Aetna Dir, Service Operations in Chicago, Illinois

Req ID: 38288BR

POSITION SUMMARY

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.

Fundamental Components:

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 Aetnas 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:

5+ years experience in managing high volume transaction processing, financial management, project delivery, production, systems analysis and application program development.Healthcare experience preferred.Customer service experience.Multiple years proven leadership experience setting strategic direction and influencing change that resulted in quantifiable positive outcomes.

EDUCATION

The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.

FUNCTIONAL EXPERIENCES

Functional - Administration / Operations/File Maintenance/More Than 10 Years

Functional - General Management/Vendor management (non-IT)/1-3 Years

Functional - Project Management/Project Leader/1-3 Years

Functional - Medical Management/Medical Management - Managed Care/Insurance Clinical Staff/1-3 Years

Functional - Information Management/Data acquisition, data management, programming and documentation/4-6 Years

Telework Specifications:

POSITION NUMBER: 2847

ADDITIONAL JOB INFORMATION

Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.

We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.

Together we will empower people to live healthier lives.

Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

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

Job Function: Customer Service