Aetna Case Management Associate in Harrisburg, Pennsylvania
Req ID: 63463BR
The Case Management Associate is the front line of customer service for our case management program, responsible for the outreach to and enrollment of our eligible members.
Our Case Management Associates demonstrate a highly energetic blend of sales person, health care navigator and health plan customer support representative.
The Case Management Associate is responsible for direct member outreach and engagement, facilitating case assignment, and connecting identified Commercial and Medicare Advantage members to care management services.
Fundamental Components included but are not limited to:
Effectively meets daily metrics with speed, accuracy, and a positive attitude with a focus on number of outbound dials and effectiveness in enrolling members into Aetna Case Management programs.
Accurately and consistently documents each call in the member s electronic record, thoroughly completing required actions with a high level of detail to ensure we meet our compliance requirements
Protects the confidentiality of member information and adheres to company policies regarding privacy/ HIPAA
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
Ability to be agile, managing multiple priorities and adapting to change with enthusiasm
Determined to build strong relationships with peers
Demonstrates an outgoing , enthusiastic, and caring presence over the telephone
Qualifications Requirements and Preferences:
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.
Call center experience preferred
Familiarity with basic medical terminology and/or experience working in the medical field
Strong organizational skills, including effective verbal and written communications skills
- The minimum level of education required for candidates in this position is a High School Diploma, G.E.D. or equivalent experience
Additional Job Information:
Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.
We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.
Together we will empower people to live healthier lives.
Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.
We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Job Function: Healthcare
Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.