Aetna is expanding our engagement hub servicesThe engagement hubs are focused on driving member engagement into aetna’s care management programs, while also delivering care services to members who do not need long term support but have immediate care needsThe engagement specialist is responsible for telephonic outreach to and enrollment of our eligible membersOur engagement specialists demonstrate a highly energetic blend of salesperson, health care navigator and health plan customer support representativeThe engagement specialist is responsible for direct member outreach and engagement, facilitating case assignment, and connecting identified members to care managers immediately through a warm transfer.
Job responsibilities:
Initiates telephonic engagement with assigned members to introduce the program with the goal of enrolling the member in aetna care management.
Effectively meets daily metrics with speed, accuracy, and a positive attitudeThe metrics are focused on unique members attempted daily and the volume of members that agree to enroll in care managementThis is not a sales position, enrollment is free, but influencing is important to this work.
Documentation is critical to successThe engagement specialist accurately and consistently document each call in the members electronic record, thoroughly completing required actions with a high level of detail to ensure we meet our compliance requirements
Effectively supports members during enrollment calls, appropriately managing difficult or emotional member situations, responding promptly to member needs, and demonstrating empathy and a sense of urgency when appropriate
Conducts triage, connecting members with appropriate care team personnel including care managers and customer service
Demonstrates an outgoing, enthusiastic, and caring presence over the telephone.
Works efficiently and independently, meeting deliverables and deadlines
Adheres to care management, privacy and confidentiality, and quality management processes in compliance with regulatory, accreditation guidelines, company policies and procedures
Demonstrates an ability to be agile, managing multiple priorities at one time, and adapting to change with enthusiasm
Other responsibilities as assigned
Required qualifications
Experience with computers including knowledge of microsoft word, outlook, and excel - data entry and documentation within member records is preferred
2 years of experience preferably in customer service, telemarketing and/or sales
Call center experience preferred familiarity with basic medical terminology preferred
Flexibility to work occasional nights and weekends outside of standard business hours which can span from 8:00 am 8:00 pm
Strong organizational skills, including effective verbal and written communications skills
Bilingual (spanish) preferred
Covid requirements
Covid-19 vaccination requirement
Cvs health requires its colleagues in certain positions to be fully vaccinated against covid-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.
If you are vaccinated, you are required to have received at least one covid-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 30 days of your employmentFor the two covid-19 shot regimen, you will be required to provide proof of your second covid-19 shot within the first 60 days of your employmentFailure to provide timely proof of your covid-19 vaccination status will result in the termination of your employment with cvs health.
If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 30 days of your employment in order to remain employed with cvs healthAs a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinatedIf your request for an accommodation is not approved, then your employment may be terminated.
Preferred qualifications
Please see requirements above
Education
The highest level of education desired for candidates in this position is a high school diploma, g.e.dOr equivalent experience.
Business overview
At aetna, a cvs health company, we are joined in a common purpose: helping people on their path to better healthWe are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focusedWorking 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 workplaceCvs health is an equal opportunity and affirmative action employerWe do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran statusWe 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.
