Lead Director Healthcare Insurance Operations Meritain TPA Remote
Lead Director Healthcare Insurance Operations Meritain TPA Remote
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$ 100000 - 231540
1 Vacancy
Job Description
At CVS Health were building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nations leading health solutions company we reach millions of Americans through our local presence digital channels and more than 300000 purposedriven 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.
A Brief Overview
Provides strategic leadership and oversight to ensure exceptional member experiences and satisfaction by developing and implementing service strategies leading multiple teams and functions monitoring service quality and performance metrics resolving escalated customer issuesand collaborating with other departments to enhance the overall member experience. Applies leadership skills customercentric mindset and problemsolving abilities to drive customer loyalty retention and advocacy while promoting a positive and serviceoriented culture within the organization.
What you will do:
Leads five different functional areas within Meritain claims adjustments recovery FSA administration front end mail and data administration with approximately six direct reports offshore vendors and overall scope of approximately 160 employees.
Develops strategies to optimize service operations ensuring the efficient and effective delivery of services to meet customer needs and expectations.
Implements industry best practices and proven methodologies to streamline service processes and improve operational efficiency.
Evaluates selects and integrates innovative technologies and systems to optimize service operations and enhance customer support efforts.
Manages and allocates resources effectively to ensure that services are delivered efficiently on time and within budget
Develops and monitors key performance indicators (KPIs) to measure service performance ensuring that the services provided meet the established quality standards and customer expectations.
Fosters a customercentric culture emphasizing empathy effective communication and problemsolving skills in all customer interactions.
Focuses on customer satisfaction and retention by monitoring customer feedback addressing complaints and implementing measures to enhance the customer experience.
Communicates strategically with IT and data management teams leveraging technology and data analytics to optimize service operations improve efficiency and enhance customer insights.
Stays updated on industry trends emerging technologies and best practices in service operations incorporating relevant knowledge into operational strategies and driving innovation in service delivery.
For this role you will need Minimum Requirements:
Minimum 10 years work experience in healthcare insurance operations and/or customer service providing strong member experiences.
Proven leadership experience managing teams in a complex matrix organization
Outsource vendor experience a plus
Ability to inspire develop and guide teams toward achieving goals
Experience tracking key performance indicators (KPIs) and using data to drive results
Innovative thinker with ability to drive automation efficiencies and best practices
Adept at and delivery (planning delivering and supporting) skills
Adept at business intelligence
Adept at collaboration and teamwork
Mastery of problem solving and decisionmaking skills
Mastery of growth mindset (agility and developing yourself and others) skills
Education
Bachelors degree preferred/specialized training/relevant professional qualification.
Pay Range
The typical pay range for this role is:
$100000.00 $231540.00
This pay range represents the base hourly rate or base annual fulltime 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 shortterm incentive program in addition to the base pay range listed above. This position also includes an award target in the companys equity award program.
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 people
We 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.
Nocost 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.
For more information visit anticipate the application window for this opening will close on: 05/24/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal state and local laws.
Required Experience:
Director
Employment Type
Full-Time
