Network Relations Manager

Company: Aetna
Location: Cary
Posted on: March 16, 2023

Job Description:

Job Description Acts as the primary liaison for assigned complex and integrated providers, (i.e. market/regional/national, large group or hospital systems) to establish, oversee, and maintain provider risk management and positive relationships and supports high value initiative activities; * Conducts provider education, ensures contract compliance, provider communication, claims research and assists with resolution * Implementation of internal and external solutions to achieve provider satisfaction, cost targets, network growth, and efficiency targets. Pay Range The typical pay range for this role is: Minimum: 60,300 Maximum: 130,000 Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location. Required Qualifications Must be experienced in working with all reimbursement payment methodologies * 3-5 years of provider relations and/or network management experience required * Experienced in working with hospitals, large provider groups, is a plus * Must have excellent written, oral, and interpersonal communication skills * Computer literate in Word, Excel, Microsoft Office * Must be flexible and able to handle a highly, fast-paced environment * Must reside in North or South Carolina Preferred Qualifications Knowledge of Commercial and Medicare payment methodologies * Medical claims processing knowledge * QuickBase knowledge a plus * Critical thinking, problem resolution and ability to work independently * Excellent time management skills * Must be flexible and able to handle a highly, fast-paced environment Education Bachelor's degree or equivalent with work experience Business Overview Bring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. 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.

Keywords: Aetna, Cary , Network Relations Manager, Executive , Cary, North Carolina