Skip to main content

A new day in healthcare. Together, CVS Health and Aetna help people on their path to better health.

Manager, Service Operations (60974BR)

Primary Location: Sandy City, Utah
Additional Locations: UT-Sandy
Apply
Description:
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 supp

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:
5+ 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 combination of education and experience.
Advanced degree preferred.


Functional Skills:
Customer Service - Call center monitoring & analysis - Inbound calls - call center location, Customer Service - Customer Service - Member Services - HMO products, Leadership - Lead a business in different geographies or multiple markets, Management - Management - Medicare

Technology Experience:
Call Management - CMS, Desktop Tool - Microsoft Exchange, Desktop Tool - Microsoft Word, Desktop Tool - TE Microsoft Excel

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. 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 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.

#LI-MR1

Click To Review Our Benefits (PDF)

Apply

Jobs for you

Recently Viewed Jobs

You do not have any recently viewed jobs

Your Saved Jobs

You do not have any saved jobs

Sign up for Job Alerts

Join our Talent Community

At Aetna, we are pioneering a total approach to health and wellness and we need talented candidates like you to join our team. Become a member of our talent community to be the first to know about career initiatives that match your skills and interests as they become available, in addition to details on upcoming events, networking opportunities, and news about Aetna.

Join Our Talent Community

Sign up to receive information about job openings that are tailored to your skills and interests. Plus, get the latest career news from Aetna.