[Hiring] Medicare Service Advocate @CVS Health

Role Description

We are currently recruiting top talent for our Service Advocate role in our Medicare Stars Member Advocacy Center. The Member Advocacy Center (MAC Team) is an elite team in Medicare Stars that conducts various high touch omnichannel outreach campaigns to deliver a differentiated member experience that closes gaps in care, provides a human connection with the member and proactively assists in navigating their health plan benefits. We are knowledgeable and trusted advocates for our members. The key to our success is our talent.

In this role, the majority of your work will involve connecting with members through outbound and inbound calls. As member expectations continue to evolve, you may also communicate with our members via video conferencing and/or SMS to answer unasked questions and resolve issues. Our service advocates have a high degree of empathy and patience. This position also requires performing a holistic approach on benefit usage and education, and claims, including but not limited to:

• Medical
• Dental
• Prescriptions
• Value-added items and services

The service advocate will be using several computer-based programs to service the members' needs and will need to be able to work in a metric-based production environment. We encourage bilingual applicants to apply.

• Ability to navigate multiple systems
• Acts as an advocate for our members
• Connects with members to diminish service disruption and educate members on plans
• Create lasting relationships with our members
• Documents and tracks contacts with members
• Educates plan benefits, answers questions, and resolves issues based on campaign outreach
• Educates members on our self-service options
• Ensures that every caller is treated with respect, kindness and all questions are thoroughly answered
• Exceeds member expectations
• Follows campaign guidelines for exceptional service
• Respond to inquiries from our Medicare Advantage members
• Takes ownership and follows through on commitments
• Work in a team and production-based environment to create world class service

Qualifications

• 1 year of customer service experience in any line of business
• Ability to creatively solve members’ problems and have desire to help and advocate for them
• Problem solving with demonstrated ownership qualities
• Demonstrated empathy, compassion and listening skills
• Window based application knowledge

Requirements

• Proven leadership skills
• Demonstrate ability to de-escalate situations
• Effective communication and documentation skills
• Ability to quickly learn new skills and apply them
• Demonstrated skills to multitask and problem solve
• Healthcare and medical terminology knowledge
• Medical billing and claims process experience

Education

• High School Diploma or GED

Benefits

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include:

• Medical, dental, and vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Other resources, based on eligibility

Additional details about available benefits are provided during the application process and on Benefits Moments.