Job Description

Job DescriptionSite of Care Specialist is the face of Aetna to provide targeted personalized service based on a holistic view of the member benefits health information and through engagement.Handles site of service transitions based on medical policy via telephone internet web-chat or written correspondence.Calls are typically non-routine and may require deviation from standard screens scripts and procedures to engage consult and educate members and providers by delivering individualized programs based upon the members unique needs and preferences.Utilizes resources to assist members in understanding components of the Aetna products including claims accumulators usage and balances and cost sharing.Provides support to the Department in meeting client expectations regarding efficiency service levels privacy maintenance and quality of decision-making.Responsible for maintaining compliance with ERISA and client specific requirements.Works as part of the team to meet business unit objectives.Pay RangeThe typical pay range for this role is:Minimum: 18.50Maximum: 33.65Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors including location.Required QualificationsA proven background in medical/pharmacy benefits particularly infused specialty medications.Ability to deal with a diverse customer base in a friendly and confident manner including medical office providers and members.Must display empathy and effective listening skills to deliver successful cost-saving transitions of care.Analytical skills and the ability to master complex systems are prerequisites.A balance of compassion integrity discretion sound judgment with a strong desire to achieve and exceed metrics.Familiar with computer systems and Microsoft Office skills. Ability to prioritize and manage multiple tasks; Excellent organization skills; Strong detail orientation; Strong verbal and written communication skills;Preferred QualificationsKnowledge of Aetna systems and processes including ATV ASD ACAS NLX SFDC and others.EducationRequired High School or equivalent/Preferred Associates Degree or Bachelors DegreeBusiness OverviewBring your heart to CVS Health Every one of us at CVS Health shares a single clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand with heart at its center our purpose 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. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal convenient and affordable. We strive to promote and sustain a culture of diversity inclusion and belonging every day. CVS Health is an affirmative action employer and is an equal opportunity employer as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting hiring promotion or any other personnel action based on race ethnicity color national origin sex/gender sexual orientation gender identity or expression religion age disability protected veteran status or any other characteristic protected by applicable federal state or local law. We proudly support and encourage people with military experience (active veterans reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.