Aetna

Specialty and Provider Network Manager-Value Based Care

Aetna

Remote
Full-TimeDepends on ExperienceSenior LevelMasters
Job Description

Are you a driven and passionate healthcare professional looking for a dynamic role in the rapidly evolving world of value-based care? Aetna is seeking a Specialty and Provider Network Manager to join our team and help us build and maintain strong relationships with specialty and provider networks. In this role, you will play a crucial part in our mission to provide high-quality, cost-effective care to our members. We are looking for someone with a strong background in healthcare management, a deep understanding of value-based care principles, and exceptional communication and negotiation skills. If you are ready to make a meaningful impact and be a part of a leading healthcare company, we encourage you to apply for this exciting opportunity.

  1. Develop and maintain strong relationships with specialty and provider networks to ensure high-quality, cost-effective care for Aetna members.
  2. Act as a liaison between Aetna and specialty and provider networks, facilitating communication and resolving any issues that may arise.
  3. Collaborate with internal teams to identify network needs and develop strategies to meet those needs.
  4. Conduct regular meetings and trainings with specialty and provider networks to keep them informed of Aetna's policies and procedures.
  5. Monitor and analyze network performance, identifying areas for improvement and implementing action plans to address any deficiencies.
  6. Negotiate contracts and fees with specialty and provider networks to ensure favorable terms for Aetna.
  7. Stay updated on industry trends and developments related to value-based care, and provide recommendations for incorporating them into Aetna's network strategy.
  8. Develop and implement strategies to expand Aetna's network reach and increase member access to high-quality, cost-effective providers.
  9. Act as a subject matter expert on value-based care principles and educate internal teams on best practices.
  10. Maintain accurate records and reports on network activities and performance.
  11. Collaborate with cross-functional teams to support the overall goals and objectives of Aetna.
  12. Continuously evaluate and improve processes and procedures related to network management.
  13. Serve as a representative of Aetna in external meetings and events related to network management.
  14. Mentor and train junior team members to ensure a high-performing network management team.
Where is this job?
This job opening is listed as 100% remote
Job Qualifications
  • Experience In Value-Based Care: The Ideal Candidate Should Have A Minimum Of 3-5 Years Of Experience In Managing Value-Based Care Programs, Such As Accountable Care Organizations (Acos), Bundled Payment Models, And/Or Pay-For-Performance Arrangements.

  • Strong Understanding Of Healthcare Industry: A Deep Understanding Of The Current Healthcare Landscape, Including Market Trends, Regulatory Environment, And Key Stakeholders, Is Essential For A Specialty And Provider Network Manager In Value-Based Care.

  • Knowledge Of Provider Network Management: The Candidate Should Have A Proven Track Record Of Successfully Managing Provider Networks, Including Contracting, Credentialing, And Maintaining Relationships With Providers.

  • Analytical Skills: As A Key Component Of Value-Based Care Is Data And Analytics, The Candidate Should Possess Strong Analytical Skills To Assess And Evaluate Network Performance, Identify Areas For Improvement, And Make Data-Driven Decisions.

  • Excellent Communication And Collaboration Skills: This Role Requires Working Closely With Internal Teams, Providers, And Other Key Stakeholders. The Candidate Should Have Excellent Communication And Collaboration Skills To Build And Maintain Relationships, Negotiate Contracts, And Drive Results.

Required Skills
  • Risk Management

  • Quality Improvement

  • Data Analysis

  • Contract Negotiation

  • Performance monitoring

  • Utilization management

  • network development

  • Care Coordination

  • Provider Relations

  • Provider Engagement

  • Value-Based Payment

Soft Skills
  • Communication

  • Conflict Resolution

  • Emotional Intelligence

  • Leadership

  • Time management

  • creativity

  • flexibility

  • Teamwork

  • Adaptability

  • Problem-Solving

Compensation

According to JobzMall, the average salary range for a Specialty and Provider Network Manager-Value Based Care is $85,000-$120,000 per year. However, this can vary depending on factors such as location, experience, and employer. Some individuals in this role may also receive bonuses or incentives based on performance.

Additional Information
Aetna is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
Required LanguagesEnglish
Job PostedMarch 13th, 2025
Apply BeforeMay 22nd, 2025
This job posting is from a verified source. 

Apply with Video Cover Letter Add a warm greeting to your application and stand out!

About Aetna

Aetna Inc. is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, primarily through employer-paid (fully or partly) insurance and benefit programs, and through Medicare. Since November 28, 2018, the company has been a subsidiary of CVS Health.

Frequently asked questions

Get interviewed today!

JobzMall is the world‘ s largest video talent marketplace.It‘s ultrafast, fun, and human.

Get Started