Bring 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.

Program Overview:

Help us elevate our patient care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members' health care and social determinant needs. Join us in this exciting opportunity as we grow and expand dually eligible members to change lives in new markets across the country.

• Responsible for initial review and outreach tasks.
• Tracks Medicaid redetermination and researches eligibility issues.
• Utilizes Dynamo, QNXT and other Aetna systems to build, research and enter member information, as needed.
• Assists Case Managers with coordination of benefits and services.
• Promotes communication, both internally and externally to enhance effectiveness of medical management services (e.g., health care providers, and health care team members respectively)
• Provides support services to team members by answering telephone calls, taking messages, researching information, and assisting in solving problems.
• Adheres to Compliance with Policies and Regulatory Standards.
• Maintains accurate and complete documentation of required information that meets contract requirements.
• Protects the confidentiality of member information and adheres to company policies regarding confidentiality

• 2years' experience as a medical assistant, office assistant.

• Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification, and resolution of issues to promote positive outcomes for members.
• Computer literacy to navigate through internal/external computer systems, including Excel and Microsoft Word.
• Ability to effectively participate in a multi-disciplinary team including internal and external participants.
• Effective communication, telephonic and organization skills.

• Familiarity with basic medical terminology and concepts used in care management.
• Medicaid/ Medicare experience preferred.