Experienced Health Concierge - Transforming Member Experience through Personalized Care and Support

Join the CVS Health Team: Revolutionizing Healthcare through Compassion and Innovation At CVS Health, we're on a mission to bring our heart to every moment of your health. As a leader in the healthcare industry, we're committed to delivering enhanced human-centric health care that's personal, convenient, and affordable. Our purpose is guided by our brand, with heart at its center, and our Heart At Work Behaviors support this vision. We're seeking a dedicated and compassionate Health Concierge to join our team and make a meaningful difference in the lives of our members. About the Role: Health Concierge As a Health Concierge, you will be the face of Aetna, providing targeted, personalized service to our members based on a holistic view of their benefits, health information, and engagement needs. You'll handle customer service inquiries and problems via various channels, including phone, internet, web-chat, and written correspondence. Your role will be to educate, consult, and engage members on their unique needs, preferences, and understanding of Aetna plans, tools, and resources, guiding them along a clear path to care. Key Responsibilities: Provide customized interactions based on customer preference and individualized needs, creating an emotional connection with our members. Utilize resources to assist customers in understanding components of Aetna products, including claims, accumulators, usage, and balances, and cost sharing. Answer questions and resolve issues as a 'single-point-of-contact' based on phone calls, plan sponsors, PSS/ISO, members, and providers. Educate and assist customers on various elements of benefit plan information and available services to enhance the overall customer service experience. Use customer service threshold framework to make financial decisions to resolve member issues. Take immediate action when confronted with a problem or made aware of a situation, taking ownership of each customer contact to resolve their issues and connect them with additional services as appropriate. Identify member needs beyond the initial inquiry by answering the unasked questions and providing related information. Resolve issues without or with limited management intervention, responding quickly to meet customer needs and resolve problems while avoiding overcommitting. Process claim referrals, new claim hand-offs, and escalate issues as appropriate through the system for grievances and appeals. Initiate out-reach/welcome calls to ensure constituents' expectations are met or exceeded. Identify trends and emerging customer service issues and work to develop solutions to address potential problems and/or plan features of interest. Partner with other departments to deliver client-specific presentations and coordinate efforts to successfully resolve service issues and develop process improvements. Essential Qualifications: Customer Service experience in a transaction-based environment, such as a call center or retail location, demonstrating ability to be empathetic and compassionate. Effective organizational skills and ability to manage multiple tasks. Effective communication skills, both verbal and written. Ability to sit anywhere in the US but will be working Central Time Zone. High School Diploma plus experience required; Bachelor's degree preferred. Preferred Qualifications: Microsoft Office Suite proficiency. Previous experience in a healthcare or insurance industry. Skills and Competencies: Excellent communication and interpersonal skills. Ability to empathize with customers and provide personalized support. Strong problem-solving and analytical skills. Ability to work in a fast-paced environment and manage multiple tasks. Proficient in using various software applications and systems. Career Growth Opportunities and Learning Benefits: At CVS Health, we're committed to the growth and development of our employees. As a Health Concierge, you'll have opportunities to develop your skills and expertise in a dynamic and supportive environment. You'll be able to: Participate in training and development programs to enhance your knowledge and skills. Take on additional responsibilities and contribute to special projects and initiatives. Collaborate with colleagues and leaders to drive process improvements and innovation. Work Environment and Company Culture: We're a company that puts our heart into caring for our colleagues and our communities. Our work environment is collaborative, inclusive, and supportive, with a culture that values diversity, equity, and inclusion. As a remote worker, you'll be part of a distributed team that's connected through technology and a shared commitment to our mission. Compensation, Perks, and Benefits: We offer a competitive salary and a comprehensive benefits package, including: Medical, dental, and vision benefits. 401(k) retirement savings plan and Employee Stock Purchase Plan. Term life insurance and disability benefits. Well-being programs, education assistance, and free development courses. CVS store discount and discount programs with participating partners. Paid Time Off (PTO) and paid holidays. Join Our Team: If you're a compassionate and dedicated professional looking to make a difference in the lives of others, we want to hear from you. As a Health Concierge, you'll be part of a team that's transforming the healthcare experience through personalized care and support. Apply now and join our mission to bring our heart to every moment of your health. We anticipate the application window for this opening will close on 12/20/2024. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws. Apply for this job