Req ID: 49980BR
Responsible for national support of the for Aetna Service Operations organization through reporting and analysis, data analytics and modeling, audit and compliance oversight, mandates implementation, call and claim policy (e.policy), real estate optimization, internal communications and management processes. Provides leadership to a significant portion of the Service Operations organization throughmultiple levels of managers.
Position can be located in any service operations hub, located across the US. Fundamental Components: • Improves overall organization performance through design, development and implementation of business metrics and measurement systems to support organization s performance objectives; distills high-volume, complex data into actionable information; develops simple, accessible, user-driven reporting tools to meet the needs of a broad range of users at all levels of the organization; monitors and drives improvement in performance results; administers quarterly incentive plan for front-line staff.• Improves service operations performance and member experience through use of data analytics and predictive modeling to identify service opportunities and to drive improvement actions.• Improves the organization s compliance environment through oversight of all audit- and compliance-related activities across the Service Operations organization; interfaces with internal and external auditors and compliance business partners on SO-related engagements; ensures timely and accurate implementation of state regulatory mandates; ensures ongoing compliance with regulatory requirements; coordinates investigation and closure of privacy-related matters; ensures an adequate controls environment (SOC1 and SOX); monitors Management Action Plans.• Supports efficient and effective operations through maintenance of call and claim policies (e.policies); ensures policies are compliant with regulatory requirements; ensures ongoing accuracy and relevancy of policy; drives improvements in user experience.• Supports efficient and effective operations through maintenance of call and claim policies (e.policies); ensures policies are compliant with regulatory requirements; ensures ongoing accuracy and relevancy of policy; drives improvements in user experience.• Chairs the Health Operations Policy Process (HOPP) Council, and enterprise-wide forum and decision-making body for health policy. • Supports business and financial performance of the organization through development and execution of Service Operations long term real estate strategy; collaborates with Real Estate Services to represent Service Operations needs and ensure that workstations are available in the right quantity, location and timeframe, and at the right cost; manages vacancy rates in the portfolio to reduce costs; drives improvements in RE utilization.• Oversees hiring / staffing processes to ensure adherence to budget constraints as well as incremental progress toward long-term real estate strategy; ensures telework strategies align with the organization s overall workforce goals.• Provides internal communications support for the organization; ensures development and implementation of communications strategies and plans to support the organization s objectives. Background/Experience Desired• 15 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.• Proven track record in managing large multiple, complex and integrated projects/programs/production with budget responsibility of $50 - $100 million.• Proven strong leadership skills managing large high performance teams.• Experienced working with vendors.• Demonstrated negotiation skills. Education and Certification Requirements• Bachelor's degree in a closely-related field, or equivalent combination of education and experience.• Advanced degree preferred.
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 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