Aetna Flexible Part-Time Remote - Work From Home: Apply Now

Aetna Flexible Part-Time Remote - Work From Home: Apply Now

Industry: Private...
Employment Type: Full Time
Work Hours: 8
Salary: $35 - $45Hour
Location: United States
Company: Aetna

Descriptions:

Aetna Flexible Part-Time Remote - Work From Home: Apply Now

The Supervisor of Service Operations will maintain oversight of a team of claim processors and all claim related functions for Medicaid Claim Operations. We are seeking a highly motivated individual who will establish a clear vision aligned with company values and team goals. The claim Supervisor works with staff to align daily processing activities to successfully meet Health Plan metrics.

Responsibilities will include:

Managing a team of claim processors and overseeing daily operations for assigned health plan to achieve state required metrics.
Manage employee performance and development.
Identifies risks and barriers and collaborates with business partners to improve processes.
Coaches and mentors team members, assisting with complex questions and customer interactions.
Acts as liaison between staff and other areas, communicating workflow results, ideas, and solutions.
Completes various business reports, including tracking, trending and results.
Works with the Medicaid leadership team to allocate resources to meet volume and performance standards.
Builds a cohesive team through collaboration, inclusion, and diverse thinking.
Ability to work in a fast-paced production environment.

Required Qualifications

Leadership experience
Project management.
Inventory management.
Excellent verbal and written communication.
Advanced Excel Skills
QNXT Claim System
SQL
Quick Base

Preferred Qualifications

2+ Years experience processing claims on the QNXT system

Ability to navigate the hub, claim policies and procedures

Education
Please replace this section with the Education Requirements

Aetna Flexible Part-Time Remote - Work From Home: Apply Now

About the Aetna Company:

Aetna, a prominent name in the U.S. healthcare industry, has evolved into a comprehensive health benefits provider. Now a subsidiary of CVS Health, the company offers a wide range of health insurance plans and related services.

A Rich History

Founded as an insurance company in the 19th century, Aetna's roots are deep in the American business landscape. Named after the active volcano Mount Etna, symbolizing strength and resilience, the company has mirrored that spirit in its operations. Over the decades, Aetna expanded its services beyond property insurance to encompass health insurance, becoming a major player in the managed care sector.

A Focus on Member Well-being

Aetna's core mission is to help people live healthier lives. The company achieves this by offering a variety of health insurance plans tailored to individuals, families, and employers. These plans cover medical, dental, behavioral health, and pharmacy benefits. Beyond traditional insurance, Aetna also provides a range of programs and services aimed at preventive care, chronic disease management, and wellness initiatives.

The CVS Health Partnership

In a strategic move to enhance its healthcare offerings, Aetna merged with CVS Health in 2018. This partnership brought together a pharmacy giant and a leading health insurer, creating a powerful force in the industry. The combined entity aims to deliver more accessible, affordable, and effective healthcare solutions by integrating pharmacy, medical, and behavioral health services.

A Commitment to Innovation

Aetna is at the forefront of healthcare innovation. The company leverages technology to improve the member experience, streamline administrative processes, and enhance care delivery. From digital health tools to data analytics, Aetna is committed to finding new ways to improve health outcomes and lower costs.

Challenges and Opportunities

The healthcare industry is dynamic, marked by constant changes in regulations, technology, and consumer expectations. Aetna, like other major players, faces challenges such as rising healthcare costs, increasing competition, and the need to adapt to evolving consumer preferences. However, the company also enjoys significant opportunities to expand its market share, develop innovative products, and improve population health.

In conclusion, Aetna is a vital component of the U.S. healthcare system. With its rich history, extensive network, and focus on innovation, the company is well-positioned to continue serving the evolving needs of its members and customers. As part of CVS Health, Aetna is poised to play a pivotal role in shaping the future of healthcare in America.

Aetna Flexible Part-Time Remote - Work From Home: Apply Now

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