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Proactive Member Advocate

Primary Location: New Albany, OH
Additional Locations: OH-New Albany
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 AdvocateProactiveTeam, you will be on the front line of our most innovative and differentiated service offering. Our Aetna One® AdvocatePSEprogram takes member engagement to the next level.Proactive MemberAdvocatesproactively work with membersthrough personalizedand frequent touchpoints to deliver a simple andpowerful member experience, we call this Advocacy. Our specializedproactiveadvocate teamaddressesall member needs –starting with our outreach to assist the member through their healthcare journey and continuing with answering any questions the member may have from network or benefits to clinical or emotional. 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
  • This is an outbound call center position. Proactive Member Advocates are primarily responsible for proactively making outbound calls to engage members and assist them along their health care Journey
  • Steering members toward behavior change that will enhance their benefits and member experience.
  • Willingness to learn, understand and deliver complex information regarding member’s health benefits or well-being.
  • Owns the members concerns all the way through to resolution no matter where that might take us. You may be interacting with providers, clinicians, pharmacists, and many other professional’s in an effort to provide total satisfaction and resolution to 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 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 emergency service, or services rendered in a setting other than a practitioner’s office.
  • 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
  • Displays high emotional intelligence to understand member’s true needs and influence or motivate their behavior toward healthy action
  • Strong written and 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, showing 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:
Additional Information

Our PSE team is available Monday-Friday 8:00 am – 8:00 pm and Saturday from 8:00 am – 4:30 pm. Currently, we are seeking candidates to fill full-time positions (40 hours per week) for all shifts.

Aetna is about more than just doing a job. We strive to help re-shape healthcare for America and across the globe. We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.

Required Skills:
Benefits Management - Interacting with Medical Professionals, Benefits Management - Understanding Clinical Impacts, Service - Handling Service Challenges

Desired Skills:
General Business - Communicating for Impact, Leadership - Collaborating for Results, Sales - Knowing Customers

Functional Skills:
Administration / Operation - Data Entry, Communication - Employee communications, Communication - Member communications, Information Management - Microsoft Internet Explorer

Technology Experience:
Aetna Application - TE Aetna Strategic Desktop, Database - Intuit QuickBase, Desktop Tool - Microsoft Explorer, Desktop Tool - Microsoft Word

Potential Telework Position:

Percent of Travel Required:
0 - 10%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

Benefit Eligibility:
Benefit eligibility may vary by 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.


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