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Manager, DSNP State Contract Management (61927BR)
at Aetna
Orlando, FL

Manager, DSNP State Contract Management (61927BR)
at Aetna
Orlando, FL

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Description

Description: The National DSNP Program Office supports DSNP growth, expansion, strategy, clinical & administrative operations for all DSNP. We are hiring a Manager, DSNP State Contract Management who will engage with the states on meeting DSNP contracting requirements and Medicaid services.

Our Manager, DSNP State Contract will administer detailed DSNP contracts with each state we offer our DSNP Product. Own the entire state Medicaid agency contract process for Aetna's DSNP Product. Implement DSNP contracts to execute product strategy flawlessly in collaboration with cross-functional business partners (Ops Integrity, Compliance, Legal, Operations, Actuarial, Market Leaders, Network, etc.) to increase and retain Aetna membership and ensure Aetna is in full compliance with each states contract requirements.

Opportunity is open across the US and not location specific and we are willing to consider applicants based on location (US only) and full time work from home. Fundamental Components: (*) Develop overall plan for state (e.g. duals categories, type of DSNP) - State Engagement
(*) Coordinate, lead and participate in state Medicaid meetings
(*) Identify key points of contract with each state and ensure Aetna is in full compliance
(*) Managing existing Medicaid relationships and help to establish new Medicaid agency relationships
(*) Support local markets which offer DSNP product

(*) Obtain templates SMAC from state or provide templates if requested
(*) Provide feedback to state
(*) Provide state with included counties and any other required input
(*) Secure NPI number, master provider file and duals and identify state point of contract for operations
(*) Document the process by which the state will identify and share information about providers that contract with the State Medicaid Agency, so it can be included in the D-SNP provider directory
(*) Managed entire state contract process




Background Experience: (*) 5+ years related cross-functional, project management experience
(*) Specific knowledge and expertise in State Medicaid Agency Contracting with DSNP
(*) Familiarity in working with different states and State Medicaid Agencies
(*) DSNP experience
(*) BA or equivalent; typically advanced degree. Additional Job Information: Key skills are strategic thinking, communicating for impact, collaboration, and driving for results. Requires ability to be innovative and resourceful in developing solutions. Must have and impart a sense of urgency with key business partners. Required Skills: General Business - Demonstrating Business and Industry Acumen, General Business - Ensuring Project Discipline, Leadership - Collaborating for Results, Leadership - Creating Accountability Desired Skills: General Business - Communicating for Impact, General Business - Demonstrating Business and Industry Acumen, General Business - Ensuring Project Discipline, Leadership - Driving a Culture of Compliance Functional Skills: General Management - Project management (non-IT), Products-Medical - All Individual Medicare Plans, Project Management - Cross-functional project management Technology Experience: Database - Intuit QuickBase, Desktop Tool - Microsoft PowerPoint, Desktop Tool - TE Microsoft Excel Potential Telework Position: Yes Percent of Travel Required: 10 - 25% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests

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