上海招聘

Position Summary/Mission:

This position is responsible for Claim, Call and Correspondence workload management, as well as inventory management across Aetna and vendor staff, trending and reporting and quality management. The goal of this position is to ensure claim, call and correspondence work is distributed appropriately across available resources and that turnaround time and quality goals are met in accordance with plan policies, procedures and agreed service levels.

Fundamental Components & Physical Requirements:

? Develop, monitor and review performance reports and contact the vendor Supervisor regarding aged work.
? Follow up with the vendor to manage their work.
? Monitor backlogs for increased incoming claim, call or correspondence volume.
? Monitor rework and fastrack work queues to ensure turn around time goals are met.
? Complete weekly backlog reports and all turn around time reports.
? Develop, produce and review performance exception reports.
? Manage all backlogs with the vendor.
? Formulate, affect, interpret, or implement management policies or operating practices.
? Develop and maintain workflows that govern the management of work for claims processors and customer service representatives.
? Assist with planning long- and short-term business objectives.
? Provide input on appropriate vendor selection.
? Provide guidance as to what work should be handled by each AGB or vendor team.
? Investigate and resolve matters of significance on behalf of management.
? Review escalated service issues, undertake specific claim reviews as needed, and provide guidance on reports and tools available for Actuary.
? Hold frequent performance review sessions with the Vendor management teams.
? Remove vendor resources from handling work if performance is unacceptable.
? Ensure complaints are satisfactorily investigated and resolved within required regulatory timeframes.
? Manage internal workflows to ensure internal turnaround times and service levels are met by Aetna colleagues.
? Analyze error reports and resolve error trends
Coordinate the vendor claim review/rebuttal process with supervisory staff
Provide rework analysis to improve site/vendor quality results
? Review and update process workflows to ensure good practice and efficiencies are maintained.
? Monitor the quality of the vendor performance to ensure quality and performance targets are met and deal with any missed targets.
? Produce and analyse management information reports to demonstrate and monitor vendor performance in accordance with performance targets and identify trends, and circulate these reports to all interested parties.
? Develop and maintain strong collaborative relationships
? Effectively manages cross-functional projects that support the business strategy

Background/Experience Desired:

? Management experience preferred
? Vendor or relationship management experience preferred

Educational Requirements:

? Bachelor's degree or equivalent work experience
? Advanced degree preferred

Additional Information (not mandatory to complete):

? Negotiation skills.
? Well organized.
? Prioritizes tasks effectively.
? Strong influencing skills
? Problem solving skills.
? Strong project management skills (financial, analytical, planning and implementation).
? Solid written and oral communication skills.
? Strong influencing skills
? Critical problem solving ability
? Highly organized and able to quickly prioritize multiple assignments with high quality results.
? Ability to handle diverse assignments and juggle multiple priorities with ease.
? Exceptional communications skills including ability to interact with a variety of external and internal audiences including senior management and vendors.
? Experience with staff selection and development.

安态（上海）企业服务有限公司是美国安泰集团在中国的全资子公司。美国安泰集团公司（纽约证券交易所代号: AET，以下简称安泰集团） 始创于1853年，全球总部位于美国康涅狄格州哈特福德市，是美国历史最悠久的金融保险集团之一，也是全球财富500强企业，2010年营业收入超过342亿美金。

跨入21世纪，安泰集团已发展成为国际领先的专业健康福利保障公司，业务范围涵盖健康保险产品及相关服务，其中包括医疗、药物、牙科、行为健康、团体人寿和伤残计划，以及针对公共医疗补助计划的医疗管理功能和保健管理服务。

安泰集团在全球聘用了超过35000名员工，包括执业医师、护士、药剂师及其他临床专业人士。作为健康福利保障业的翘楚，我们的客户包括员工团体、个人、大学学生、***和小时工、健康计划、资助计划、劳工组织及外籍人员。

2008年3月，安泰集团被美国财富杂志推选为美国最值得推崇的健康福利保障公司。同年，安泰集团也被美国商业周刊杂志推选为最适合开展职业生涯的公司之一。

安态（上海）企业服务有限公司致力引进美国先进的健康管理理念与技术，为中国市场企业客户提供高质量的健康管理服务和健康保险外包服务。

更多信息，请登陆公司网站：
www.aetna.com

Aetna (Shanghai) Enterprise Services Co. Ltd is a wholly owned enterprise of Aetna Inc. Aetna (NYSE: AET) was established in 1853 with headquarter in Hartford, CT, USA. As a global Fortune 500 company, Aetna is a well-known finance – insurance group in the US. Its 2010 revenue exceeded USD 34.2 billion.

Entering into the 21st century, Aetna now is a leading provider of health and related benefits programs, covering health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities and health care management services for Medicaid plans.

Aetna has over 35,000 employees worldwide, including licensed physicians, nurses, pharmacists and other clinic staff. Being the leading health-related benefit provider, Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, governmental units, government-sponsored plans, labor groups and expatriates.

In 2008, Aetna was ranked 1st in Fortune's 2008 Most Admired Health Care Company and was also recognized as one of the "Best Places to Launch a Career" in 2008 by Business Week.

Aetna (Shanghai) Enterprise Services Co. Ltd aims to introduce international concepts and practice of health management services into China to provide high quality health management services.

For more information, please visit our website:
www.aetnainternational.com