Job Description Oversees the implementation and on-going execution of the Service Operations strategic and operational business plan for one or more business segment functions, including but not limited to customer service, claim processing, provider services, implementation, and/or plan sponsor operations. Develops priorities and sets direction for business segment applying knowledge of business, competitive landscape and regulatory environment. Coordinates business segment policies and procedures in support of financial, operational and service requirements. Provides leadership and direction through multiple managers. Manages a business area function which may include but is not limited to the following: Claim, Customer Service, Plan Sponsor Services, Implementation Services, Provider Services, Financial Analysis, Overpayment Recovery and Forecasting, for all operations centers in a business area. Maintains oversight of budget for area of responsibility. Implements and monitors Service Operations business plan and oversees any activities associated with consolidation, restructuring or business transitions impacting service operations. Analyzes and forecasts key financial drivers and make recommendations for adjustments to budgets and business plans through effective use of forecasting tools.
Monitors specific service center plans for sending or receiving transferred business, ensuring customer service standards are maintained. Collaborates and partners with other functional managers, other business areas across/within regions or segments and within other centralized corporate areas to ensure all workflow processes and interdependencies are identified and addressed on an on-going basis. Establishes a clear vision aligned with company valuesÍ¾ sets specific challenging and achievable objectives and action plansÍ¾ motivates others to balance customer needs and business successÍ¾ 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 goalsÍ¾ builds a cohesive team that works well together.
Collaborates and partners with Sales and Marketing, other Service Operations leaders, other business areas cross/within the segments and regions and within other centralized corporate areas to ensure all workflow processes and interdependencies are identified and addressed on an ongoing basis.(*) Ensures compliance outcomes are included in all plans and goals.(*)
Required Qualifications Multiple years proven leadership experience setting strategic direction and influencing change that resulted in quantifiable positive outcomes. Demonstrated negotiation skills. Proven strong leadership skills managing large high performance teams. 10+ years experience in project delivery, systems analysis and application program development.
Preferred Qualifications Healthcare experience preferred. Experienced working with vendors. Customer service experience.
Education Bachelor degree in a closely-related field, or an equivalent combination of formal education and recent, related experienceÍ¾ preference will be given to applicants with a Masterâ™s degree Advanced degree preferred.
Business Overview 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.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
Internal Number: 1634612BR
About CVS Health
Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation’s premier health innovation company. Through our health services, insurance plans and community pharmacists, we’re pioneering a bold new approach to total health. As a CVS Health colleague, you’ll be at the center of it all.
At CVS Health, we work every day to help people on their path to better health. Never has it been more important for us to deliver on our purpose to our valued customers, patients, members, and employees. With a presence in communities across the country, CVS Health colleagues are and will continue to be a critical piece of the country’s health care solution. The health and safety of our employees, patients, customers, and members is our top priority as we face the impact of COVID-19 together. If you would like to learn about the actions we are taking as a company as we learn more about COVID-19 and its spread, we encourage you to visit our COVID-19 resource center at https://cvshealth.com/covid-19
We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to... attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.
CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran – we highly value and are committed to all forms of diversity in the workplace. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. Please note that we only accept applications for employment via this site.
We provide reasonable accommodations to qualified individuals with disabilities. If you need to request an accommodation, a qualified interpreter, written information in other formats, translation or other services, please contact our Advice and Counsel Reasonable Accommodations team by emailing Advice and Counsel Reasonable Accommodations team or calling 877-805-9511.
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