Senior Manager, Provider Plan Sponsor Consulting

• Identifying specific provider network strategies to manage medical cost and trend
• Creating strong relationships with local and national network teams
• Maintaining an in-depth knowledge of Aetna network strategies and performance
• Reviewing data to inform recommendations
• Serving as a subject matter expert on network related performance including contracting methodologies, network competitiveness and value-based designs
• Communicating complex networking arrangements and delivery performance results to a wide variety of audiences
• Independently managing all network-related, customer- specific health plan performance and identify root causes, identify solutions and present meaningful analysis

• Minimum of 7+ years of direct industry experience negotiating provider contracts and/or provider relations
• Strong understanding of health care network product spectrum and contracting methodologies including advanced knowledge of value-based designs
• Strong communication skills: Able to articulate (verbally and written) complex business results, issues and strategies in a clear, concise and confident manner to all levels and positions of an organization (internal and external)
• Must have strong knowledge of claim coding (CPT/DRG, etc.), provider networks, benefit designs, healthcare products/funding, medical management programs and financial acumen
• Relationship management: Demonstrated relationship management skills at the senior level
• capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously
• Strategic Thinking: Must have demonstrated ability to think strategically in an independent manner and ‘out of the box’ versus accepting the status quo
• Technical Skills: Must possess strong technical skills in Microsoft Office Applications (Excel, Word, PowerPoint) as well as experience using analytic/reporting applications

Familiarity with medical cost analytics and advanced technical skills

• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for all colleagues 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