Medicare Collaboration Manager
Aetna - Scottsdale, AZ

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ACS is a fast-paced, high growth division of Aetna’s Emerging Businesses. The department builds partnerships with provider organizations through innovative insurance reimbursement models and redesigned care delivery programs and technology solutions focused on population health management. ACS is redefining how payers and providers work together and achieving the triple aims of improved patient experience, improved quality of care, and lower cost of care per capita. Medicare Collaborations specifically focus on Medicare Advantage (MA) patients.
The Medicare Provider Collaboration Manager will report into the Field Operations arm of ACS and will work on several deals. The Provider Collaboration Manager will be accountable for leading all aspects of the successful implementation, account management, and benefit realization of the Provider Collaborations. This individual is responsible for the development, coordination, execution and management of Medicare Network Provider Collaboration strategies in defined geographies to support Medicare Advantage growth and performance improvement opportunities. Through active client management, systemic analyses, and consultancy, s/he ensures the achievement of financial, product, technology, clinical, and operational Provider Collaboration goals.

KEY RESPONSIBILITIES:Expand the Aetna Medicare Provider Collaboration Program by:
  • Identifying and recruiting of provider organizations in collaboration with regional, local market, and Accountable Care Solutions team
  • Negotiating complex collaboration and shared risk agreements to achieve desired engagement, quality, and financial outcomes
  • Building growth strategies to increase member penetration
  • Coordinating cross functional teams of care management, local market, and ACS to support critical engagement activities and to achieve performance targets
  • Continually improving quality and efficiency measures and performance
  • Defining and implementing enhanced operational, systems, and reporting requirements
  • Managing all contractual requirements
  • The highest level of education desired for candidates in this position is Bachelor’s degree or equivalent experience.
FUNCTIONAL EXPERIENCES:4 – 6 years of the following:
  • Network/Network strategy
  • Network Management/ Contract Negotiation
  • Network/ Medical cost management
  • Network management/ Provider relations
  • Information management/ Business information analysis
  • Microsoft Excel, Access, and PowerPoint
Mid America & West Regions
Clickhereto review the benefits associated with this position.
Aetna does not permit the use of tobacco related products or drugs in the workplace.
Job Function: Management
Job Function: Management
Job Function: Management
Job Function: Management
Job Function: Management
Job Function: Management
Job Function: Management
Job Function: Management

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