foster growth of managed care products; and enhance profitability of Aetna Global Benefits.
Manages delivery of regional support functions for network operations, developing provider contracts, including
establishing rates and reimbursement programs.
Contract support, review & approval; and COLA and other contract trackingEnsure the maintenance and integrity of the regional provider data baseManage the development and delivery of training programs for all aspects of network management and provider contracting operationsProvide network contracting support and information analysis to ensure the development of cost-
review and execute negotiated provider agreementsProvide advise and guidance to Senior Management and their senior staff on health delivery issues ensuring market compliance with company contracting policies / methodologiesAssist in the formulation and execution of regional and local market provider network strategies to include training and education for regional and local market teamsManage and / or participate in selected projects and company initiativesExercises sound judgment in decision-
makingMakes decisions in a systematic way that focus on department / business objectivesSets specific, challenging and achievable objectives and action plansNegotiate and oversee implementation of all member-
based payment agreements; perform direct negotiation assistance to all markets in complex agreementsAct as liaison to legal, finance and core health delivery department to facilitate effective interaction with regional / local market health delivery teams
Background / Experience Desired
Major program development experience in support of network management and provider contracting operations.Substantial financial management background.
Arabic Language skills essential
Education and Certification Requirements
Bachelor's Degree or equivalent work experience.
Additional Information In-depth knowledge of managed care business and healthcare environment.Excellent attention to detailStrong negotiation skills#LI-BR1
Job Function : Health Care