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Aetna Program Manager, Value-Based Solutions and Network Operations in Wellesley, Massachusetts

Req ID: 60282BR

Job Description

Accountable for supporting the development of market network

strategy and leveraging Value Based Solutions (VBS) and Medicare assets and

overall company network resources. Provide market and competitive information,

support, specialist resources, documentation, analysis needed to support the

attainment of local and enterprise network business objectives. Support

negotiations and development of Value Based Contracts, Collaborations, Advance

Physician Partnerships and/or Joint Venture Health Plan or Risk Bearing Entity

(RBE) relationships. Help document and develop partnership guidelines and

leverage enterprise best practices for providers with innovative models or

national scope. Become a trusted advisor and key resource for all provider

network related issues for local markets.

Fundamental Components included but are not limited to:

· Proactively leads a program and/or most complex

projects by setting strategic direction

· Stimulates strategic thinking in support of

business direction

· Supports all project and/or program management

work including monitoring and tracking of progress and status update

communications, such as rolling out new programs/ strategy to geographic area

of responsibility

· Leverages deep quantitative and qualitative market

intelligence to ensure that network strategy is powered by comprehensive and

robust strategic analysis

· Assist in responding to Request For Information

from providers for strategic partnerships

· Develops executive level analyses and

presentation materials

· Supports relationships with local and enterprise

leaders and contacts

· Coordinates and facilitates discussions to

engage key players required to help local markets develop and execute their

value-based strategies

· Helps develop and drive territory and market-specific

Medicare, commercial Value Based Contracting (VBC) and Joint Venture strategies

that lead to increasingly accretive arrangements

· Collaborates with Aetna s market leadership and

senior executives to develop business case and gain internal approvals

· Works collaboratively with health plans,

territories, and business segments on Medicare network related activities such

as service area expansions, adequacy, compliance, audits

· Helps identify and close gaps in organization

capability/support inhibiting attainment of network performance and growth

potential

· Communicates in a candid, transparent and

persuasive manner, seeking others input and adjusting approach based on

audience and the need

Qualifications Requirements and Preferences:

· 2+ years experience and technical/functional

expertise, with advanced knowledge in one or more of the following at a managed

care or provider organization:

o Network development/management, or network

operations

o Consulting

o Mergers and acquisitions

o Finance

o Medicare Advantage

· 2+ years experience with value based contracting

from a payer or provider perspective

· Proven project management skills

· Proven track record of meeting project

milestones and negotiating for resources

· Demonstrated sales and/or relationship

management skills at a senior level and with external constituents

· Experience developing executive level

presentation materials

· Strong analytical skills

Additional Job Information:

Ability to communicate effectively with all levels of management.

Proven ability to satisfy customers needs and develop alternatives to resolve issues.

Benefit Eligibility

Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Job Function: Management

Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.

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