Experienced Service Advocate – Operations – Work From Home Opportunity with CVS Health for Ambitious and Compassionate Individuals

Introduction to CVS Health

At CVS Health, we are driven by a singular, clear purpose: to bring our heart to every moment of your health. This purpose guides our commitment to delivering improved, human-centered healthcare for a rapidly changing world. Anchored in our brand — with heart at its center — our mission sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors support this purpose, empowering every individual who works at CVS Health to feel enabled by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make healthcare more personal, convenient, and affordable.

Job Overview

The Service Advocate position within the Operations team collaborates with members via multiple channels (digital, phone) and leads outreach efforts to our Medicare healthcare members to motivate and encourage healthy behaviors through innovative, compassionate, and empathetic communications. The goal of each outreach is to ensure that each member has a clear understanding of the available benefits offered to them under their Medicare plan for specific screenings and medications. The Service Advocate delivers provider and member telephonic outreaches to ensure receipt of essential health services, medications, and resources to improve Star health outcomes.

Key Responsibilities

• Work on at least one of several departmental programs that involve inbound and outbound calls to members who may benefit from designated services, including healthcare visits/screenings, vaccination, or medication refill.
• Effectively capture barriers and data collection, utilize persuasive speaking skills to provide solutions to facilitate closing gaps in care, and provide top-tier support to each member.
• Ensure that each customer is treated professionally, with respect, and all questions are thoroughly answered or triaged and responded to.
• Act as a liaison and assist in coordinating care between health planning, providers, and pharmacies as needed.
• Actively listen and gather member-reported data elements in the CRM tool to support clinical record tracking for HEDIS clinical record documentation of services.
• Provide members with the right information at the right time to help them make better decisions about their health and healthcare, to improve member experience, retention, and growth by efficiently delivering coordination services to members and providers.
• Engage, consult, and educate members based on the member's unique needs, preferences, and understanding of the services.
• Take ownership of end-to-end responsibility for the member experience and offer exceptional support.
• Respond to questions and resolve issues as a "single resource" including escalating to leadership as necessary.
• Build a trusting relationship with the member by taking responsibility to understand the member's needs thoroughly.
• Walk members through programs, Aetna tools, and resources to support healthcare behavior.
• Take ownership of the member assigned to resolve their issues and connect them with additional services as appropriate.
• Report and track all member contacts, events, and outcomes through appropriate systems and processes.
• Utilize professional communication skills to build relationships with both internal and external individuals/constituents.
• Utilize relevant system tools and resources to deliver quality business communications, including letters and spreadsheets in response to requests received.
• Handle multiple functions as well as multiple products while maintaining and/or exceeding performance standards.
• Identify issues that should be escalated properly and provide ideas for resolution.
• Demonstrate expertise and present a positive image of the company while interacting with members and constituents.
• Support individual, team, and business objectives and initiatives; accept ownership for individual results.

Additional Responsibilities and Duties

The Service Advocate will also be responsible for:

• Windows-based application knowledge with the ability to use standard corporate software packages and corporate applications with a high level of computer literacy.
• Effective communication skills and experience speaking with clinical providers and/or clinical staff.
• Strong listening and interpersonal skills; skilled at creating and maintaining effective working relationships.
• Strong analytical skills focusing on accuracy and attention to detail.
• Demonstrated ability to de-escalate situations.
• Demonstrated empathy, curiosity, passion for learning, empathy, and listening skills.
• Ability to apply creative thinking skills when needed to solve members' concerns and want to advocate for them.
• Ability to thrive with change, to adapt to different focuses in short amounts of time.
• Ability to work independently, apply critical thinking skills when required, perform multiple tasks easily, and demonstrate expertise in all interactions.
• Ability to resolve complex issues with responsiveness and carefulness.
• Ability to absorb and apply new and evolving information.
• Ability to make effective and independent decisions.
• Ability to multitask, prioritize, and really adapt to a high-speed changing environment.

Essential and Preferred Qualifications

To be successful in this role, you will need:

• Recent and related experience working with HEDIS screening measures and behavior change.
• Related experience working directly with individuals/consumers - ideally in a call center setting.
• Minimum 2 years of current and related experience within healthcare, healthcare marketing, outreach, and/or health education, health coaching, and disease management experience.
• 2 - 4 years of experience in a healthcare setting with direct communication with different levels of management, including clinical providers.

Preferred qualifications include:

• Bilingual or multilingual candidates heavily preferred.
• Bachelor's degree or equivalent preferred.
• Clinical certification (certified nursing assistant, medical assistant, etc.) is strongly suggested but not required.

Education and Certification Requirements

A high school diploma or G.E.D. is required for this position.

Compensation and Benefits

The typical salary range for this position is competitive and reflects the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on various factors, including experience, education, geography, and other relevant factors.

In addition to your compensation, enjoy the rewards of an organization that puts its heart into taking care of its colleagues and communities. CVS Health offers a full range of medical, dental, and vision benefits, as well as a 401(k) retirement savings plan, and an Employee Stock Purchase Plan. The company also provides a fully paid term life insurance plan for eligible employees, and short-term and long-term disability benefits. CVS Health offers various wellness programs, education assistance, free development courses, and a CVS store discount program with participating partners. With regards to downtime, company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year.

Career Growth Opportunities and Learning Benefits

At CVS Health, we are committed to helping our colleagues grow and develop in their careers. We offer a range of training and development programs, including leadership development, mentorship, and career advancement opportunities. Our colleagues also have access to a range of educational resources, including online courses and degree programs, to help them build new skills and advance their careers.

Work Environment and Company Culture

Our company culture is built on a foundation of respect, empathy, and inclusivity. We believe in creating a work environment that is supportive, collaborative, and empowering, where all colleagues can thrive and reach their full potential. We are committed to diversity, equity, and inclusion, and we strive to create a workplace that reflects the communities we serve.

Conclusion

If you are a compassionate and ambitious individual who is passionate about delivering exceptional customer service and improving healthcare outcomes, we encourage you to apply for this exciting opportunity. As a Service Advocate with CVS Health, you will have the chance to make a real difference in the lives of our members, while also growing and developing your career in a supportive and inclusive environment. Don't miss out on this opportunity to join our team and start making a positive impact today!