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　　Position Summary

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　　The Medicare Service Operations Claims Supervisor will be responsible for claim processing for Medicare supplemental benefit claims. The supervisor will supervise a stateside team of Claim Benefit Specialists who handle claims for members and providers.

　　This position involves:

　　Responsible for managing and mentoring the claims team, communicating with business partners and have a understanding of inventory management and staffing.Develop and mentor staff to provide cost effective claim review/processing and claim service while ensuring compliance and quality standards are met.Manage and monitor daily inventory to ensure production standards and TATs are met and/or exceeded.Allocate resources to meet volume and performance standards including Key Performance Metrics (KPMs).Must have the ability to work collaboratively, ability to communicate effectively with candor, ability to identify risks early, strong organizational skills, and strong leadership skills including staff development.Identify and execute team process improvement.Assess individual and team performance using all available tools/applications and provide timely results and candid feedback regularly.Acts as a liaison between staff and other areas, including management, member and provider services, communicating workflows, results, ideas, and solutions.Utilize available incentive programs to reward, recognize, and celebrate team and individual successes.Demonstrates the ability to be flexible and creative in a fast paced, constantly changing environment.The candidate for this position will need to present a positive, professional image of the company at all times.Candidate will be expected to effectively apply and enforce Aetna HR policies and practices.

　　Required Qualifications

　　The ideal candidate would have current/previous successful processing experience on HRP and/or direct member reimbursement claims.

　　Leadership skills, ability to keep commitments and meet deadlines, and a strong business knowledge.

　　Good problem solver/negotiator.

　　Excellent oral and written communication skills.

　　Self-driven and ability to manage multiple priorities.

　　Be efficient & flexible to meet organizational goals.

　　Proven track record of successfully dealing with multiple priorities, tasks, and fluctuating deadlines.

　　Understands inventory and workload management, preferred.

　　Preferred Qualifications

　　Minimum 1 yr processing experience on HRPEducation

　　High School Diploma, G.E.D. or equivalent work experience.

　　Pay Range

　　The typical pay range for this role is:

　　$40,600.00 - $85,100.00

　　This 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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

　　CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

　　You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

　　CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through [email protected] If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.