[Hiring] Care Management Associate Member Connection @CVS Health

Role Description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Aetna’s Medicaid Care Management Member Connections Team is a new initiative focused on prioritizing Medicaid member interaction, maximizing inbound and outbound touchpoints to solve members’ needs and create behavioral change. This team has a drive to exceed the delivery of Medicaid Health care services.

• The Member Connections Care Management Associate supports comprehensive coordination of healthcare services through telephonic outreach to and enrollment of our eligible members.
• Demonstrates a highly energetic blend of salesperson, healthcare navigator and health plan customer support representative.
• Responsible for direct member outreach and engagement, facilitating case assignment, and connecting identified members to care managers immediately through a warm transfer.
• Successfully enrolls members into care management, supporting the implementation of care plans to promote effective utilization of healthcare services.
• Provides support services to team members by answering telephone calls, taking messages, researching information and assisting in solving problems.
• Adheres to compliance with policies and procedure/regulatory standards.
• Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
• Protects the confidentiality of member information and adheres to company policies regarding confidentiality.

Qualifications

• 1-2+ years strong customer service skills to coordinate service delivery.
• Attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members.
• Completes documentation of each member call in the electronic record with a high level of detail.
• Works independently and competently, meeting deliverables and deadlines.
• Ability to effectively participate in a multi-disciplinary team including internal and external participants.
• Effective communication, telephonic and organization skills.
• Demonstrates ability to meet daily metrics with speed, accuracy and a positive attitude.

Requirements

• 2 - 4 years’ experience in call center healthcare field preferred.
• Experience with computers including knowledge of Microsoft Word, Outlook, and Excel.
• Familiarity with basic medical terminology and concepts used in care management preferred.
• Flexibility to work occasional nights and weekends outside of standard business hours.
• Strong organizational skills, including effective verbal and written communication skills.
• Bilingual (Spanish) preferred.
• LA Medicaid experience.

Education

• HS Diploma required.

Benefits

• Comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families.
• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs and other resources, based on eligibility.

Pay Range

The typical pay range for this role is: $18.50 - $42.35. 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.