Regional Network Director - 51152BR
Aetna Inc.
Dubai, United Arab Emirates , US
منذ 92 يوم

Family Summary

  • Design, develop, contract, maintain and enhance relationships with Middle East & Africa facilities, physicians, ancillary providers and vendors which serve as contractual networks of care for members;
  • foster growth of managed care products; and enhance profitability of Aetna Global Benefits.

    Position Summary

    Manages delivery of regional support functions for network operations, developing provider contracts, including

    establishing rates and reimbursement programs.

    Fundamental Requirements

  • Oversee the development and delivery of regional support functions for local market network operationsDirects the establishment of rates, incentives ,fee schedules and reimbursement programs for the local marketsManage provider contract support functions including the development of boiler plate contracts and state filings;
  • 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-

  • effective provider contractsBe accountable for team objectives, budget, financial results and objectivesSelect and build strong functional teams through formal training, diverse assignments, coaching, mentoring and performance managementFormulate and implement strategy for the organization / unit to meet objectives and other business initiativesDevelop and influence changes / enhancements to business processes, policies and infrastructure to improve operational efficiencyDevelop and set provider network policy and guidelines;
  • 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

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