Supervisor, Claim Operations (Aetna International)

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. 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. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 04/11/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.

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