Contract Negotiation Manager - Pennsylvania & Delaware

Position Summary We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. What you will do Negotiate, execute, review, and analyze contracts and/or handle dispute resolution and settlement negotiations with solo, small group, or local providers. Manage contract performance in support of network quality, availability, and financial goals and strategies. Recruit providers as needed to ensure attainment of network expansion and adequacy targets. Collaborate cross‑functionally to contribute to provider compensation and pricing development activities and recommendations, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities. Identify and recommend solutions to manage cost issues and support cost‑saving initiatives and/or settlement activities. Provide network development, maintenance, and refinement activities and strategies in support of cross‑market network management unit. Assist with the design, development, management, and/or implementation of strategic network configurations, including integration activities. Optimize interactions with assigned providers and internal business partners to manage relationships and ensure provider needs are met. Ensure resolution of escalated issues related to claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information. Required Qualifications Minimum of 5 years of experience negotiating contracts with ancillary providers, facilities, and physician groups, including contract language, development and analysis of rate proposals, identifying operational and financial improvement opportunities, and collection and analysis of competitive data and key financial metrics. 3+ years of experience in provider relationship management or related healthcare roles, with proven and proficient contract management skills. Understanding of common contract provisions, provider reimbursement methodologies and terms, and industry standard payment policies and practices. Understanding of provider financial issues, regulatory requirements, and competitor strategies. Demonstrates high proficiency with Microsoft Office suite applications (e.g., Outlook, Word, Excel, etc.). Ability to build collaborative relationships with providers and work cross‑functionally to resolve complex provider contract issues. Highly organized and able to successfully manage and prioritize multiple negotiations, issues, and other tasks to ensure completion and meet deadlines. Candidate must reside in Pennsylvania or Delaware. Preferred Qualifications Experience with Commercial and Medicare lines of business. Bachelor’s degree preferred or a combination of professional work experience and education. Both Fee‑for‑Service and Value‑Based contracting experience preferred. Anticipated Weekly Hours 40 hours per week, Full time. Pay Range $60,300.00 - $145,860.00 (base salary; actual offer depends on experience, education, geography and other factors). Benefits Medical coverage Dental coverage Vision coverage Paid time off Retirement savings options Wellness programs Other resources (based on eligibility) Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. #J-18808-Ljbffr 4062 Aetna Resources, LLC