Company: Aetna Inc.
Posted on: January 15, 2022
Negotiates, executes, conducts high level review and
analysis, dispute resolution and/or settlement negotiations
of contracts with larger and more complex,
market/regional/national based group/system providers in
accordance with company standards in order to maintain
and enhance provider networks while meeting and
exceeding accessibility, quality and financial goals and
* Negotiates and executes, conducts high level review
and analysis, dispute resolution and/or settlement
negotiations of contracts with larger and more complex,
market-based, group/system providers.
* Manages contract performance and supports the
development and implementation of value based
contract relationships in support of business
* Recruits providers as needed to ensure attainment
of network expansion and adequacy targets.
* Accountable for cost arrangements within defined
* 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.
* Responsible for identifying and managing cost
issues and initiating appropriate cost saving initiatives
and/or settlement activities.
* Assists with the design, development, management,
and or implementation of strategic network
configurations and integration activities. May optimize
interaction with assigned providers and internal business
partners to manage relationships to ensure provider needs
* Ensures resolution of escalated issues related, but not
limited to, claims payment, contract interpretation and
parameters, or accuracy of provider contract or
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
* 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.
* Proven working knowledge of provider financial
issues and competitor strategies, complex
contracting options, financial/contracting arrangements
and regulatory requirements.
* 5-7 years related experience and comprehensive
level of negotiating skills with successful track record
negotiating contracts with individual or complex
provider systems or groups.
* Strong communication, critical thinking, problem
resolution and interpersonal skills.
Bachelor's Degree or equivalent combination of
education and 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
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
Keywords: Aetna Inc., Wilmington , Network Manager, Executive , Wilmington, Delaware
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