Aetna Network Contract Spec in Tampa, Florida
Req ID: 58101BR
Responsible for loading, implementation, maintenance of standard provider contracts, schedules and agreements and files in support of business segment contracting initiatives. This includes working with provider data and a multitude of contracting and provider data projects.
*Builds, loads and maintains standard contracts, agreements, amendments and/or fee schedules, tables in contract management systems.
*Ensure that signature and delegation activities are complete per required timeframes. Partners with internal constituents and provides information to ensure contract compliance adherence to company policies and procedures including contracting guidelines, clinical and payment policy information, coding requirements, and other required policies/procedures.
*Sends, receives, processes and documents and triages provider contracts and agreements and ensures all paperwork is received, complete and accurate. Sends agreement to providers. Partners cross-functionally to ensure credentialing process is complete. Requests appropriate analyses (financial, legal, business language reviews) as appropriate.
*Maintains contract and agreement files and file management systems and spreadsheets and is single point of contact for questions related to same as well as special projects, internal audit, core, provider service organization and other functional areas for contract copies and information.
*Handles a multitude of provider data projects and other duties as assigned
Looking for individual with:
*Passion to succeed on projects
*Sharp Microsoft Office skills
*Ability to communicate well both through email and phone
*Ability to project manage projects well with little direction
*Works well with others
*Experience working with contracts or provider data a plus
The highest level of education desired for candidates in this position is a Associate's degree or equivalent experience.
ADDITIONAL JOB INFORMATION
Looking for high performance individual looking to grow within healthcare contracting. This is a great opportunity for the right individual to work with a great team of individuals and would report directly to the Senior Director of Network Management for a third of Florida.
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 candidates'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.
Job Function: Health Care
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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