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Aetna is now a CVS Health Company

A1A Onsite Plan Sponsor Liaison

Primary Location: High Point, NC
Additional Locations: NC-High Point, NJ-Somerset County
The Account Manager / Field Advocate is empowered to serve as a bridge between Aetna and our new National Account and Aetna One Advocate customer. This role will be the single point of contact for our Plan Sponsor and be located within their corporate headquarters located in Somerset, NJ. The successful candidate will be required to interact with all levels at the customer’s location from their CEO, COO and other C-suite executives, to their front-line service and clinical employees, as well as with providers and brokers. The Field Advocate needs to be an empathetic and accountable individual responsible for providing end-to-end support. As the onsite single point-of-contact, this role will build trust with all levels at the Plan Sponsor as well as with Aetna’s service and clinical teams. They must demonstrate ownership for the resolution of issues and act with fast knowledge using integrated service tools. This role will drive a deep understanding of the customer’s needs through analysis of financial, claim and clinical data. The Field Advocate will engage our customer, members, providers and brokers through personalized, effective and frequent touchpoints. This role requires the successful candidate to be both analytical and have customer presence.

Fundamental Components:
  • An Aetna employee co-located at our customer’s corporate headquarters in Somerset, NJ
  • The role functions as an extension of both our customer and Aetna teams and must be able to build relationships with both teams to be successful
  • Analyze large and complex reports as well as individual claims to deliver the underlying and resulting conclusions to a diverse group of both internal and external teams
  • Works with Data Analytics team to determine opportunities for targeted engagement and focused program utilization to positively impact future spend
  • Provides high-quality, customer-focused engagement using knowledge of procedures and systems to meet and/or exceed customer satisfaction while educating constituents on Aetna’s policies and programs
  • Serve as subject matter expert in handling escalations from the advocate team. Engage with the internal clinical and services teams, and conduct outreach to members as needed, to ensure proper handling of most sensitive or complex cases with a focus on positive member experience and resolution
  • Complete plan sponsor-specific training and refresher training as needed with the team and update any plan sponsor-specific tools; coordinates and/or delivers health education, program seminars/workshops and webinars
  • Handles sensitive member information with discretion
  • Resolves issues with or without limited management intervention
Key Qualifications:
  • Showcases a passion about healthcare, building relationships and improving the customer experience
  • Must be both analytical as well have a customer presence
  • Deep problem-solving skills, demonstrates ownership of issue resolution and accountability
  • Demonstrates the ability to build trusting relationships with all levels within both internal and external teams
  • Demonstrates a passion for health and customer service that drives proactive engagement
  • Deep understanding of healthcare economics, medical management, plan design and claim adjudication
  • Lends Subject Matter Expertise to team members and acts as resource for day to day processes, provides direction on routine and difficult issues
  • Collaborates with colleagues and co-workers to deliver a world class customer experience
  • Possesses top-notch people skills – listening, caring, connecting, showing empathy, and supporting
  • Highly perceptive individual with strong self-awareness and empathy in interacting at various levels with different audiences
  • Ability to make effective and independent decisions
  • Demonstrates responsiveness and a sense of urgency when dealing with customers

Background Experience:
  • 5+ years’ experience working directly with large complex customers and teams within the healthcare space delivering a highly experiential interaction
  • Proven track record as an Account Manager / Field Advocate
  • Experience analyzing data and delivering it’s results to a diverse group including C-suite executives
  • Bachelor’s Degree or equivalent work experience
  • Demonstrated ability to uphold Aetna’s values of caring, inspiration, integrity, and excellence in each member interaction
  • Ability to multi-task, prioritize and effectively adapt to a fast-paced changing environment
  • Demonstrated organizational and communication skills required

Additional Job Information:
Demonstrates strong leadership skills.
Strong communication skills (verbal, written, presentation)
Strong understanding of multiple aspects of the plans and products preferred
Ability to work with cross-functional business units and vendors to support the customer’s needs; promotes collaboration among constituents and represents a professional image of the company.
Strong project management skills. Critical thinking and decision making skills.
Automatic adjudication knowledge (e.g., number of claims affected on on-standard plans, knowing when a benefit auto adjudicates).
Strong knowledge of health insurance standards.

Required Skills:
Leadership - Driving a Culture of Compliance, Service - Creating a Differentiated Service Experience, Service - Handling Service Challenges

Desired Skills:
Leadership - Collaborating for Results, Service - Providing Solutions to Constituent Needs, Service - Working Across Boundaries

Functional Skills:
Customer Service - Customer Service - Member Services - Traditional products

Technology Experience:
Desktop Tool - Microsoft PowerPoint, Desktop Tool - Microsoft Word

Potential Telework Position:

Percent of Travel Required:
10 - 25%

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)


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