Member Advocate - New Jersey (Remote)

CVS Health • Montclair, NJ

1d • $19 - $42 • Remote

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Location: This role will be work at home with 25-40% travel within Northern counties of NJ (Passaic, Bergen, Essex, Hudson, Morris or Union counties). Schedule: Standard business hours Monday-Friday 8:00am-5:00pm EST. Position Summary The Member Advocate is responsible for direct member outreach and engagement Join us in this exciting opportunity as we grow and expand DSNP into new markets across the country. Our Mission Aetna is an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. We collaborate with members, providers, and community organizations in pursuit of quality solutions that address the full continuum of our members’ health care and social determinant needs. Dual Eligible Special Needs Plans (DSNP) members are enrolled in Medicare and Medicaid.

Requirements

• 2 years of experience preferably in customer service, telemarketing, Medicaid, and/or sales.
• Experience with computers, including knowledge of Microsoft Word, Outlook, and Excel - data entry and documentation within member records is preferred.
• Must reside in New Jersey and be able to travel 25-40% to attend member meetings.
• This is a remote role with 25-40% travel required, candidates must have a dedicated workspace free of interruptions.
• Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted.

Nice To Haves

• Call center experience preferred.
• Familiarity with basic medical terminology preferred.
• Flexibility with work schedule to meet business needs.
• Strong organizational skills, including effective verbal and written communications skills.
• Bilingual desired.

Responsibilities

• Initiates engagement with assigned members to introduce the program and gather updated member demographic information with speed, accuracy, and a positive attitude.
• Schedules completion of the assessment based on the member’s preferences and the assigned care manager’s schedule.
• 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 when needed.
• Ability to be agile, manage multiple priorities, and adapt to change with enthusiasm.
• Determined to build strong relationships with peers and our DSNP members.
• Demonstrates an outgoing, enthusiastic, and caring presence over the telephone.
• Act as a Medicaid recertification specialist for the team.

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
• For more information, visit https://jobs.cvshealth.com/us/en/benefits

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED