Medicare Supplement Claims Audit Supervisor- Hybrid ...

Job DescriptionClaims Quality Audit Supervisor coordinates daily activities of claims audit staff. Assists in developing claims audit policies and procedures. Recognizing efficiency and effectiveness of own team, identifying and resolving routine problems. Sets priorities for and coaches employees to meet goals.Develops, motivates, evaluates and coaches staff on work procedures, Available to staff to answers questions, and give on going feedback.Utilizes available incentive programs to reward, recognize and celebrate team and individual successes.Assesses individual and team performance on a regular basis and provide candid and timely feedback regarding developmental and training needs. Establishes clear vision aligned with company values; motivates others to balance customer needs and business success. Manages and monitors daily workflow and reporting to ensure business objectives are maintained and accurately reported; ensures resources are aligned appropriately across function. Develops and maintains strong collaborative relationships with constituents and internal business partners to maintain excellent lines of communication.Remove barriers to job performance and ensures regulatory compliance.. Attracts, selects, and retains high caliber, diverse talentable to successfully achieve or exceed business goals. Builds a cohesive team that works well together.Acts as liaison between staff and other areas, including management, all segments, provider teams, etc., communicating workflow results, ideas, and solutions.Proactively analyzes constituent data, identifies trends and issues. Recognizes and acts on the needs to improve the development and delivery of products and services.Required QualificationsHybrid Work Schedule Required 2 days in office 1-3 years experience leading a team Must have healthcare Experience Multiple years proven leadership experience setting strategic direction and influencing change that resulted in quantifiable positive outcomes. Proven strong leadership skills managing large high performance teams. Excellent oral and written communication skills required. Strong negotiation skills required. Strong analytical and problem solving capabilities Ability to work independently and promote self direction to team Strong PC skills, including Windows, Word, Excel and Adobe Acrobat. Must be able to adapt to software changes as they occur. Knowledge of medical terminology and health insurance concepts. Thorough understanding of claims processing procedures and requirements. Ability to think creatively to produce solutions to claims processing problems. High level of interpersonal skills to work effectively with others. Strong communications, listening, facilitation and consulting skills. Excellent project management skills. Demonstrated ability to be a change agent and foster innovative solutions. Ability to organize and recall large amounts of detailed information. Ability to project a professional image and positive attitude in any work environment. Ability to comply with privacy and confidentiality standards. Ability to be flexible, work under pressure and meet deadlinesCOVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred QualificationsStrong background and experience with audit methodologies and techniques. Prior audit knowledge conducting internal as well as external audit reviews. Ability to build relationships while asking tough questions.EducationHigh School diploma or equivalentBusiness OverviewAt Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

Created: 2025-10-04