Contract Negotiation Manager

Recruits providers as needed to ensure network adequacy and achievement of network expansion goals. Negotiates contracts with health care providers using pre-determined internal guidelines and financial standards. Uses various sources of competitive intel to negotiate best in market discounts. Develops rate proposals and performs financial analyses to ensure that results are within pre-determined targets. Negotiates contract language in accordance with Aetna standards, engaging other departments as needed for review and approval of contract terms outside the standards. Responsible for building contracts and amendments in contract management system in accordance with Aetna established guidelines, obtaining signatures, monitoring their progress post-signature, and verifying their accuracy post-release. Manages contract performance and works with various internal departments to address questions, issues, and activities related to execution, loading, and ongoing maintenance of provider contracts. Manages relationships with key providers and ensures resolution of escalated issues related, but not limited to, claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information. Negotiates settlements as needed. Responsible for identifying and making recommendations to manage cost issues and supporting cost saving initiatives.