Supervisor, Claim Operations (Aetna International)

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Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

An Operations Supervisor is a key leader in supporting the Aetna International claim processing team with coaching and development, while strategically focusing and communicating claim inventory volumes, trends, and challenges. The Operations Supervisor is responsible for fostering relationships with those outside of the claims department to continue to fulfill the company purpose of aiding our members on their path to a better health.

What you will do

• Ensures the efficient and timely processing of claims by effectively managing the workflow processing and completion within the department.
• Implements and maintains quality control processes to ensure accuracy and consistency in claim processing.
• Advises team members in resolving complex or escalated claims issues by providing guidance on claim handling procedures, policy interpretation, and compliance with industry regulations.
• Analyzes key performance indicators (KPIs) to assess the productivity and quality of the claims department and prepares regular performance reports for management.
• Streamlines and improves claim processing procedures by collaborating with cross-functional teams to implement process enhancements, automation, and system upgrades to increase efficiency and accuracy.
• Ensures consistent compliance with applicable laws, regulations, and industry standards related to claims processing.
• Assists management in the development of the department's budget by monitoring expenses, analyzing budget variances, and recommending cost-saving measures while ensuring operational effectiveness and maintaining service quality.
• Establishes a positive work environment, encouraging professional development, and addressing any performance issues.
• Directs tasks and responsibilities to team members, ensuring the claim workload distribution is equitable and efficient.

Required Qualifications

• 3-5 years of experience working in healthcare.
• 1-3 years of experience leading a team of 10+ direct reports.
• Ability to work in Plantation, FL office 5 days (Monday-Friday) per week.

Preferred Qualifications

• Experience working with claims.
• Proficient in Microsoft tools, Power BI, and PMP.
• Experience working in a high performing production based environment.
• Able to drive performance to meet customer satisfaction standards.
• Extensive knowledge of KPIs.
• Understands and sets parameters around inventory management.
• Effective communication skills.
• Critical thinking and root cause analysis skills.

Education

Associate’s degree or equivalent experience (high school diploma + 2 years of relevant experience).

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$43,888.00 - $85,068.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.  The Company offers a full range of medical, dental, and vision benefits.  Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.  The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education a