Skip to main content

A new day in healthcare. Together, CVS Health and Aetna help people on their path to better health.

Next Best Action Advocate

Primary Location: Harrisburg, PA
Additional Locations: PA-Harrisburg
Apply
Description:
  • Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources.


Fundamental Components:
Improved Health Care Decision Making:
  • Through the use of information/data review, conducts evaluation of member’s needs/eligibility and outreaches for one-time campaigns, focused on driving improved health care decisions around topics such as selection of the best lab facility or options for immediate care beyond the emergency room, reminders for preventative health screenings, and compliance with medications.
  • Utilizes highly developed consultative skills with a focus on verbal and written communications, listening and questioning techniques, and the ability to quickly build trust and influence in support of a member’s improved health outcomes.
  • Provides information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.

Enhancement of Member Impact:
  • Demonstrate an outgoing, enthusiastic, and caring presence over the telephone to engage in meaningful and relevant conversations with each member, adjusting the conversation to reflect the information being shared by the member, and keeping the focus on improved health outcomes.
  • Influences in a caring and supporting manner that results in behavior change and adoption of each campaign’s goal.
  • Effectively support members during calls, appropriately managing difficult of emotional member situations, responding promptly to member needs, and demonstrating empathy and a sense of urgency when appropriate.
  • Identifies appropriate scenarios for member transfer to Member Services, Clinical colleagues, or other Case Management teams within Aetna to support members’ comprehensive health needs.

Leveraging Technology:
  • Demonstrates experience with technology-based interactions, including video, email, text, etc. and omni-channel campaigns.
  • Utilizes Aetna systems to build, research, and enter member information; perform non-medical research pertinent to establishment, maintenance, and closure of open cases.
  • Accurately and consistently documents each call in the member’s electronic records, thoroughly completing required actions with a high level of detail.
  • Exhibits impact-oriented mindset, and enthusiasm working in a fast paced, agile team environment.


Background Experience:
  • 2 years experience in customer service, retail or inside sales, telemarketing or health coaching is preferred.
  • Call center experience preferred. Familiarity with basic medical terminology preferred.
  • Bilingual language skills are a plus (e.g. Spanish).
  • Bachelor’s degree required.


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.

Click To Review Our Benefits (PDF)

Apply

Jobs for you

Recently Viewed Jobs

You do not have any recently viewed jobs

Your Saved Jobs

You do not have any saved jobs

Sign up for Job Alerts

Join our Talent Community

At Aetna, we are pioneering a total approach to health and wellness and we need talented candidates like you to join our team. Become a member of our talent community to be the first to know about career initiatives that match your skills and interests as they become available, in addition to details on upcoming events, networking opportunities, and news about Aetna.

Join Our Talent Community

Sign up to receive information about job openings that are tailored to your skills and interests. Plus, get the latest career news from Aetna.