- Maintains oversight of functions in multiple service centers, including claim payments, claim rework, member or provider inquiries, billing, enrollment, accounts receivable, and/or implementation services.
- Executes strategic and operational plans in support of business segment customer services objectives and initiatives.
- Sets business area priorities, allocates resources and develops plans for multiple related teams.
- Ensures all critical service metrics and operational results are achieved.
- Leads multiple managers, highly specialized professional staff or significant outsourced operations.
- Oversees the operations of multiple service centers in different locations handling a customer service function, which may include claims, member or provider services, billing, enrollment, accounts receivable and implementation services.
- Oversees operating systems including policies and procedures, operating structure, and information flow across multiple service centers.
- Directs implementation of service standards for each location to ensure delivery of quality-focused, consistent cost effective service and administration.
- Analyzes operational practices for effectiveness and practicality, while creating a culture which is innovative in its approach to solutions.
- Establishes a clear vision aligned with company values; sets specific challenging and achievable objectives and action plans; motivates others to balance customer needs, budgets, and business success.
- Develops an organization that attracts, selects, and retains high caliber, diverse talent able to successfully achieve or exceed business goals; builds a cohesive team that works well together and across other business segment functions.
- Effectively and proactively manages to budget, analyzing and acting upon financial variances from plan by identifying additional cost saving strategies.
- Leads and builds high performance teams across units by providing leadership, mentoring and coaching in achieving understanding of the voice of the customer.
- Accountable for leading staff in accordance with Aetna’s standards of leadership excellence.
- Monitors and evaluates service center operational plans ensuring customer service standards are maintained during facility shutdowns (anticipated or unanticipated) and during business activity transfers between locations.
- Coordinates major plan modifications necessitated by unanticipated business or technology developments.
- Develops and implements business strategies to provide accurate and proactive customer service to members, plan sponsors and brokers aligned to service center.
- Provides operational support for market management of plan sponsors, members and network providers.
- Ensures compliance outcomes are included in all plans and goals.
- Demonstrated negotiation skills.
- Multiple years proven leadership experience setting strategic direction and influencing change that resulted in quantifiable positive outcomes.
- Proven strong leadership skills managing large high performance teams.
- Experienced working with vendors.
- Customer service experience.
- Bachelor’s degree in a closely-related field, or equivalent combination of education and experience.
- Must be located in Kentucky.
- CVS Health requires its Colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, or religious belief that prevents them from being vaccinated.
- If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 10 days of your employment.
- For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 45 days of your employment.
- In some states and roles, you may be required to provide proof of full vaccination before you can begin to actively work.
- Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.
- If you are unable to be fully vaccinated due to disability, medical condition, or religious belief, you will be required to apply for a reasonable accommodation within the first 10 days of your employment in order to remain employed with CVS Health.
- As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated.
- In some states and roles, you may be required to have an approved reasonable accommodation before you can begin to actively work.
- If your request for an accommodation is not approved, then your employment may be terminated.
- Preferred: Healthcare experience and an advanced degree.
- We seek fresh ideas, fresh opinions, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day.
- Our high-energy and client-focused colleagues work hard every single day to make a positive difference in the lives of our customers.
- Aetna is an Equal Opportunity, Affirmative Action Employer
- Advanced degree preferred.
- Bachelor’s degree or equivalent experience required.
- At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health.
- We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused.
- Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
- We are committed to maintaining a diverse and inclusive workplace.
- CVS Health is an equal opportunity and affirmative action employer.
- We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status.
- We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.