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Claims Manager, Singapore - 71416BR

Primary Location: Singapore, SGP
Additional Locations: SGP-Singapore
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Description:
Family Summary/Mission
To increase member satisfaction, retention, and growth by efficiently delivering competitive services to members and providers through a fully integrated organization staffed by knowledgeable, customer-focused professionals supported by exemplary technologies and processes.

Position Summary/Mission
Maintains oversight of Claims functions in multiple service centers for a defined region with direct staff reporting to them that support claims in addition to responsibility for work done by Vendor staff. This positions internally links to internal teams, including claim payments, claim rework, member or provider inquiries, billing, enrollment, accounts receivable, and/or implementation services. Executes strategic and operational plans in support of business segment customer services objectives and initiatives. Sets business area priorities, allocates resources and develops plans for multiple related teams. Ensures all critical service metrics and operational results are achieved. Leads multiple managers, highly specialized professional staff or significant outsourced operations.

Fundamental Components & Physical Requirements include but are not limited to
  • Oversees the operations of multiple service centers in different locations handling a Claims Operation function.
  • Utilizing expert knowledge to oversee operating systems including policies and procedures, operating structure, and information flow across multiple service centers.
  • Directs implementation of Claims service standards for each location to ensure delivery of quality-focused, consistent cost-effective service and administration both in-house and for work administered by vendors.
  • Analyzes claims operational practices for effectiveness and practicality, while creating a culture which is innovative in its approach to solutions.
  • Establishes a clear vision aligned with company values; sets specific challenging and achievable objectives and action plans; motivates others to balance customer needs, budgets, and business success.
  • Develops an organization that attracts, selects, and retains high caliber, diverse talent able to successfully achieve or exceed business goals; builds a cohesive team that works well together and across other business segment functions.
  • Effectively and proactively manages to budget, analyzing and acting upon financial variances from plan by identifying additional cost saving strategies.
  • Validates production billing volumes and rates across the global platform.
  • Leads and builds high performance teams across units by providing leadership, mentoring and coaching in achieving understanding of the voice of the customer.
  • Accountable for leading staff in accordance with Aetna’s standards of leadership excellence.
  • Monitors and evaluates service center operational plans ensuring customer service standards are maintained during facility shutdowns (anticipated or unanticipated) and during business activity transfers between locations. Coordinates major plan modifications necessitated by unanticipated business or technology developments.
  • Develops and implements business strategies to provide accurate and proactive customer service to members, plan sponsors and brokers aligned to service center. Provides operational support for market management of plan sponsors, members and network providers.
  • Ensures compliance outcomes are included in all plans and goals.

Background Experience Desired
3+ years’ experience in managing claims processing teams

Education and Certification Requirements
  • University/college degree preferable or equivalent work experience
  • Higher education or local market equivalent

Additional Information
  • Strong project management skills
  • Solid written and oral communication skills
  • Solid leadership skills including staff development
  • Outstanding customer service skills are required
  • Prioritizes tasks effectively
  • Well organized
  • Negotiation skills
  • Technical skills
  • Problem-solving skills
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EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

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