A1A Proactive Service Engagement Advocate - Member Services
What is A1A?
Aetna One Advocate is Aetnas premier service and clinical offering for Aetna nation-wide and creates industry-leading solutions for our customers and members.
The model is a fully integrated population health and customer service solution for large plan sponsors high-touch, high-tech member advocacy service which combines data-driven processes with the expertise of highly trained clinical and concierge member services. The mission of this model is designed to meet each member at every aspect of their health care journey.
Our embedded customer-dedicated service and clinical pods allow maximization of inbound and outbound touchpoints to solve members needs and create behavior change.
Our data analytics, white-glove service and end-to-end ownership of member support creates a trusted partner in health.
This is an exciting time to join Aetna a CVS Health company in our journey to change the way healthcare is delivered today.
We are health care innovators.Aetna is one of the largest healthcare companies in the country.
At Aetna we are committed to delivering world class service to our members.
As a part of our Aetna One Advocate Proactive Team, you will be on the front line of our most innovative and differentiated service offering.
Our Aetna One Advocate PSE program takes member engagement to the next level.
* Proactive Member Advocates proactively work with members through personalized and frequent touchpoints to deliver a simple and powerful member experience, we call this Advocacy.
* Our specialized proactive advocate team addresses all member needs - starting with our outreach to assist the member through their healthcare journey and continuing with answering any questions the member may have from network or benefits to clinical or emotional. In one simple word, we "Advocate" on behalf of our members.
* We own their healthcare journey and we wont stop until they are satisfied. Every interaction is handled with the utmost care, consideration, and passion for the members we serve.
* Consistently showcase a passion for health and helping people
* This is an outbound call center position. Proactive Member Advocates are primarily responsible for proactively making outbound calls to engage members and assist them along their health care Journey
* Steering members toward behavior change that will enhance their benefits and member experience.
* Willingness to learn, understand and deliver complex information regarding members health benefits or well-being.
* Owns the members concerns all the way through to resolution no matter where that might take us.
* You may be interacting with providers, clinicians, pharmacists, and many other professionals in an effort to provide total satisfaction and resolution to the member.
* Consistently seek to build trusting relationships with members by understanding their needs and health aspirations
* Deliver a suite of services to members that support easy navigation of the healthcare system, from providing personalized recommendations, to maintaining individual data accuracy and integrity.
* Assists the member in finding their health ambition Connects the member with additional administrative and clinical resources as needed.
* Uses proactive, predictive and preventative analytics to service members.
* Provides high-quality, customer-focused telephonic service using knowledge of procedures and systems to meet and/or exceed customer satisfaction.
* Coordinates with clinicians to compile the member's Care Plan and conduct adherence follow-up Works with case managers for members requiring urgent or emergency service, or services rendered in a setting other than a practitioners office.
* Prioritizes effectively to meet member service goals / deadlines.
* Resolves member issues, while effectively making the right decisions for our members.
* Collaborate with colleagues and co-workers to deliver a world class customer experience.
* Available to work 10:30AM-7:00 PM AZ
* 3+ years experience directly interacting with the public, delivering high touch, experiential interactions - preferably in a healthcare call center, ministry, education, military, retail, hotel/concierge, non-profit, financial services, travel agency, real estate or other customer advocate role
* High School Diploma or G.E.D required - College degree or equivalent work experience strongly preferred
* Displays high emotional intelligence to understand members true needs and influence or motivate their behavior toward healthy action
* Strong written and verbal communication skills required
* Ability to multi-task, prioritize and effectively adapt to a fast-paced changing environment required
* Demonstrated organizational and communication skills required
* Intermediate typing skills - 50 WPM strongly desired
* Ability to seamlessly, multi-task while using multiple systems, to efficiently provide service to members
* Deep problem-solving skills with demonstrated ownership of issue resolution
* Possess top-notch people skills - listening, caring, connecting, showing empathy, and supporting
* Highly perceptive individual with strong self-awareness and empathy in interacting with various audiences
* Demonstrated propensity for responsiveness and a sense of urgency when helping members
* Demonstrated ability to uphold Aetnas values of caring, inspiration, integrity, and excellence in each member interaction and in building team cohesiveness
* Strong skillset in the use of the suite of Microsoft Office tools strongly desired
* Ability to work effectively in a team environment required
* Ability to learn and retain in a complex environment.
* High School diploma, G.E.D. or equivalent experience
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.