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A1A Customer Service Manager

Primary Location: New Albany, OH
Additional Locations: OH-New Albany
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Description:
Aetna One Advocate is Aetna’s premier service and clinical offering for Aetna nation-wide and creates industry-leading solutions for our customers and members. The model is a fully integrated population health and customer service solution for large plan sponsors. The model is a high-touch, high-tech member advocacy service which combines data-driven processes with the expertise of highly trained clinical and concierge member services.
The mission of this model is designed to meet each member at every aspect of their health care journey. Our embedded customer-dedicated service and clinical pods allow maximization of inbound and outbound touchpoints to solve members’ needs and create behavior change. Our data analytics, white-glove service and end-to-end ownership of member support creates a trusted partner in health. This is an exciting time to join Aetna a CVS Health company in our journey to change the way healthcare is delivered today. We are health care innovators.

The A1A Customer Service Manager will maintain oversight of functions in local service center, including but not limited to customer service, claim, provider services, complaints, grievances, and appeals, implementation, and/or plan sponsor operations. Executes local strategic and operational plan in support of business segment customer service objectives and initiatives. Plans, directs and implements procedures that will assure a high level of customer access and satisfaction. Responsible for the quality and effectiveness of own team and related teams, identifying and resolving technical, operational and team problems. Manages a team of professional employees and/or supervisors.

Fundamental Components:
  • Oversees the operations in a local service center handling a customer service function, which may include claims, member or provider services, billing, enrollment, accounts receivable and implementation services.
  • Develops, monitors and reviews performance reports and service performance trends for each account against the plan and recommends specific actions or remedies as necessary.
  • Develops and maintains strong collaborative relationships within operations as well as with patient management, Sales and Marketing, PSS, Underwriting, Utilization Management, and network management in establishing appropriate service level agreements.
  • Develops, trains, evaluates, and coaches staff to provide cost effective claim processing and claim and customer service while ensuring that quality standards are met.
  • Assesses individual and team performance on a regular basis and provide candid and timely developmental feedback; monitors training plans and ensure training needs are met.
  • Establishes a clear vision aligned with company values; sets specific challenging and achievable objectives and action plans; motivates others to balance customer needs and business success; challenges self and others to look to the future to create quality products, services, and solutions.
  • Attracts, selects, and retains high caliber, diverse talent able to successfully achieve or exceed business goals; builds a cohesive team that works well together.
  • Creates and maintains tools, job aids, and training materials to help employees in their efforts to resolve issues and improve their relationship with customers.
  • Collects, analyzes and reports on operations information in support of process, systems, and policy redesign.
  • Effectively applies and enforces Aetna HR policies and practices, i.e. FML/EML, Attendance, Code of Conduct, and Disciplinary Guidelines.
  • Effectively manages cross-functional projects that support the business strategy.


Background Experience:
  • 8+ years’ experience in managing high volume transaction processing, financial management, project delivery, production, systems analysis and application program development.
  • 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. Healthcare experience preferred. Experienced working with vendors.
  • Customer service experience.
  • Bachelor's degree in a closely-related field, or equivalent work experience. Advanced degree preferred.


Additional Job Information:
-Minimum of 8 years of experience managing/leading an operations team

- Minimum of 3 years of customer facing experience and presenting to customers and Senior Leadership Level.

-Strong verbal and written communication skills

-Strong and creative presentation design capabilities


-Exhibits “big picture” strategic thinking capabilities

-Clearly demonstrates ability to lead, drive and inspire leaders to achieve results

-Strong analytical skills

-Ability to determine root cause and create effective action plans to close performance gap

-Clearly demonstrates aptitude to manage with courage

Required Skills:
Leadership - Anticipating and Innovating, Leadership - Collaborating for Results, Leadership - Creating Accountability

Desired Skills:
Leadership - Engaging and Developing People, Service - Creating a Differentiated Service Experience, Service - Handling Service Challenges

Potential Telework Position:
No

Percent of Travel Required:
0 - 10%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

Benefit Eligibility:
Benefit eligibility may vary by position.

Candidate Privacy Information:
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.

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