At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position SummaryAetna is recruiting for a Manager in Services Operations on the Shared Services team. The Manager, e.Policies Quality Project Management will be part of an experienced team responsible for a variety of functions to support and manage e.Policies. The primary focus of the role will be acting as an advocate for and supporting the business by serving as a quality champion (i.e., measuring and monitoring the quality and effectiveness of work processes in claim and call policy). Additional focus will be on projects related to operational efficiency and process improvementKey functions of this role include:
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- Leading the planning and execution of key organizational projects, ensuring consistent alignment with organizational goals, timelines, and resource constraints.
- Developing project plans, defining deliverables and deadlines, and establishing project milestones for the organization.
- Developing, implementing, and enforcing quality control standards and processes in line with best practices.
- Consulting and/or working cross-functionally to influence and promote change to continually deliver quality service to our internal customers
- Conducting audits and reviews ensuring compliance with performance standards and quality outcomes (e.g., quality, accuracy, and timeliness)
- Reporting on performance results and providing support, as needed, in the development of action plans for quality improvement
- Monitoring the participation and completion of required training for colleagues and completing appropriate follow-up with managers
- Providing technical and subject matter expertise relative to policies, procedures, and Claim and Call Policy applications/systems tools
- Collecting and monitoring customer feedback and satisfaction levels to assess the quality of services and tools provided. Communicating results to leadership and identifying process improvements to implement.
- Fostering a positive and unified team culture by coaching more junior colleagues to enhance their skills and performance
- 5+ years of experience working with claims, calls, and/or quality
- (including claims processing, claims policy, customer service, or related experience)
- Experience using and navigating ePolicies
- Adept at problem solving and decision-making
- Adept at collaboration and teamwork
- Adept at execution and delivery (planning, delivering, and supporting)
- Strong written and verbal communication skills, adapting to meet the needs of the intended audience
- Strong organizational and leadership skills
- Experience in Aetna Service Operations call, claim and/or quality functions
- Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment
- Experience with developing and maintaining effective working relationships
- Bachelor's degree or equivalent work experience
40Time Type
Full timePay Range
The typical pay range for this role is:$66,330.00 - $145,860.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
- Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
- Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.