Medicaid Claim Operations Lead (Hybrid)

CVS Health Corporation; United States; Hybrid; USD 44,000 - 85,000; Full time

Benefits offered by this job

Medical, dental & vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health Corporation is seeking a Supervisor of Service Operations to lead a team of Medicaid claim processors and oversee all claim-related functions. The role drives alignment with health plan metrics, staff development, and cross-functional collaboration to optimize daily processing activities.

The position requires strong leadership, problem-solving, and advanced Excel skills, with hybrid work options and a performance-driven culture that values inclusion and teamwork.

Qualifications

• Strong problem-solving, organizational, and time management skills.
• Leadership experience.
• Project management.
• Inventory management.
• Excellent verbal and written communication.
• Advanced Excel Skills.
• QNXT Claim System.
• SQL Quick Base.

Responsibilities

• Managing a team of claim processors and overseeing daily operations for assigned health plan to achieve state required metrics.
• Manage employee performance and development.
• Identifies risks and barriers and collaborates with business partners to improve processes.
• Coaches and mentors team members, assisting with complex questions and customer interactions.
• Acts as liaison between staff and other areas, communicating workflow results, ideas, and solutions.
• Completes various business reports, including tracking, trending and results.
• Works with the Medicaid leadership team to allocate resources to meet volume and performance standards.
• Builds a cohesive team through collaboration, inclusion, and diverse thinking.

Skills

Leadership

Project management

Time management

Problem solving

Advanced Excel

Communication (verbal & written)

Inventory management

Education

High School Diploma or equivalent

Tools

QNXT

SQL

Quick Base

Job description

CVS Health Corporation is seeking a Supervisor of Service Operations to lead a team of Medicaid claim processors and oversee all claim-related functions. The role drives alignment with health plan metrics, staff development, and cross-functional collaboration to optimize daily processing activities.

The position requires strong leadership, problem-solving, and advanced Excel skills, with hybrid work options and a performance-driven culture that values inclusion and teamwork.