Supervisor Claim Operations

Claim Processing Supervisor

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven 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.

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.

Fundamental Components :

• 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.
• 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 and by using mid-year and annual scorecards.
• Acts as a liaison between staff and other areas, including management, plan sponsors, provider teams, 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.
• Candidate will be expected to effectively apply and enforce Aetna / CVS HR policies and practices.
• The candidate for this position will need to present a positive, professional image of the company at all times.

Required Qualifications :

Preferred Qualifications :

Education :

Anticipated Weekly Hours : 40

Time Type : Full time

Pay Range :

The typical pay range for this role is : $43,888.00 - $93,574.00

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.

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 :

We anticipate the application window for this opening will close on : 11 / 29 / 2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.