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Manager, Service Operations

Primary Location: Pittsburgh, Pennsylvania
Additional Locations: PA-Pittsburgh

The successful candidate
will manage a unit of Medicare Claim Processors and corresponding work streams
on the HMO Platform. The role includes leading a team of Supervisors and
Quality Analysts dedicated to delivering performance excellence.

Fundamental Components:

Primary duties of the
position include: Management of multiple inventories and daily work
assignments, addressing performance gaps and collaborating with the Claim
Leadership team to achieve the departments overall claim metrics. The role
includes exposure with developing an effective capacity model and forecast.
Continual process improvement and monitoring of quality and compliance risk
(e.g. regular interaction with Quality Management, Claim Policy, etc.) that includes
root cause analysis and effective remediation. Ensuring that all required
training as well as ongoing staff development are completed timely. Maintaining
a seamless workflow for staff located across multiple MSO claim sites as well
as those in a telework environment.

Background Experience:

Supervisory or prior
management experience; Medicare experience desired. Direct experience managing
inventory across multiple work steams required. Ability to work across
boundaries; Strong communication skills both verbal and written are critical to
achieving success in this position. Effective time management and the ability
to create and administer action plans are highly desired.

Additional Job Information:
Highly visible role
managing a significant segment of the Medicare claim inventory. This position
offers the successful candidate the opportunity to showcase their process
improvement and leadership skills as part of an established leadership team.

Required Skills:
Leadership - Collaborating for Results, Leadership - Driving a Culture of Compliance, Service - Demonstrating Service Discipline

Desired Skills:
General Business - Communicating for Impact, Leadership - Anticipating and Innovating, Leadership - Creating a World Class Workforce

Functional Skills:
Claim - Claim processing - Medical - Medicare, Claim - Management: < 25 employees

Potential Telework Position:

Percent of Travel Required:
0 - 10%

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

Benefit Eligibility:
Benefit eligibility may vary by position. Click here to review the benefits associated with this 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

Click To Review Our Benefits (PDF)


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