[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.
• By successfully enrolling members into care management, further supports 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, thoroughly completing required actions with a high level of detail.
• Works independently and competently, meeting deliverables and deadlines while demonstrating an outgoing, enthusiastic and caring presence telephonically.
• Ability to effectively participate in a multi-disciplinary team including internal and external participants.
• Effective communication, telephonic and organization skills with ability to manage multiple priorities at one time.
• 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 and competitive mix of pay and benefits.
• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs and other resources, based on eligibility.

Company Description

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.