Description: 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 Team, you will be on the front line of our most innovative and differentiated service offering. Our Aetna One Advocate program takes member engagement to the next level. Service Advocates engage members through personalized, premium and frequent touchpoints to deliver a simple, powerful, and proactive member experience, we call this Advocacy. Our specialized advocate teams address members' needs - from benefits and network services to clinical and emotional support - all backed by local resources right in the member's community. 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: Consistently showcase a passion for health and helping people - Acts as a single-point-of-contact for the member. Explains member plan of benefits, member's rights and responsibilities in accordance with contracted arrangements, claim status information, benefit coverage, plan eligibility, dental, vision, pharmacy, HSA, provider details, care management, on-boarding, tool usage and available programs/resources. - Own the members concerns all the way through to resolution no matter where that might take us. You will interact with providers, clinicians, pharmacists, and other professional's in an effort to provide total satisfaction and resolution for 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 next best action 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 emergent service, or services rendered in a setting other than a practitioner's office. - This is an inbound and outbound call center position. Service Advocates are responsible for answering inbound calls regarding member's health care needs, while following up on commitments in a timely manner. Service Advocates will proactively make outbound calls to engage members and assist them along their health care Journey. - Handle sensitive member information with discretion - 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. Background Experience: - 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 - Strong written & 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, 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. Additional Job Information: Strong communications skills. Strong analytical skills focusing on accuracy and attention to detail. Computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word. Understanding of medical terminology. Ability to maintain accuracy and production standaWe are seeking candidates to fill full-time positions (40 hours per week) with shift start times between 10:30am and 12:30 pm & shift ending times between 7:00pm and 9:00pm with a rotation of Saturdays and Holidays.Training hours are 830a-5pm for 12 weeks Monday - Friday. We also offer a shift of 2:30pm - 11pm that includes a 10% shift differential. Required Skills: Service - Creating a Differentiated Service Experience, Service - Handling Service Challenges, Service - Providing Solutions to Constituent Needs Desired Skills: General Business - Consulting for Solutions, Leadership - Collaborating for Results Functional Skills: Customer Service - Customer Service - Member Services - Traditional products Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.