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Network Representative

Company Aetna
Location Jacksonville, FL 32207
Update 8 Day ago
300
Create, maintain and align data for new and participating dentist to allow members to select a provider from on-line directories and to insure accurate provider compensation. Provide ongoing support to Provider Relations by completing research, data analysis and managing communications.

Fundamental Components:
Insure data integrity across multiple databases for the DMO, PPO Dental Networks, and 3rd party affiliations. Handle system alignment for the monthly capitation cycles to allow dentist in capped dental plans to receive the correct compensation and member rosters. Process dentist contract activation request, maintenance and terminations timely and accurately. Participate in projects for annual state validations and other data alignment request to come up. Insure all systems maintenance caries over accurately to on-line/ web based and paper directory tools given to our members to select a dentist. Committed to integrity and excellence

BACKGROUND/EXPERIENCE desired:
Demonstrated ability to handle multiple assignments competently, accurately and efficiently.
Strong analytical and written/oral communication skills.
Associates or BS degree or 0 to 2 years experience directly related to the duties and responsibilities specified or an equivalent combination of education and work experience.

EDUCATION
The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.

REQUIRED SKILLS
Leadership/Collaborating for Results/FOUNDATION
Leadership/Driving a Culture of Compliance/FOUNDATION
Leadership/Creating Accountability/FOUNDATION

DESIRED SKILLS
Service/Demonstrating Service Discipline/FOUNDATION
Service/Working Across Boundaries/ADVANCED
Technology/Leveraging Technology/FOUNDATION

ADDITIONAL JOB INFORMATION
This position gives the right candidate the ability to work independently and handle varied task throughout the day. Being flexible to change will give you an edge since our team supports many systems that require you to continuously look at ways to do our work more efficiently. The data alignment requires an individual that is detailed oriented to insure the provider data and compensation is accurately set-up across multiple systems. Clear, concise communication skills are a plus since this position requires working with internal and external business areas. Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come. We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence. Together we will empower people to live healthier lives.

Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.

We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.

Together we will empower people to live healthier lives.

Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

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.

Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

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 for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.