Supervisor Claim Operations, CVS Health

CVS Health

Location:
United States, Hartford

Category:
Customer Service

Contract Type:
Employment contract

Salary:

43888.00 - 93574.00 USD / Year

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Job Description:

Responsible for the overall supervision of Claim Processing employees. Achieve superior service performance through an integrated process of operational, quality, medical cost and resource management tools and applications; meeting and/or exceeding department and company goals. Develop, train, evaluate and coach staff to provide cost effective claim review/processing; manage daily inventory; allocate resources to meet performance standards; leadership, collaboration, and communication skills required.

Job Responsibility:

Develop, train, evaluate and coach 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 are met and/or exceeded
Allocate resources to meet volume and performance standards including Key Performance Metrics (KPMs) and Performance Guarantees
Work collaboratively
Communicate effectively with candor
Identify risks early
Strong organizational skills
Strong leadership skills including staff development
Identify and execute team process improvement
Assess individual and team performance using all available tools/applications
Provide timely results and candid feedback regularly and by using mid-year and annual scorecards
Act as a liaison between staff and other areas, including management, plan sponsors, provider teams
Communicate workflows, results, ideas, and solutions
Utilize available incentive programs to reward, recognize, and celebrate team and individual successes
Be flexible and creative in a fast paced, constantly changing environment
Apply and enforce Aetna/CVS HR policies and practices
Present a positive, professional image of the company

Requirements:

2+ Year prior work experience in a claim processing role
The candidate must have success in claim processing/service, leadership, oral and written communication skills, keeping commitments and meeting deadlines, and strong business knowledge
Proven track record of successfully dealing with multiple priorities, tasks, and fluctuating deadlines
Understands projecting work volumes and workload management preferred
High School Diploma and equivalent work experience

Nice to have:

Prior experience working in a quality assurance and production capacity
Associate's degree

What we offer:

Affordable medical plan options
401(k) plan including matching company contributions
Employee stock purchase plan
No-cost programs including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access

Additional Information:

Job Posted:
October 28, 2025

Expiration:
November 29, 2025

Employment Type:

Fulltime

Work Type:

On-site work

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Supervisor Claim Operations