Senior Service Advocate - Ops

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

The Senior Service Advocate position is part of Aetna’s Clinical Care & Advocacy Solutions division and will be a part of the team supporting the Next Best Action (NBA) Call Pod.

Normal Working Hours will be scheduled between 8:00 AM to 8:00 PM EST, Monday through Friday.

Responsibilities include but are not limited to the following:

• Steering members toward behavior change that will enhance their benefits and member experience.
• Willingness to learn, understand and deliver complex information regarding member’s 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 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 practitioner’s 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

Required Qualifications

• Demonstrated knowledge and use of Microsoft Office Suite (One-Note, Word Excel, Outlook, and/ or Teams)

Preferred Qualifications

• 2 years' experience in a healthcare call center, ministry, education, and/or military
• Displays high emotional intelligence to understand member’s true needs and influence or motivate their behavior toward healthy action
• Strong written and verbal communication skills
• Ability to multi-task, prioritize and effectively adapt to a fast-paced changing environment
• Demonstrated organizational and communication skills
• 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 Aetna’s values of caring, inspiration, integrity, and excellence in each member interaction and in building team cohesiveness
• Ability to work effectively in a team environment required
• Ability to learn and retain in a complex environment
• College experience and/or degree

Education

High School Diploma or equivalent GED

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.
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.