Vice President, National Networks & Contracting @ Aetna
Senior Vice President - Network & Medical Cost Management @ UnitedHealth Group
Education:
Master of Business Administration (MBA), Concentration in Health Care Management @
University of New Haven
About:
Vice President, National Care Management @ Responsible for the overall strategy, clinical product development and execution of Aetna's Commercial & Medicare Clinical Operations including Utilization Management, Case Management, Disease Management, Behavioral Health, Wellness and Population Health solutions/programs including ActiveHealth Management. Operational scale of 7K+ clinical, behavioral and operational staff. Responsible for the implementation and development of clinical
Vice President, National Care Management @ Responsible for the overall strategy, clinical product development and execution of Aetna's Commercial & Medicare Clinical Operations including Utilization Management, Case Management, Disease Management, Behavioral Health, Wellness and Population Health solutions/programs including ActiveHealth Management. Operational scale of 7K+ clinical, behavioral and operational staff. Responsible for the implementation and development of clinical programs that support Aetna's ACO and Joint Venture relationships. From July 2010 to Present (5 years 6 months) Vice President, National Networks & Contracting @ Responsibilities included Provider eSolutions, National Networks, National Contracting & Provider Reimbursement, Contracting Policy & Medicare Contracting Strategy, Provider Quality Performance Programs and Special Investigations Unit. From July 2005 to June 2010 (5 years) Senior Vice President - Network & Medical Cost Management @ Responsible for the overall network and medical cost management for the United HealthCare's Northeast region including all unit price (contracting) and utilization (medical management) operations. Oversight and responsibility for the acquisition/integration of Oxford Health plans medical cost management functions. From 2001 to 2005 (4 years)
Bachelor of Applied Science (B.A.Sc.), Health/Health Care Administration/Management @ Springfield CollegeMaster of Business Administration (MBA), Concentration in Health Care Management @ University of New Haven Paul Marchetti is skilled in: Health Insurance, Managed Care, Insurance, Medicare, Business Development, Leadership, Strategic Planning, Product Development, Employee Benefits, Claim, Health Savings Accounts, Commercial Insurance, Healthcare, Program Management, Health Policy
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