Dir Network Management- Aetna - WFH Flexible
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Leads and manages teams of employees who develop, negotiate, contract, and enhance provider networks of high quality, are cost efficient and will improve healthcare for our customers. Oversees the development of programs to maintain and enhance collaborative provider relationships and operational effectiveness. Maintains accountability for related compliance, quality and financial goals. Manages a high functioning team responsible for ensuring overall network competitiveness and profitability for a given geographical area or assigned provider type. The Director’s responsibility and complexity may vary by market size and the need for units may be organized around services such as hospitals, providers, providers, or both; the type of contract, such as fee for service or value based, compliance functions and or cost management efforts.
8 – 10 years related experience in health operations, network relations and development, command of financials and pricing strategies, and sales interface.
Experience building and maintaining relationships with provider systems.
A successful track record managing and negotiating major provider contracts.
In depth knowledge of various reimbursement structures and payment methodologies for both hospitals and providers/providers.
In-depth knowledge of managed care business, regulatory /legal requirements.
Solid leadership skills, including staff development and talent management.
COVID-19 Vaccination Requirement
CVS Health requires its Colleagues in certain positions to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.
- If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 30 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 60 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.
- If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 30 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.
Knowledge and experience with value based contracting and accountable care models.
Analytical experience reviewing data and identifying medical cost trends with ability to implement initiatives to mitigate medical cost.
Bachelors degree or equivalent work experience
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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