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 assigned 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 every 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 fully.
• Walk members through programs, 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

• 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 communication 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, and listening skills.
• Ability to apply creative thinking skills when required to solve members' concerns and advocate for them.
• Ability to thrive in 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 Qualifications

The ideal candidate will have recent and relevant experience working with HEDIS screening measures and behavior change. Related experience working directly with individuals/consumers — ideally in a call center setting — is also required. A minimum of 2 years of current and relevant experience within healthcare, healthcare marketing, outreach, and/or health education, health coaching, and disease management experience is necessary. 2-4 years of experience in a healthcare setting with direct communication with different levels of management, including clinical providers, is also required.

Preferred Qualifications

• Bilingual or multilingual candidates are heavily preferred.
• A Bachelor's degree or equivalent is preferred.
• Clinical certification (certified nursing assistant, clinical 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 employees and communities. CVS Health offers a full range of medical, dental, and vision benefits, as well as a 401(k) retirement savings plan, an Employee Stock Purchase Plan, and a completely paid term life insurance plan for qualified employees. The company also provides short-term and long-term disability benefits, various wellness programs, education assistance, free development courses, and a CVS store discount program with participating partners. With respect to downtime, CVS Health employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year.

How to Apply

To apply for this exciting opportunity, please read the official notification carefully from the CVS Health website. Fill out the application form, attach the required documents and passport-size photo with a signature, and submit. Don't miss this chance to join a team that is dedicated to delivering exceptional healthcare services and making a positive impact on the lives of its members.

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 Service Advocate – Operations – Work From Home opportunity with CVS Health. As a Service Advocate, you will play a critical role in supporting our members and providing them with the resources and guidance they need to make informed decisions about their health. With a competitive salary, comprehensive benefits package, and opportunities for growth and development, this is an exciting opportunity to join a team that is dedicated to making a positive difference in the lives of its members. Apply today and take the first step towards a rewarding and challenging career with CVS Health!