Aetna A1A Proactive Member Advocate in Phoenix, Arizona
Req ID: 67533BR
Aetna One Advocate is Aetna s premier service and clinical offering for Aetna nation-wide and creates industry-leading solutions for our customers and members. The model is a fully integrated population health and customer service solution for large plan sponsors high-touch, high-tech member advocacy service which combines data-driven processes with the expertise of highly trained clinical and concierge member services. The mission of this model is designed to meet each member at every aspect of their health care journey. Our embedded customer-dedicated service and clinical pods allow maximization of inbound and outbound touchpoints to solve members needs and create behavior change. Our data analytics, white-glove service and end-to-end ownership of member support creates a trusted partner in health. This is an exciting time to join Aetna a CVS Health company in our journey to change the way healthcare is delivered today. We are health care innovators.
Aetna is one of the largest healthcare companies in the country.
At Aetna we are committed to delivering world class service to our members.
As a part of our Aetna One Advocate Proactive Team, you will be on the front line of our most innovative and differentiated service offering.
Our Aetna One® Advocate PSE program takes member engagement to the next level.
Proactive Member Advocates proactively work with members through personalized and frequent touchpoints to deliver a simple and powerful member experience, we call this Advocacy.
Our specialized proactive advocate team addresses all member needs – starting with our outreach to assist the member through their healthcare journey and continuing with answering any questions the member may have from network or benefits to clinical or emotional.
In one simple word, we “Advocate on behalf of our members.
We own their healthcare journey and we won t stop until they are satisfied.
Every interaction is handled with the utmost care, consideration and passion for the members we serve.
Fundamental Components included but are not limited to:
Consistently showcase a passion for health and helping people
This is an outbound call center position. Proactive Member Advocates are primarily responsible for proactively making outbound calls to engage members and assist them along their health care Journey
Steering members toward behavior change that will enhance their benefits and member experience.
Willingness to learn, understand and deliver complex information regarding member s health benefits or well-being.
Owns the members concerns all the way through to resolution no matter where that might take us. You may be interacting with providers, clinicians, pharmacists, and many other professional s in an effort to provide total satisfaction and resolution to the member
Consistently seek to build trusting relationships with members by understanding their needs and health aspirations
Deliver a suite of services to members that support easy navigation of the healthcare system, from providing personalized recommendations, to maintaining individual data accuracy and integrity
Assists the member in finding their health ambition
Connects the member with additional administrative and clinical resources as needed
Uses proactive, predictive and preventative analytics to service members
Provides high-quality, customer-focused telephonic service using knowledge of procedures and systems to meet and/or exceed customer satisfaction
Coordinates with clinicians to compile the member's Care Plan and conduct adherence follow-up
Works with case managers for members requiring urgent or emergency service, or services rendered in a setting other than a practitioner s office.
Prioritizes effectively to meet member service goals / deadlines
Resolves member issues, while effectively making the right decisions for our members
Collaborate with colleagues and co-workers to deliver a world class customer experience
Qualifications Requirements and Preferences:
3+ years experience directly interacting with the public, delivering high touch, experiential interactions – preferably in a healthcare call center, ministry, education, military, retail, hotel/concierge, non-profit, financial services, travel agency, real estate or other customer advocate role
High School Diploma or G.E.D required - College degree or equivalent work experience strongly preferred
Displays high emotional intelligence to understand member s true needs and influence or motivate their behavior toward healthy action
Strong written and verbal communication skills required
Ability to multi-task, prioritize and effectively adapt to a fast-paced changing environment required
Demonstrated organizational and communication skills required
Intermediate typing skills – 50 WPM strongly desired
Ability to seamlessly, multi-task while using multiple systems, to efficiently provide service to members
Deep problem-solving skills with demonstrated ownership of issue resolution
Possess top-notch people skills – listening, caring, connecting, showing empathy, and supporting
Highly perceptive individual with strong self-awareness and empathy in interacting with various audiences
Demonstrated propensity for responsiveness and a sense of urgency when helping members
Demonstrated ability to uphold Aetna s values of caring, inspiration, integrity, and excellence in each member interaction and in building team cohesiveness
Strong skillset in the use of the suite of Microsoft Office tools strongly desired
Ability to work effectively in a team environment required
Ability to learn and retain in a complex environment
Communication - Employee communications, Customer Service - Customer Service - Member Services - Traditional products
Aetna Application - Aetna Strategic Desktop Reporting, Desktop Tool - Microsoft Outlook
General Business - Communicating for Impact, General Business - Consulting for Solutions, Service - Creating a Differentiated Service Experience
Service - Handling Service Challenges, Service - Providing Solutions to Constituent Needs, Service - Working Across Boundaries
Additional Job Information:
Our PSE team is available Monday-Friday 8:00 am – 8:00 pm and Saturday from 8:00 am – 4:30 pm. Currently, we are seeking candidates to fill full-time positions (40 hours per week) for all shifts.
Aetna is about more than just doing a job. We strive to help re-shape healthcare for America and across the globe. 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. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.
Benefit eligibility may vary by position.
Job Function: Customer Service
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.