Director - Service Operations - Aetna - Moon Township

Job description
Working At Aetna -- the Value To You
What does it mean to work at Aetna? A lot. From programs and benefits that support your financial, physical and emotional health to opportunities to build your knowledge and expand your career, the company makes working here a valuable experience in many ways.


POSITION SUMMARY
Maintains oversight of functions in multiple service centers, including claim payments, claim rework, member or provider inquiries, billing, enrollment, accounts receivable, and/or implementation services. 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.


Fundamental Components:
Oversees the operations of multiple service centers in different locations handling a customer service function, which may include claims, member or provider services, billing, enrollment, accounts receivable and implementation services.
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 Aetna's 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, plan sponsors and brokers aligned to service center. Provides operational support for market management of plan sponsors, members and network providers.
Ensures compliance outcomes are included in all plans and goals.
Exhibits the following Manager Behaviors:
Proven strong leadership skills managing large high performance teams
Experienced working with vendors
Demonstrated negotiation skills

Required Skills:
BACKGROUND/EXPERIENCE desired:

5+ 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

EDUCATION
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.

FUNCTIONAL EXPERIENCES
Functional - Management/Management - Operations/4-6 Years

TECHNOLOGY EXPERIENCES
Technical - Operating Systems/Windows 2003/4-6 Years/End User

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