Join a multi-discipline team focused on provider contracts that result in improved quality of care and cost for both commercial and Medicare Advantage lines of business. Through management of a small team, apply rigorous analysis and financial discipline to evaluating contracting opportunities and identifying new and better ways of contracting with our provider partners.
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Fundamental Components:
- New commercial VBC model rollout:
Serve as an owner of and a steward for the new commercial VBC model being rolled out in 2020. Participate heavily in first few groups to be stood up on this new construct, since market teams will need guidance as they begin using the new model. Actively engage with MEU to educate and train them on the necessary processes to standardly administer this new model going forward. Glean lessons learned from early adopters to continue to improve, expand, and modify the new commercial VBC model.
- Specialist performance / other VBC development:
Develop new and innovative VBCs that help to fill the specialist gap that exists in most available VBC options today. Determine the best approach for effectively measuring specialist performance, as that will be a critical component of any specialist VBC deals.
Work with others in our central VBC org and with MEU to evaluate and develop other potential VBC opportunities (bundles, for example). - Strategic contracting opportunities:
Partner with local market teams (engagement managers, network, GMs) to evaluate potential strategic contracting opportunities through membership and financial projections. Support external discussions with potential provider partners for opportunities that are determined to be accretive to Aetna.
- General contracting support:
Provide financial and analytical support for evaluation and update of the financial terms in our standard contracting guidelines. Develop financial guidelines for contract parameters as needed for terms that fall outside our standard contracting, and partner with legal to review those terms as needed.
Provide ad hoc financial and analytical support to the broader VBC team and on VBC-related elements of enterprise efforts as needs arise.
Background Experience:
Bachelor’s degree along w/10+ years of prior experience
Prior experience with provider contracts
Must have your ASA (Associate of the Society of Actuary) or FSA (Fellow of the Society of Actuary)
Prior management experience is required as you will have a team of 5
Strong communication skills
Experience with both Commercial and Medicare Advantage business preferred
The ideal candidate can live anywhere in the U.S.A. and you can work in one of our hub locations or work-at-home
Potential Telework Position:
Yes
Percent of Travel Required:
0 – 10%
EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer
Benefit Eligibility:
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Candidate Privacy Information:
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.
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