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LA MEDICAID Provider Relations Liaison - Work from Home-Lafayette, LA
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Baton Rouge, Louisiana |
About this job
POSITION SUMMARY
Office location anticipated in Metairie/New Orleans area. The Provider Relations Liaison develops, maintains, and enhances provider relationships in support of regional and national networking objectives. Responsible for the overall relationship management for assigned provider community.
Fundamental Components:
-Responsible for developing and maintaining relationships with physician and business leadership of key physician groups, ancillary providers, and delivery systems (*) -Interacts with large, high profile physician groups, IPAs, PHOs and hospital systems to resolve disputes and find solutions that are mutually beneficial for both providers and the organization (*) -Builds strong relationships with providers and key contacts to support on-going negotiating efforts (*) -Finalizes routine contracts and recruitment arrangements with providers (*) -Understands medical cost drivers and executes specific medical cost initiatives to support operational objectives -Proactively identifies new trends within the industry and works to raise awareness throughout the organization in order to gain consensus on a course of action and ultimately drive to implementation (*) -Identifies opportunities for process improvement and works cross-functionally within the organization to gain desired outcomes regarding provider service issues -Accesses and coordinates highly sensitive member medical record content to meet QM and NCQA requirements (*) -May coordinate with Sales & Marketing to address high profile plan sponsor issues related to the network and identify provider educational opportunities -Monitors the ever-changing and competitive landscape of health care delivery and evaluates the potential to adopt and implement policies and procedures to keep Aetna at the lead or ahead of industry movements -Executes organizational strategy at the market level to meet and exceed company goals and objectives
BACKGROUND/EXPERIENCE desired:
Demonstrated knowledge of medical cost drivers and managed care industry. -Proven ability to synthesize and translate competitive intelligence into decision-making process. -2+ years related experience. -Medicaid experience preferred. -Bachelor's degree desired or equivalent work experience. Computer proficiency, MS office suite applications(Word, Excel, etc.)
EDUCATION
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
TECHNOLOGY EXPERIENCES
Technical - Desktop Tools/Microsoft Word/1-3 Years/End User
Technical - Desktop Tools/TE Microsoft Excel/1-3 Years/End User
Technical - Desktop Tools/Microsoft Outlook/1-3 Years/End User
Technical - Desktop Tools/Microsoft SharePoint/1-3 Years/End User
Telework Specifications:
Please confirm with hiring manager if this position will be eligible for telework.
ADDITIONAL JOB INFORMATION
Working knowledge of provider business operations. -Analytical/data-driven decision-making skills. -Strong communication, critical thinking, interpersonal and negotiation skills. Aetna Better Health of Louisiana is looking for caring people who share our vision of helping to provide innovative, community-based health care for Bayou Health members in Louisiana. Aetna Better Health is a great place to work. As an employee, not only will you be helping others, youll be part of a team just as dedicated as you. Our company values diversity and is dedicated to helping you achieve your career goals.
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.
We conduct pre-employment drug and background testing. Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Employment Type Regular Career Band Description Professional
Office location anticipated in Metairie/New Orleans area. The Provider Relations Liaison develops, maintains, and enhances provider relationships in support of regional and national networking objectives. Responsible for the overall relationship management for assigned provider community.
Fundamental Components:
-Responsible for developing and maintaining relationships with physician and business leadership of key physician groups, ancillary providers, and delivery systems (*) -Interacts with large, high profile physician groups, IPAs, PHOs and hospital systems to resolve disputes and find solutions that are mutually beneficial for both providers and the organization (*) -Builds strong relationships with providers and key contacts to support on-going negotiating efforts (*) -Finalizes routine contracts and recruitment arrangements with providers (*) -Understands medical cost drivers and executes specific medical cost initiatives to support operational objectives -Proactively identifies new trends within the industry and works to raise awareness throughout the organization in order to gain consensus on a course of action and ultimately drive to implementation (*) -Identifies opportunities for process improvement and works cross-functionally within the organization to gain desired outcomes regarding provider service issues -Accesses and coordinates highly sensitive member medical record content to meet QM and NCQA requirements (*) -May coordinate with Sales & Marketing to address high profile plan sponsor issues related to the network and identify provider educational opportunities -Monitors the ever-changing and competitive landscape of health care delivery and evaluates the potential to adopt and implement policies and procedures to keep Aetna at the lead or ahead of industry movements -Executes organizational strategy at the market level to meet and exceed company goals and objectives
BACKGROUND/EXPERIENCE desired:
Demonstrated knowledge of medical cost drivers and managed care industry. -Proven ability to synthesize and translate competitive intelligence into decision-making process. -2+ years related experience. -Medicaid experience preferred. -Bachelor's degree desired or equivalent work experience. Computer proficiency, MS office suite applications(Word, Excel, etc.)
EDUCATION
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
TECHNOLOGY EXPERIENCES
Technical - Desktop Tools/Microsoft Word/1-3 Years/End User
Technical - Desktop Tools/TE Microsoft Excel/1-3 Years/End User
Technical - Desktop Tools/Microsoft Outlook/1-3 Years/End User
Technical - Desktop Tools/Microsoft SharePoint/1-3 Years/End User
Telework Specifications:
Please confirm with hiring manager if this position will be eligible for telework.
ADDITIONAL JOB INFORMATION
Working knowledge of provider business operations. -Analytical/data-driven decision-making skills. -Strong communication, critical thinking, interpersonal and negotiation skills. Aetna Better Health of Louisiana is looking for caring people who share our vision of helping to provide innovative, community-based health care for Bayou Health members in Louisiana. Aetna Better Health is a great place to work. As an employee, not only will you be helping others, youll be part of a team just as dedicated as you. Our company values diversity and is dedicated to helping you achieve your career goals.
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.
We conduct pre-employment drug and background testing. Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Employment Type Regular Career Band Description Professional
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