tam2005
04-16-2008, 02:20 PM
Unresearched...
ABOUT OUR COMPANY
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.
JOB MISSION SUMMARY
The dedication of talented and caring health care professionals drives the delivery of high quality, cost effective products and services. They make it possible for members to get the right health care treatment for their needs and for Aetna to keep its competitive edge.
RESPONSIBILITIES
- Maintains the Provider Data (contractual) for AWCA network providers
- Ensures all provider information is accurately recorded and maintained to provide for proper reimbursement
- Develops and maintains standards for database integrity, corrective actions, database alignment, and manages communication processes with other departments regarding database improvements
- Manually loads, maintains, and resolves new and revised participating provider data transactions that cannot be administered systematically due to their contractually sensitive or strategic nature
- Conducts and manages on-going reviews of contract installations; partners with quality management in identifying, analyzing and reporting on trends
- Establishes, maintains and aligns contracted provider data and negotiated reimbursement arrangements across provider systems
- Reviews new and existing contract reimbursement arrangements and determines most appropriate system input methodology that facilitates accurate and consistent bill repricing
- Coordinates the receipt of provider data with outside vendors and other entities (Confinity)
- May provide functional leadership within unit
SKILLS
- Must have excellent organizational skills
- Experience working with and inputting critical data
- Demonstrated track record of attention to detail and a high degree of accuracy working with critical data
- Demonstrated analytical skills - able to interpret data, translate it into meaningful information and draw conclusions
- Knowledge of EPDB (Enterprise Provider Date Base), SCM (Strategic Contract Manager), SCSR, MCS, CHPL preferred
ADDITIONAL INFORMATION
- This position is a WAH (Work At Home / Telework) position for local candidates
We value leadership, creativity and initiative. If you share those values and a commitment to excellence and innovation, consider a career with our company.
Apply Here (https://aetna.recruitmax.com/ENG/candidates/default.cfm?szCategory=jobprofile&szOrderID=22966)
ABOUT OUR COMPANY
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.
JOB MISSION SUMMARY
The dedication of talented and caring health care professionals drives the delivery of high quality, cost effective products and services. They make it possible for members to get the right health care treatment for their needs and for Aetna to keep its competitive edge.
RESPONSIBILITIES
- Maintains the Provider Data (contractual) for AWCA network providers
- Ensures all provider information is accurately recorded and maintained to provide for proper reimbursement
- Develops and maintains standards for database integrity, corrective actions, database alignment, and manages communication processes with other departments regarding database improvements
- Manually loads, maintains, and resolves new and revised participating provider data transactions that cannot be administered systematically due to their contractually sensitive or strategic nature
- Conducts and manages on-going reviews of contract installations; partners with quality management in identifying, analyzing and reporting on trends
- Establishes, maintains and aligns contracted provider data and negotiated reimbursement arrangements across provider systems
- Reviews new and existing contract reimbursement arrangements and determines most appropriate system input methodology that facilitates accurate and consistent bill repricing
- Coordinates the receipt of provider data with outside vendors and other entities (Confinity)
- May provide functional leadership within unit
SKILLS
- Must have excellent organizational skills
- Experience working with and inputting critical data
- Demonstrated track record of attention to detail and a high degree of accuracy working with critical data
- Demonstrated analytical skills - able to interpret data, translate it into meaningful information and draw conclusions
- Knowledge of EPDB (Enterprise Provider Date Base), SCM (Strategic Contract Manager), SCSR, MCS, CHPL preferred
ADDITIONAL INFORMATION
- This position is a WAH (Work At Home / Telework) position for local candidates
We value leadership, creativity and initiative. If you share those values and a commitment to excellence and innovation, consider a career with our company.
Apply Here (https://aetna.recruitmax.com/ENG/candidates/default.cfm?szCategory=jobprofile&szOrderID=22966)