Member Advocate

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.

Position Summary

Work alongside other DSNP care team members including social workers, care managers and care coordinators to provide the best member experience by:

• Educating and assisting members on various elements of Medicaid entitlements, benefit plan information and available services created to enhance the overall member experience with the company. Utilize all relevant information to effectively influence member engagement.
• Initiating contact with members who have lost Medicaid eligibility and fall into DSNP grace period to remind them to reobtain Medicaid and LIS recertification. Assist members with finding resources to help them reapply if necessary.
• Coordinating and sending annual reminders for members at risk of losing LIS, Medicaid, or DSNP eligibility.
• Taking ownership of each customer contact to anticipate customer needs, resolve their issues and connect them with additional services as appropriate

Other responsibilities include:

• Tracking member’s Medicaid certification and eligibility dates and MCO plan information, as well as Medicaid status.
• Researching other general Medicaid programs and entitlements the members are eligible for and initiate process to inform members of these benefits.
• Complete accurate case documentation as needed.
• Other member support functions as assigned.

Works with National DSNP Program Office Medicaid Policy Manager and State Contract Manager to provide general assistance with Medicaid benefits and entitlements.
Required Qualifications

• Associates degree or equivalent work experience
• In-depth knowledge of benefits program and system design (Health and Welfare, Wealth, other benefits), related financials, legal/regulatory requirements.

• Knowledge and understanding of state policy or Medicaid eligibility and low-income state resources.
• Strong collaboration skills and innovative problem-solving abilities.
• Strong verbal and written communication skills
• Ability to work independently, accurately, and efficiently
• Innovative Thinking and “Change Agent” - Looks for, identifies and acts on opportunities to improve how we design, develop, and deliver products and services.
• Empathy towards customers’ needs and concerns.
• Work from home - Schedule Monday-Friday 8am-5pm

Preferred Qualifications

• Knowledge of Medicaid benefits, services, program and system design (Health and Welfare, Wealth, other benefits), legal/regulatory requirements.
• Knowledge and understanding of state policy or Medicaid eligibility and low-income state resources

Education

• Associates degree or equivalent work experience

Pay Range

The typical pay range for this role is:

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 jobs.CVSHealth.com/benefits

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.