Job Description
Job Description
Aetnas Corporate Care Management 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 Information and Referral Specialist provides information, referral, assistance with accessing resources, health coaching, and supportive care to members. The I&R Specialist will support multiple member service initiatives by assessing the members stated and unstated needs, addressing resource needs, and effectively utilizing community, health care, and plan benefit resources.
Fundamental Components:
Utilize designated interactions to assess the members stated and unstated needs, including social determinants of health
Thoroughly complete member questionnaires, accurately assess member need, and appropriately document results in the member record
Secure resources to address the members needs, including connection to community and national resources
Accurately assess the need for clinical (Nurse RN or Social Worker) intervention and work closely with Engagement Hub Clinical Consultants to serve our members
Educate members on available services and empower participation
Assist the member in actively participating with their health care providers and Aetna Care Management teams regarding decisions that impact their health and well-being
Document all member interaction into the appropriate member record(s)
Demonstrate empathy for situations faced by our members and their caregivers
Troubleshoot unavailability of resources, securing support as needed to close member gaps
Assist members in problem-solving when no services are available which can meet their needs
Follow program workflows consistently, following up with members to ensure needed services were secured and meeting the members needs
Required Qualifications
At least 2 years working within the healthcare, non-profit, or community-based services industry
Candidates with experience in information & referral, health coaching, care management, social work, aging network, sales, or similar backgrounds are encouraged to apply
Comprehensive working knowledge of services available within ones community and across our nation (e.g. faith based/nonprofit services)
Community health or public health experience preferred
Managed Care/Medicare/Medicaid experience preferred
Bilingual required (Spanish)
Flexibility with work schedule to meet business needs
Preferred Qualifications
Please see requirements above
Education
The minimum level of education desired is a Bachelors Degree preferred. Candidates with at least 4 years of aligned experience, regardless of education, are encouraged to apply.
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.
Aetnas Corporate Care Management 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 Information and Referral Specialist provides information, referral, assistance with accessing resources, health coaching, and supportive care to members. The I&R Specialist will support multiple member service initiatives by assessing the members stated and unstated needs, addressing resource needs, and effectively utilizing community, health care, and plan benefit resources.
Fundamental Components:
Utilize designated interactions to assess the members stated and unstated needs, including social determinants of health
Thoroughly complete member questionnaires, accurately assess member need, and appropriately document results in the member record
Secure resources to address the members needs, including connection to community and national resources
Accurately assess the need for clinical (Nurse RN or Social Worker) intervention and work closely with Engagement Hub Clinical Consultants to serve our members
Educate members on available services and empower participation
Assist the member in actively participating with their health care providers and Aetna Care Management teams regarding decisions that impact their health and well-being
Document all member interaction into the appropriate member record(s)
Demonstrate empathy for situations faced by our members and their caregivers
Troubleshoot unavailability of resources, securing support as needed to close member gaps
Assist members in problem-solving when no services are available which can meet their needs
Follow program workflows consistently, following up with members to ensure needed services were secured and meeting the members needs
Required Qualifications
At least 2 years working within the healthcare, non-profit, or community-based services industry
Candidates with experience in information & referral, health coaching, care management, social work, aging network, sales, or similar backgrounds are encouraged to apply
Comprehensive working knowledge of services available within ones community and across our nation (e.g. faith based/nonprofit services)
Community health or public health experience preferred
Managed Care/Medicare/Medicaid experience preferred
Bilingual required (Spanish)
Flexibility with work schedule to meet business needs
Preferred Qualifications
Please see requirements above
Education
The minimum level of education desired is a Bachelors Degree preferred. Candidates with at least 4 years of aligned experience, regardless of education, are encouraged to apply.
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.
67218939