Aetna MLTS or MCO Healthcare Supervisor-Plan Sponsor Support in New York, New York
Req ID: 57145BR
Supervise individual units responsible for the implementation, preparation, processing, and maintenance of enrollment, billing, and other benefit plan information for members. Support and consult with team by utilizing Aetna policy guidelines in accordance with key performance measures to ensure accuracy and customer satisfaction
Supervises, mentors and directs a team responsible for plan administrative functions or functional support areas. (*)
Develops, trains, evaluates, and coaches staff to provide cost effective decisions within Plan Sponsor Services or Implementation Services while ensuring operating standards are met; continually assesses individual and team performance against key business objectives and provides candid and timely developmental feedback. (*)
() Ensures policy and procedures associated with post implementation and on-going benefit administration services satisfy regulatory compliance requirements. ()
(*) Coordinates research efforts and resolution for revenue adjustment issues; ensures modifications are reported accordingly.
(*) Coordinates the collection and cancellation process for delinquent accounts in accordance with pre-established business procedures.
(*) Evaluates customer billing requirements, payment arrangements and service history in order to deliver a timely and technically sound product; ensures remittances are posted accurately across various benefit designations and corresponding account structures.
(*) Monitors and reports on the level of overall customer satisfaction against quality assurance, audit, and performance management initiatives; works to promote continuous process improvement relative to achieved results.
(*) Acts as a liaison between staff and other areas, including management, plan sponsors, marketing, etc., communicating workflow results, ideas and solutions.
(*) May direct the installation of new accounts and /or ongoing maintenance in support of department objectives.
(*) Establishes a clear vision aligned with company values; motivates others to balance customer needs and business success.
Must have previous MLTC, MCO or Healthcare management experience.
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
General Management/Vendor management (non-IT)/4-6 Years
- Administration / Operations/Management: < 10 employees/1-3 Years
Management/Management - Data analysis and interpretation/1-3 Years
Management/Management - Plan Sponsor Services/1-3 Years
Customer Service/Customer Service - Plan Sponsor - Enrollment - Traditional/1-3 Years
General Business/Communicating for Impact/ADVANCED
Service/Improving constituent-focused Processes/ADVANCED
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.
Aetna takes our candidates'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
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.