Aetna Remote Jobs – Director

Job Description:

At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

Job Responsibilities:

• 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 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.
• Oversees the operations of multiple service centers in different locations handling a customer service function, which may include claims, member or provider services, billing, enrollment, accounts receivable and implementation services.
• Oversees operating systems including policies and procedures, operating structure, and information flow across multiple service centers.
• Directs implementation of service standards for each location to ensure delivery of quality-focused, consistent cost effective service and administration.
• Analyzes 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.
• 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.

Job Requirements:

• Required: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.
• 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.
• Bachelor’s degree or equivalent experience required.

Job Details:

Company: Aetna

Vacancy Type:  Full Time

Job Location: Louisville, KY, US

Application Deadline: N/A

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