Manager - Healthcare Quality
CVS HealthSalary not specified
Full Time
Junior (1 to 2 years)
Not SpecifiedCompensation
Mid-level (3 to 4 years)Experience Level
Full TimeJob Type
UnknownVisa
InsuranceIndustries
Requirements
- Demonstrated operations experience in a multinational health organization or health insurance company is preferred
- Bachelor degree or above in medical health, insurance or operation etc
- Strong working knowledge of applicable health insurance, TPA service, hospital network development, big health management and implementation methodologies. Project management and operations’ experience is a plus
- Strong interpersonal skills, independent, energetic, pro-active and able to work in a fast-paced environment under pressure
- Proficiency in Microsoft Office suite, including PowerPoint, Excel and Word
- Participate in AIG corporate AML training, and be obligated to perform AML related duties, including KYC, large/suspicious transaction reports, high-risk customer reports etc
Responsibilities
- Enhance A&H health products through third parties' value-added health service
- Manage various health vendors and assistance providers to optimize the operational process of personal insurance's products to achieve the high quality health service in A&H
- Consistently drive process optimization to meet customer’s expectations, and to meet PI business growth and overall P&L contribution
- Responsible for problem solving related to health service areas in day-to-day operating running, explores the opportunities to enhance the service through the digital transformation
- Closely work with UW/PM on TPA vendors selection, CBRA onboarding, negotiation and assessment process to meet defined service metrics
- Cooperate with internal teams to implement various policies and projects. Working with UW, IT and operation teams to deliver the health service in policy service
- Develop TPA service mode and health service standards/KPI to meet the requirements of compliance and regulatory
- Timely and accurately complete the health service report according to regulators’ requirements, conduct regular onsite or remote inspection activities to ensure the TPA service in the high quality control
- Responsible for conducting annual TPA vendor onsite-inspection, audit and assessment report. Coordinate with internal auditor, claims and UW to deliver vendors audit
- Tasked with deliverable of health vendors SLA report and service improvement
- Ad-hoc tasks/projects assigned by managers
Skills
Vendor Management
Process Optimization
Digital Transformation
Negotiation
Auditing
Compliance
Regulatory Reporting
KPI Development
SLA Management
TPA Vendor Assessment
AIG
Global insurance provider for individuals and businesses
About AIG
AIG provides a variety of insurance products and services aimed at individuals, families, and businesses. Their offerings include life insurance, retirement planning, and commercial insurance, which help clients manage risk and protect their assets. AIG operates by underwriting insurance policies and managing risk, while also investing the premiums collected to generate income. This company stands out from competitors by not only focusing on traditional insurance but also emphasizing cybersecurity and data protection to keep clients' information safe. AIG's goal is to help clients achieve financial security and peace of mind through comprehensive insurance solutions.
New York City, New YorkHeadquarters
1919Year Founded
IPOCompany Stage
Cybersecurity, Financial ServicesIndustries
10,001+Employees