provider needs and Aetnas objectives. ( ) Building and Maintaining Relationships o Responsible for developing and maintaining relationships with physician and business leadership of key physician groups, ancillary providers, and delivery systems ( ) o Interacts with large, high profile physician groups, IPAs, PHOs and hospital systems to facilitate solutions that are mutually beneficial for both providers and the organization ( ) Collaboration for Results o Collaborates cross-functionally on more complex issues to ensure provider needs are met and outstanding issues are resolved. i.e. provider service efficiencies, provider service improvement initiatives, identifies opportunities for process improvement. ( ) o Collaborates with internal team members on the implementation of large, high profile physician groups, IPAs, PHOs and hospital systems to ensure a positive business relationship ( )
Proven ability to synthesize and translate competitive intelligence into decision-making process. Multi-functional experience 2-5 years industry experience. (Medical Cost Drivers and Managed Care Industry) Working knowledge of provider business operations (PRL) Analytical/data driven decision-making skills Presentation skills Strong analytical and written/oral communication skills.
BACKGROUND/EXPERIENCE desired:
Proven ability to synthesize and translate competitive intelligence into decision-making process.
Multi-functional experience
2-5 years industry experience. (Medical Cost Drivers and Managed Care Industry)
Working knowledge of provider business operations (PRL)
Analytical/data driven decision-making skills
Presentation skills
Strong analytical and written/oral communication skills.
EDUCATION
The highest level of education desired for candidates in this position is a Associate''s degree or equivalent experience.
FUNCTIONAL EXPERIENCES
Functional - Claims/Policies & procedures/4-6 Years
Functional - Communications/Provider communications/4-6 Years
Functional - Sales & Service/Sales administration, support, reporting/1-3 Years
TECHNOLOGY EXPERIENCES
Technical - Desktop Tools/Microsoft Outlook/1-3 Years/
Technical - Desktop Tools/Microsoft PowerPoint/1-3 Years/
Technical - Desktop Tools/Video Conferencing/1-3 Years/
Technical - Desktop Tools/Adobe Acrobat Suite v5/1-3 Years/
REQUIRED SKILLS
Benefits Management/Interacting with Medical Professionals/ADVANCED
General Business/Demonstrating Business and Industry Acumen/FOUNDATION
Leadership/Driving a Culture of Compliance/ADVANCED
DESIRED SKILLS
General Business/Consulting for Solutions/ADVANCED
Leadership/Developing and Executing Strategy/FOUNDATION
Service/Providing Solutions to Constituent Needs/ADVANCED
ADDITIONAL JOB INFORMATION
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.
We conduct pre-employment drug and background testing. Benefit eligibility may vary by position. Clickhereto review the benefits associated with this position.
Job Function: Health Care

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