Ld Director Service Ops
CVS Pharmacy - Downers Grove, IL
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Job DescriptionAetna Better Health of Illinois is seeking a full time Lead Director of Operations. The Lead director will report directly to the health plan Chief Operating Officer and be responsible for leading and overseeing health plan operations including but not limited to Claims, Configuration, Enrollment, Encounters, Provider Escalation Management, Vendor Management & Oversight, Supplier Diversity. The Lead Director will also be responsible for partnering with centralized teams to ensure adherence to state Medicaid contract requirements for Call Center, Grievances & Appeals, Claims, Configuration, Provider Data Services, Procurement, Enrollment, Encounters, etc.The Lead Director will manage 4+ internal teams and be responsible for ensuring performance to Medicaid contract standard for all areas.The Lead Director will also play a key role in developing presentations and presenting to the State RegulatorPay RangeThe typical pay range for this role is:Minimum: 100,000Maximum: 221,000Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.Required Qualifications 5+ years experience with healthcare operations 5+ years experience working with government sponsored programs (Medicaid/Medicare) Experience managing multiple teams Experience developing and giving executive level presentations (C-Suite, VP, SVP level) Must be a strong public speaker with excellent written and verbal communication skills Must be able to manage ambiguity and work in fast paced environmentPreferred QualificationsPrefer candidate live in greater Chicago area Strong time management, project management, organizational, research, analytical, negotiation, communication, and interpersonal skills Strong proficiency in Microsoft Office applications (Outlook, Word, Excel, Power Point, etc.), including experience running web based meetings Demonstrated ability to lead people and get results through others Ability to organize and manage multiple priorities Excellent stakeholder relationship management skills High level of confidence and interpersonal savvy Knowledge of health plan claimsEducationBachelors degree or equivalent experienceBusiness OverviewBring your heart to CVS HealthEvery one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
Created: 2024-09-07