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Member Advocate
Position Summary/Mission
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Aetna is an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. We collaborate with members, providers, and community organizations in pursuit of quality solutions that address the full continuum of our members' health care and social determinant needs. Dual Eligible Special Needs Plans (DSNP) members are enrolled in Medicare and Medicaid. The Member Advocate is responsible for direct member outreach and engagement Join us in this exciting opportunity as we grow and expand DSNP into new markets across the country.
Fundamental Components
- Initiates engagement with assigned members to introduce the program and gather updated member demographic information with speed, accuracy, and a positive attitude
- Schedules completion of the assessment based on the member's preferences and the assigned care manager's schedule.
- Accurately and consistently documents each call in the member's electronic record, thoroughly completing required actions with a high level of detail to ensure we meet our compliance requirements
- Protects the confidentiality of member information and adheres to company policies regarding privacy/ HIPAA Effectively supports members during enrollment calls, appropriately managing difficult or emotional member situations, responding promptly to member needs, and demonstrating empathy and a sense of urgency when appropriate
- Conducts triage, connecting members with appropriate care team personnel including care managers and customer servicewhen needed
- Ability to be agile, manage multiple priorities, and adapt to change with enthusiasm
- Determined to build strong relationships with peers and our DSNP members
- Demonstrates an outgoing, enthusiastic, and caring presence over the telephone
- Act as a Medicaid recertification specialist for the team
- Must be able to travel 25-40% to attend member meetings.
- Experience with computers, including knowledge of Microsoft Word, Outlook, and Excel - data entry and documentation within member records is preferred
- 2 years of experience preferably in customer service, telemarketing, Medicaid, and/or sales
- Call center experience preferred. Familiarity with basic medical terminology preferred
- Flexibility with work schedule to meet business needs
- Strong organizational skills, including effective verbal and written communications skills
- Bilingual desired
- The highest level of education desired for candidates in this position is a High School diploma or G.E.D.
- Must reside in New Jersey
The typical pay range for this role is:
$18.50 - $42.35
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit Benefits | CVS Health
We anticipate the application window for this opening will close on: 11/22/2024
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.