Aetna Regional Network Director (MEA) in Dubai, United Arab Emirates
Req ID: 51152BR
Design, develop, contract, maintain and enhance relationships with Middle East & Africa facilities, physicians, ancillary providers and vendors which serve as contractual networks of care for members; foster growth of managed care products; and enhance profitability of Aetna Global Benefits.
Manages delivery of regional support functions for network operations, developing provider contracts, including
establishing rates and reimbursement programs.
Oversee the development and delivery of regional support functions for local market network operations
Directs the establishment of rates, incentives ,fee schedules and reimbursement programs for the local markets
Manage provider contract support functions including the development of boiler plate contracts and state filings; Contract support, review & approval; and COLA and other contract tracking
Ensure the maintenance and integrity of the regional provider data base
Manage the development and delivery of training programs for all aspects of network management and provider contracting operations
Provide network contracting support and information analysis to ensure the development of cost-effective provider contracts
Be accountable for team objectives, budget, financial results and objectives
Select and build strong functional teams through formal training, diverse assignments, coaching, mentoring and performance management
Formulate and implement strategy for the organization/unit to meet objectives and other business initiatives
Develop and influence changes/enhancements to business processes, policies and infrastructure to improve operational efficiency
Develop and set provider network policy and guidelines; review and execute negotiated provider agreements
Provide advise and guidance to Senior Management and their senior staff on health delivery issues ensuring market compliance with company contracting policies/methodologies
Assist in the formulation and execution of regional and local market provider network strategies to include training and education for regional and local market teams
Manage and/or participate in selected projects and company initiatives
Exercises sound judgment in decision-making
Makes decisions in a systematic way that focus on department/business objectives
Sets specific, challenging and achievable objectives and action plans
Negotiate and oversee implementation of all member-based payment agreements; perform direct negotiation assistance to all markets in complex agreements
Act as liaison to legal, finance and core health delivery department to facilitate effective interaction with regional/local market health delivery teams
Major program development experience in support of network management and provider contracting operations.
Substantial financial management background.
Arabic Language skills essential
Education and Certification Requirements
- Bachelor's Degree or equivalent work experience.
In-depth knowledge of managed care business and healthcare environment.
Excellent attention to detail
Strong negotiation skills
Job Function: Health Care