Aetna Regional Network Director (MEA) in Dubai, United Arab Emirates

Req ID: 51152BR

Family Summary

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.

Position Summary

Manages delivery of regional support functions for network operations, developing provider contracts, including

establishing rates and reimbursement programs.

Fundamental Requirements

  • 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

Background/Experience Desired

  • 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.

Additional Information

  • In-depth knowledge of managed care business and healthcare environment.

  • Excellent attention to detail

  • Strong negotiation skills

Job Function: Health Care