Senior Analyst, Plan Sponsor
CVS HealthAbout the role
At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
Position Summary
Candidates must reside within 50 miles of Hartford, Connecticut.
The Plan Sponsor Liaison [PSL] will serve as the Single Point of Contact for Aetna Medicare Advantage servicing to our Plan Sponsors human resources personnel [their TPA's, Brokers and Consultants] in additional to all Aetna back-office teams. The Plan Sponsor Liaison will work onsite at the customer's location in Hartford, Connecticut. Controls daily communication between departments or individual policyholders regarding benefit plan administration. Directs workflow to respond, manage, and resolve escalated and complex global issues for Claims/Calls, PSS, and health plan back-office operations. The PSL role has responsibility for a random ID card quality review, standard customization requests and updates to the Plan Sponsor Profile Pages for their book of business.
A Brief Overview
Controls daily communication between departments or individual policyholders regarding benefit plan administration. Directs workflow to respond, manage, and resolve escalated and complex global issues for Claims/Calls, PSS, and health plan back-office operations. The Plan Sponsor Liaisons serve as primary liaison between Plan Sponsors, their TPA's, Brokers, Consultants, Aetna Medicare Account Management Team, Aetna Commercial Account Management Teams and back-office departments regarding benefit plans, eligibility, claims, billing, and general benefit plan administration.
What you will do
- Assists with establishing and implementing results-based programs and innovative initiatives for the Plan Sponsors, under general supervision.
- Applies in-depth knowledge of the Plan Sponsor / back-office areas to offer feedback for decisions and innovation strategies that enhance organizational growth, visibility, member retention and customer satisfaction and trust.
- Examines escalated member-specific issues and/or broader plan administration matters as the single point of contact to provide swift resolution.
- Develops complex customer service account management plans for each account and implements plan for both new and existing accounts.
- Coordinates service delivery of new and existing accounts by attending implementation planning/process meetings.
- Responsible for ID card Quality, timeliness, and Performance Guarantee for assigned book of business.
- Responsible for Plan Sponsor Profile Page, supports Group Contact Center of Excellence for projects, workflow support and projects to enhance the member experience and customer satisfaction.
- Assists with Member Open Enrollment Meetings and customer site visits.
- Proactively identify and surface customer and plan issues for resolution while acting as a liaison to communicate workflow results, ideas, and solutions.
- Proactively resolve issues with account managers, sales representatives, and other Aetna back-office teams as appropriate.
- Identifies most urgent business problems, obtains necessary information, accurately identifies root causes, and generates solutions. Initiates and maintains partnerships with others throughout the organization. Encourages cooperation by promoting common goals and building trust. Inspires, supports, and initiates cross-functional activities
Required Qualifications
- Candidates must reside within 50 miles of Hartford, Connecticut
- 3 years experience in Group Medicare Business and Medicare Advantage Plans and Products
- Strong Leadership and Communication skills [verbal, written and / or presentation]Critical thinking, problem solving and decision-making skills
- Demonstrate prior experience in consultative skills and the ability to influence constituents for positive outcomes and initiatives
- Customer Service experience required
- Working knowledge of execution and delivery (planning, delivering, and supporting) skills Working knowledge of business intelligence 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
Preferred Qualifications
- Strong project management skills are strongly pr
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