The Contract Negotiator, negotiates, re-negotiates and executes physician and/or provider contracts in accordance with company standards in order to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals. Fundamental Components: Accountable for all aspects of physician recruitment and contracting as well as ad/hoc network contracting, as assigned. Responsible for re-negotiating or negotiating solo, complex group, hospital-based and large entity physician contracts in support of network quality, availability and financial goals. Participates in the strategic recruitment of physicians satisfying specific network goals and objectives. Provides network development, maintenance and refinement activities and strategies in support of cross-market network management units. Partners across the organization to garner support for network contracting activities to ensure all aspects of operational implementation are completed on a timely and accurate basis.
BACKGROUND/EXPERIENCE: Bachelor's degree desired or equivalent work experience.
EDUCATION: The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
TECHNOLOGY EXPERIENCES: Technical - Desktop Tools/Microsoft Word/4-6 Years
REQUIRED SKILLS: Benefits Management/Interacting with Medical Professionals
ADVANCED SKILLS: Finance/Servicing Customers Profitably, General Business/Demonstrating Business and Industry Acumen/Sales/Managing Competitive Networks, Sales/Negotiating collaboratively, Service/Providing Solutions to Constituent Needs
ADDITIONAL SKILLS - Strong written and verbal communication skills. Able to identify and capitalize on marketing opportunities to support program delivery. Mastery of provider contracts, contracting options, PADU guidelines as well as provider configurations. In-depth knowledge of the managed care industry and practices, as well as a strong understanding of Aetna competitor strategies, practices, and financial/contracting arrangements. Business knowledge including health care and Aetna culture, i.e., how to get things done within the company. Solid negotiating skills. Solid decision-making skills while executing national, regional, and market level strategies. Medicaid experience preferred but not required.