CVS Health

Remote/Telecommute

Director of Operations

Posted over 1 month ago

Job Description

Job Description
The Director of Operations is a full time telework position; must reside in Ohio. This position will report to the COO.

The Director of Operations maintains oversight of functions in multiple service centers, including claim payments, claim rework, member or provider inquiries, enrollment, encounters, and provider data services, and/or implementation of new state programs. Responsible for market specific policies and procedures. Acts as market liaison for all state operation meetings. Oversees monitoring of subcontractor contract performance. Executes strategic and operational plans in support of business segment customer services objectives and initiatives. Sets business area priorities, allocates resources and develops plans for multiple related teams. Ensures all critical service metrics and operational results are achieved. Leads multiple managers, highly specialized professional staff or significant outsourced operations. Some travel is required for meetings and business needs; in-state mostly.

Fundamental Components:
* Oversees the operations of multiple service centers ferent locations handling a customer service function, which may include claims, member or provider services, enrollment, encounters, and provider data system and overseeing the implementation of new programs.
* Oversees operating systems including policies and procedures, operating structure, and information flow across multiple service centers.
* Directs implementation of service standards for each location to ensure delivery of quality-focused, consistent cost-effective service and administration.
* Analyzes operational practices for effectiveness and practicality, while creating a culture which is innovative in its approach to solutions.
* Establishes a clear vision aligned with company values; sets specific challenging and achievable objectives and action plans; motivates others to balance customer needs, budgets, and business success.
* Develops an organization that attracts, selects, and retains high caliber, diverse talent able to successfully achieve or exceed business goals; builds a cohesive team that works well together and across other business segment functions.
* Effectively and proactively manages to budget, analyzing and acting upon financial variances from plan by identifying additional cost saving strategies.
* Leads and builds high performance teams across units by providing leadership, mentoring and coaching in achieving understanding of the voice of the customer.
* Accountable for leading staff in accordance with Aetnas standards of leadership excellence.
* Monitors and evaluates service center operational plans ensuring customer service standards are maintained during facility shutdowns (anticipated or unanticipated) and during business activity transfers between locations. Coordinates major plan modifications necessitated by unanticipated business or technology developments.
* Develops and implements business strategies to provide accurate and proactive customer service to members, state agencies aligned to service center. Provides operational support for market management of state agencies, members, and network providers.
* Ensures compliance outcomes are included in all plans and goals.

Required Qualifications
* 5+ years experience in managing high volume transaction processing, financial management, project delivery, production, systems analysis and application program development.
* Demonstrated critical thinking skills.
* Exceptional communication skills, verbal, written, and presentation.
* Multiple years proven leadership experience setting strategic direction and influencing change that resulted in quantifiable positive outcomes.
* Proven strong leadership skills managing large high-performance teams.
* Proficiency with personal computer, keyboard navigation skills, and MS Office Suite applications( Word, Excel, SharePoint, PowerPoint, etc.).
* Experience working with vendors.
* Customer service experience.
* Ability to travel, in-state mostly; must have reliable transportation, valid/active drivers license, and proof of vehicle insurance.

Preferred Qualifications
* Healthcare experience preferred.
* Medicaid and managed care experience preferred.
* Advanced degree preferred.

Education
Bachelor's degree in related field, or equivalent combination of education and experience.

Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.


We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

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