Aetna Contract Negotiator - In Office in Tampa, Florida
Req ID: 36171BR
Negotiates, competitive and complex healthcare contractual relationships with providers according to pre-determined internal guidelines and financial standards. Manage large MSO/Risk Provider groups. Ideal candidate will experience in Medicare risk contracting, MRA, STARS and medical cost management. This position will focus on Medicare products.
Negotiates, competitive and complex healthcare contractual relationships with providers according to pre-determined internal guidelines and financial standards. Understands medical cost issues and how to develop action plans. Initiates legal reviews as needed; ensure all required reviews completed by appropriate functional areas. Understands and can articulate MRA, STARS and medical cost management reports. Facilitates resolution of complex provider issues or can navigate in a matrix organization.
Managed Care payer experience 2. MSO/IPA experience 3. Strong financial experience 4. Expert excel, word, powerpoint 5. Analytical
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Healthcare Management/ is desired
Medical Management/Professional Academy for Healthcare Management is desired
Functional - Medical Management/Medical Management - Network Management/1-3 Years
Functional - Network Management/Contract negotiation/1-3 Years
Functional - Marketing/Sales support/1-3 Years
Functional - Management/Management - Process and quality improvement/1-3 Years
Functional - Finance/Financial analysis/1-3 Years
Technical - Desktop Tools/Microsoft Word/1-3 Years/End User
Technical - Desktop Tools/Microsoft Outlook/4-6 Years/End User
Technical - Desktop Tools/Microsoft PowerPoint/1-3 Years/End User
General Business/Demonstrating Business and Industry Acumen/ADVANCED
General Business/Turning Data into Information/ADVANCED
Leadership/Collaborating for Results/ADVANCED
Service/Providing Solutions to Constituent Needs/ADVANCED
Leadership/Developing and Executing Strategy/ADVANCED
Leadership/Driving a Culture of Compliance/ADVANCED
Candidate must live in a commutable distance of Tampa, FL. Once training and orientation is completed, there may be some flexibility with work at home.
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.
Job Function: Health Care