Aetna is expanding our Engagement Hub services. The 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 needs. The Engagement Specialist is responsible for telephonic outreach to and enrollment of our eligible members. Our Engagement Specialists demonstrate a highly energetic blend of salesperson, health care navigator and health plan customer support representative. The 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.
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 attitude. The metrics are focused on unique members attempted daily and the volume of members that agree to enroll in care management. This is not a sales position, enrollment is free, but influencing is important to this work.
Documentation is critical to success. The 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
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-19 Vaccination Requirement
CVS Health requires certain colleagues 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, religious belief, or other legally recognized reasons that prevents them from being 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 or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
Please see requirements above
The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.
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Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.