Senior Manager, Network Management

• Negotiates, executes, conducts high level review and analysis, dispute resolution, and/or settlement negotiations of contracts
• works with larger and more complex, market/regional/national based groups/systems to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals and cost initiatives
• contracts and implements fee for service and value-based agreements with key physician groups, facilities, and ancillary providers to support commercial and individual exchange networks
• works collaboratively with Aetna and CVS departments to identify initiatives to improve physician performance and quality of care provided to members
• recruits providers as needed to ensure attainment of network expansion and adequacy targets
• accountable for cost arrangements within defined groups
• collaborates cross-functionally to manage provider compensation and pricing development activities, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities

• 5 to 7 years contract negotiating with individual or complex provider systems or groups
• 3 to 5 years of experience with VBC, Commercial and Medicare contracting
• 3 to 5 years of stakeholder management experience – experience with leading, creating and delivering executive presentations
• prior experience contracting with hospital systems and groups
• proven working knowledge of provider financial issues and competitor strategies, large/complex contracting options, financial/contracting arrangements, and regulatory requirements
• strong communication, critical thinking, problem resolution and interpersonal skills
• advanced Excel experience including pivot tables and v-lookup function
• ability to work remotely, in Iowa, Missouri, Nebraska, or South Dakota

individual exchange and Medicaid experience

• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• employee stock purchase plan
• no-cost programs including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
• paid time off
• flexible work schedules
• family leave
• dependent care resources
• colleague assistance programs
• tuition assistance
• retiree medical access