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Aetna A1A Customer Service Manager in New Albany, Ohio

Req ID: 65059BR

Job Description

A1A is a fully integrated population health and customer service solution for large plan sponsors. Our embedded and customer-dedicated service, clinical, and rising risk pods allow maximization of inbound and outbound touchpoints to solve members needs and create behavior change. Our white-glove service and end-to-end ownership of member support creates a trusted partner in health. We are the premiere service and clinical offering for Aetna nation-wide and create industry-leading solutions for our customers and members.

The A1A Customer Service Manager will maintain oversight of functions in local service center, including but not limited to customer service, claim, provider services, complaints, grievances, and appeals, implementation, and/or plan sponsor operations. Executes local strategic and operational plan in support of business segment customer service objectives and initiatives. Plans, directs and implements procedures that will assure a high level of customer access and satisfaction. Responsible for the quality and effectiveness of own team and related teams, identifying and resolving technical, operational and team problems. Manages a team of professional employees and/or supervisors.

Fundamental Components included but are not limited to:

  • Oversees the operations in a local service center handling a customer service function, which may include claims, member or provider services, billing, enrollment, accounts receivable and implementation services.

  • Develops, monitors and reviews performance reports and service performance trends for each account against the plan and recommends specific actions or remedies as necessary.

  • Develops and maintains strong collaborative relationships within operations as well as with patient management, Sales and Marketing, PSS, Underwriting, Utilization Management, and network management in establishing appropriate service level agreements.

  • Develops, trains, evaluates, and coaches staff to provide cost effective claim processing and claim and customer service while ensuring that quality standards are met.

  • Assesses individual and team performance on a regular basis and provide candid and timely developmental feedback; monitors training plans and ensure training needs are met.

  • Establishes a clear vision aligned with company values; sets specific challenging and achievable objectives and action plans; motivates others to balance customer needs and business success; 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 goals; builds a cohesive team that works well together.

  • Creates and maintains tools, job aids, and training materials to help employees in their efforts to resolve issues and improve their relationship with customers.

  • Collects, analyzes and reports on operations information in support of process, systems, and policy redesign. Effectively applies and enforces Aetna HR policies and practices, i.e. FML/EML, Attendance, Code of Conduct, and Disciplinary Guidelines

  • Effectively manages cross-functional projects that support the business strategy.

Qualifications Requirements and Preferences:

.

  • Minimum of 8 years of experience managing/leading an operations team

  • Minimum of 3 years of customer facing experience and presenting to customers and Senior Leadership Level.

  • Strong verbal and written communication skills

  • Strong and creative presentation design capabilities

  • Exhibits “big picture strategic thinking capabilities

  • Clearly demonstrates ability to lead, drive and inspire leaders to achieve results

  • Strong analytical skills

  • Ability to determine root cause and create effective action plans to close performance gaps

  • Clearly demonstrates aptitude to manage with courage

Required Skills:

Leadership - Anticipating and Innovating, Leadership - Engaging and Developing People, Service - Handling Service Challenges

Desired Skills:

Leadership - Creating Accountability, Service - Creating a Differentiated Service Experience, Service - Working Across Boundaries

Benefit Eligibility

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

Job Function: Customer Service

Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.

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