Supervisor Claim Operations- Hybrid Work Model

Job DescriptionClaims Med Sup Audit Supervisor coordinates daily activities of claims audit staff. Assists in developing claims audit policies and procedures. Recognizing efficiency andeffectiveness of own team, identifying and resolvingroutine 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, recognizeand celebrate team and individual successes.Assesses individual and team performance on a regularbasis and provide candid and timely feedback regardingdevelopmental and training needs. Establishes clear visionaligned with company values; motivates others to balancecustomer needs and business success. Manages andmonitors daily workflow and reporting to ensure businessobjectives are maintained and accurately reported;ensures resources are aligned appropriately acrossfunction. Develops and maintains strong collaborativerelationships with constituents and internal businesspartners to maintain excellent lines of communication.Remove barriers to job performance and ensuresregulatory compliance.. Attracts, selects, and retains highcaliber, diverse talentable to successfully achieve orexceed business goals. Builds a cohesive team that workswell together.Acts as liaison between staff and other areas, includingmanagement, all segments, provider teams, etc.,communicating workflow results, ideas, and solutions.Proactively analyzes constituent data, identifies trends andissues. Recognizes and acts on the needs to improve thedevelopment and delivery of products and services. Excellent oral and written communication skills required. Strong negotiation skills required. Strong analytical and problem solving capabilities Ability to work independently and promote self directionto team Strong PC skills, including Windows, Word, Excel andAdobe Acrobat. Must be able to adapt to software changes as they occur. Knowledge of medical terminology and health insuranceconcepts. Thorough understanding of claims processing proceduresand requirements. Ability to think creatively to produce solutions to claimsprocessing problems. High level of interpersonal skills to work effectively withothers. Strong communications, listening, facilitation andconsulting skills. Excellent project management skills. Demonstrated ability to be a change agent and fosterinnovative solutions. Ability to organize and recall large amounts of detailedinformation. Ability to project a professional image and positiveattitude in any work environment. Ability to comply with privacy and confidentialitystandards. Ability to be flexible, work under pressure and meetdeadlinesPay RangeThe typical pay range for this role is:Minimum: 40,560Maximum: 81,100Please 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 Qualifications1+ years experience leading a team1-2 Days required Onsite in Franklin TNPreferred QualificationsStrong background and experience with auditmethodologies and techniques. Prior audit knowledgeconducting internal as well as external audit reviews.Ability to build relationships while asking tough questions. 1-3 years experience leading a team Must have healthcare Experience Multiple years proven leadership experience settingstrategic direction and influencing change that resulted inquantifiable positive outcomes. Proven strong leadership skills managing large highperformance teams.EducationHigh School diploma or equivalentBusiness OverviewBring your heart to CVS Health Every 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. 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: 2026-03-07