Director of Provider Relations

Qualified Candidates will be in the Jacksonville, FL area
Negotiates, competitive and complex contractual relationships with physician and ancillary providers according to pre-determined internal guidelines and financial standards. Works cross-functionally to execute network strategies. Maintains accountability for specific medical cost initiatives. Manages local network team across Northern Florida (Panhandle, North and North Central).
Fundamental Components:
Effectively negotiates complex, competitive contractual relationships with physician and ancillary providers according to prescribed guidelines in support of national and regional network strategies (Medicare and commercial business included)
Manages provider compensation/reimbursement and pricing development activities across the markets in North Florida
Responsible for understanding and managing medical costs and developing/initiating appropriate action plans based on identified opportunities
Provides sales and marketing support, community relations and guidance with comprehension of applicable federal and state regulations
Assist with the design, development, management, and/or implementation of strategic network configurations including Value Based Contracting and Population Health provider partners
Minimum of 7 years recent and related experience in managed care.
Recent and related experience in successful physician and ancillary provider contracting.
Strong communication, negotiation, and presentation skills.
Ability to lead professionals and manage through influence and cooperation.
The highest level of education desired for candidates in this position is a Master's degree.
Functional - Management/Management - Network Management/4-6 Years
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Functional - Network Management/Physician recruiting - medical/7-10 Years
Functional - General Management/Multi-functional management: < 25 employees/4-6 Years
Technical - Aetna Applications/Provider Contracts/4-6 Years/End User
Technical - Desktop Tools/Microsoft Outlook/7-10 Years/End User
Technical - Desktop Tools/Microsoft PowerPoint/7-10 Years/End User
Technical - Desktop Tools/Microsoft Word/7-10 Years/End User
Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.
We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.
Together we will empower people to live healthier lives.
Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.
We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.
Employment Type Regular Career Band Description Management

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