Aetna Manager, Service Operations in Jacksonville, Florida

Req ID: 41795BR

POSITION SUMMARY

The successful candidate will manage a unit of Medicare Claim Processors and corresponding work streams on the HMO Platform. The role includes leading a team of Supervisors and Quality Analysts dedicated to delivering performance excellence.

Fundamental Components:

Primary duties of the position include:

Management of multiple inventories and daily work assignments, addressing performance gaps and collaborating with the Claim Leadership team to achieve the departments overall claim metrics.

The role includes exposure with developing an effective capacity model and forecast.

Continual process improvement and monitoring of quality and compliance risk (e.g. regular interaction with Quality Management, Claim Policy, etc.) that includes root cause analysis and effective remediation.

Ensuring that all required training as well as ongoing staff development are completed timely.

Maintaining a seamless workflow for staff located across multiple MSO claim sites as well as those in a telework environment.

BACKGROUND/EXPERIENCE desired:

Experience managing large operations.

Proven operational experience with 100 plus employees.

Supervisory or prior management experience; Medicare experience desired.

Direct experience managing inventory across multiple work steams required.

Ability to work across boundaries; Strong communication skills both verbal and written are critical to achieving success in this position.

Effective time management and the ability to create and administer action plans are highly desired.

EDUCATION

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

FUNCTIONAL EXPERIENCES

Functional - Claims/Claim processing - Medical - Medicare/1-3 Years

Functional - Claims/Management: < 25 employees/1-3 Years

ADDITIONAL JOB INFORMATION

Highly visible role managing a significant segment of the Medicare claim inventory. This position offers the successful candidate the opportunity to showcase their process improvement and leadership skills as part of an established leadership team.

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.

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.

Job Function: Customer Service