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CVS Health · 10 hours ago

Member Advocate - Field - New Jersey

Trenton, NJ

Full-time

Hybrid

Entry Level

$18.50/hr - $42.35/hr

2+ years exp

CVS Health is a leading health solutions company dedicated to transforming health care. The Member Advocate is responsible for direct member outreach and engagement, collaborating with members and providers to address their healthcare needs.

Health CareMedicalPharmaceuticalRetailSales

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

Must be able to travel 25-40% to attend member meetings

Qualification

Customer service experienceMedicaid knowledgeCall center experienceMicrosoft WordMicrosoft ExcelBilingualEmpathyOrganizational skillsEffective communication skillsAdaptability

Required

Must reside in New Jersey

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

Must be able to travel 25-40% to attend member meetings

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, Medicaid, and/or sales

Flexibility with work schedule to meet business needs

Strong organizational skills, including effective verbal and written communications skills

The highest level of education desired for candidates in this position is a High School diploma or G.E.D

Preferred

Call center experience preferred

Familiarity with basic medical terminology preferred

Bilingual desired

Benefits

Affordable medical plan options

401(k) plan (including matching company contributions)

Employee stock purchase plan

No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching

Paid time off

Flexible work schedules

Family leave

Dependent care resources

Colleague assistance programs

Tuition assistance

Retiree medical access