Lead Director, Healthcare Insurance Operations Meritain TPA, Remote
Apply NowCompany: CVS Health
Location: Lansing, MI 48911
Description:
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.
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 issues, and collaborating with other departments to enhance the overall member experience. Applies leadership skills, customer-centric mindset, and problem-solving abilities to drive customer loyalty, retention, and advocacy while promoting a positive and service-oriented 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 customer-centric culture, emphasizing empathy, effective communication, and problem-solving 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 execution and delivery (planning, delivering, and supporting) skills
Adept at business intelligence
Adept at collaboration and teamwork
Mastery of problem solving and decision-making skills
Mastery of growth mindset (agility and developing yourself and others) skills
Education
Bachelor's degree preferred/specialized training/relevant professional qualification.
Pay Range
The typical pay range for this role is:
$100,000.00 - $231,540.00
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. This position also includes an award target in the company's 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:
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We 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.
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.
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 issues, and collaborating with other departments to enhance the overall member experience. Applies leadership skills, customer-centric mindset, and problem-solving abilities to drive customer loyalty, retention, and advocacy while promoting a positive and service-oriented 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 customer-centric culture, emphasizing empathy, effective communication, and problem-solving 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 execution and delivery (planning, delivering, and supporting) skills
Adept at business intelligence
Adept at collaboration and teamwork
Mastery of problem solving and decision-making skills
Mastery of growth mindset (agility and developing yourself and others) skills
Education
Bachelor's degree preferred/specialized training/relevant professional qualification.
Pay Range
The typical pay range for this role is:
$100,000.00 - $231,540.00
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. This position also includes an award target in the company's 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.
- No-cost 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 https://jobs.cvshealth.com/us/en/benefits
We 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.