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A1A Customer Service Advocate (WFH Training)

Company: CVS Health
Location: High Point
Posted on: June 9, 2021

Job Description:

Job DescriptionWhat 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. Description:Consistently showcases a passion for advocating for others.Demonstrates empathy and is moved to action in assisting members to navigate their health and wellness journey.Champions opportunities to be a single-point-of-contact for members. Strong collaboration skills and ability to work with colleagues to deliver a world class customer experience.Consistently seeks opportunities to do more for each member.Acts as a single-point-of-contact for the member. Explains member plan of benefits, members rights and responsibilities in accordance with contracted arrangements, claim status information, benefit coverage, plan eligibility, dental, vision, pharmacy, HSA, provider details, care management, on-boarding, tool usage and available programs/resources.Owns the members concerns all the way through to resolution no matter where that might take us. You will 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 next best action 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 emergent service, or services rendered in a setting other than a practitioners office.This is an inbound and outbound call center position. Service Advocates are responsible for answering inbound calls regarding members health care needs, while following up on commitments in a timely manner. Service Advocates will proactively make outbound calls to engage members and assist them along their health care Journey.Handle sensitive member information with discretion. Prioritizes effectively to meet member service goals / deadlines.Resolves member issues, while effectively making the right decisions for our members.Required QualificationsNo healthcare or customer service experience required.Has apassion to advocatefor others.Able to communicateempathyand has a drivetoresolve member issues.Willing to goabove and beyondmember expectations on each and every call.Able to verballyconvey a sincere willingness to help.Strong written & 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 membersDeep problem solving skills with demonstrated ownership of issue resolution.Possess top-notch people skills listening, caring, connecting, 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.Preferred QualificationsPlease review required qualifications aboveEducationHigh School diploma, G.E.D. or equivalent experienceBusiness OverviewAt 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.

Keywords: CVS Health, High Point , A1A Customer Service Advocate (WFH Training), Other , High Point, North Carolina

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