Job Description
Job Description
Aetna is expanding our Engagement Hub services. The Engagement Hubs are focused on driving member engagement into Aetnas Care Management programs, while also delivering care services to members who do not need long term support but have immediate care needs. The Engagement Specialist is responsible for telephonic outreach to and enrollment of our eligible members. Our Engagement Specialists demonstrate a highly energetic blend of salesperson, health care navigator and health plan customer support representative. The Engagement Specialist is responsible for direct member outreach and engagement, facilitating case assignment, and connecting identified members to care managers immediately through a warm transfer.
Initiates telephonic engagement with assigned members to introduce the program with the goal of enrolling the member in Aetna Care Management.
Effectively meets daily metrics with speed, accuracy, and a positive attitude. The metrics are focused on unique members attempted daily and the volume of members that agree to enroll in care management. This is not a sales position, enrollment is free, but influencing is important to this work.
Documentation is critical to success. The Engagement Specialist accurately and consistently document each call in the members electronic record, thoroughly completing required actions with a high level of detail to ensure we meet our compliance requirements
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 service
Demonstrates an outgoing, enthusiastic, and caring presence over the telephone.
Works efficiently and independently, meeting deliverables and deadlines
Adheres to care management, privacy and confidentiality, and quality management processes in compliance with regulatory, accreditation guidelines, company policies and procedures
Demonstrates an ability to be agile, managing multiple priorities at one time, and adapting to change with enthusiasm
Other responsibilities as assigned
Required Qualifications
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 and/or sales??
Call center experience preferred Familiarity with basic medical terminology preferred??
Flexibility to work occasional nights and weekends outside of standard business hours which can span from 8:00 am 8:00 pm??
Strong organizational skills, including effective verbal and written communications skills??
Bilingual (Spanish) preferred
Preferred Qualifications
Please see requirements above
Education
The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.
Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
Aetna is expanding our Engagement Hub services. The Engagement Hubs are focused on driving member engagement into Aetnas Care Management programs, while also delivering care services to members who do not need long term support but have immediate care needs. The Engagement Specialist is responsible for telephonic outreach to and enrollment of our eligible members. Our Engagement Specialists demonstrate a highly energetic blend of salesperson, health care navigator and health plan customer support representative. The Engagement Specialist is responsible for direct member outreach and engagement, facilitating case assignment, and connecting identified members to care managers immediately through a warm transfer.
Initiates telephonic engagement with assigned members to introduce the program with the goal of enrolling the member in Aetna Care Management.
Effectively meets daily metrics with speed, accuracy, and a positive attitude. The metrics are focused on unique members attempted daily and the volume of members that agree to enroll in care management. This is not a sales position, enrollment is free, but influencing is important to this work.
Documentation is critical to success. The Engagement Specialist accurately and consistently document each call in the members electronic record, thoroughly completing required actions with a high level of detail to ensure we meet our compliance requirements
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 service
Demonstrates an outgoing, enthusiastic, and caring presence over the telephone.
Works efficiently and independently, meeting deliverables and deadlines
Adheres to care management, privacy and confidentiality, and quality management processes in compliance with regulatory, accreditation guidelines, company policies and procedures
Demonstrates an ability to be agile, managing multiple priorities at one time, and adapting to change with enthusiasm
Other responsibilities as assigned
Required Qualifications
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 and/or sales??
Call center experience preferred Familiarity with basic medical terminology preferred??
Flexibility to work occasional nights and weekends outside of standard business hours which can span from 8:00 am 8:00 pm??
Strong organizational skills, including effective verbal and written communications skills??
Bilingual (Spanish) preferred
Preferred Qualifications
Please see requirements above
Education
The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.
Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
55615111