Supervisor, Claim Operations

Job DescriptionThe Supervisor, Claim Operations is responsible for the daily activities and supervision of a team of employees supporting business segment functions, including but not limited to claims and encounters. . Responsible for the quality, efficiency and effectiveness of own team, identifying and resolving routine problems. Sets priorities for and coaches employees to meet goals.Additional responsibilities to include but limited to the following:Manages and monitors daily workflow and reporting to ensure business objectives are maintained and accurately reported; ensures resources are aligned appropriately across function and/or service center.Develops and maintains strong collaborative relationships with constituents and internal business partners to maintain excellent lines of communication and share resources to meet common service center objectives.Is visible and available to staff to answers questions, assign work and give ongoing feedback.Leverages the unit's resources to resolve plan, claim and encounter inquiries or problems by identifying the issue, obtaining applicable information, perform root cause analysis, and generate and act upon the solutions.Assesses individual and team performance on a regular basis and provide candid and timely feedback regarding developmental and training needs; includes completion of monthly and annual scorecards.Develops, motivates, evaluates, and coaches staff on work procedures, proper call handling and teamwork delivering excellent customer service.Proactively analyzes constituent data, identifies trends and issues. Remove barriers to job performance and ensures regulatory compliance.Attracts, selects, and retains high caliber, diverse talent able 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.Clearly identifies what must be accomplished for successful completion of business objectives.Utilizes available incentive programs to reward, recognize and celebrate team and individual successes.Establishes clear vision aligned with company values; motivates others to balance customer needs and business success.Pay RangeThe typical pay range for this role is:Minimum: 40,600Maximum: 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 Qualifications 1-3 years Medical Claims experience 1-3 years prior leadership/team lead experience 1-3 years experience in managing or participating in high volume transaction processing Strong verbal and written communication skills Strong problem-solving skillsCOVID 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 Qualifications Medicaid/Medicare Encounters experience Claim policies and procedures Prior Supervisor experience with team of 5 or more; including staff developmentEducationHigh School Diploma or equivalent GED and combination of years of 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: 2026-04-04