Medicare Service Advocate

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.

We are currently recruiting top talent for our Service Advocate role in our Medicare Stars Member Advocacy Center. The Member Advocacy Center (MAC Team) is an elite team in Medicare Stars that conducts various high touch omnichannel outreach campaigns to deliver a differentiated member experience that closes gaps in care, provides a human connection with the member and proactively assists in navigating their health plan benefits. We are knowledgeable and trusted advocates for our members. The key to our success is our talent. 

In this role, the majority of your work will involve connecting with members through outbound and inbound calls. As member expectations continue to evolve, you may also communicate with our members via video conferencing and SMS to answer unasked questions and resolve issues. Our service advocates have a high degree of empathy and patience.  

This position also requires performing a  holistic approach on benefit usage and education, and claims, including but not limited to; medical, dental, prescriptions, and value-added items and services. The service advocate will be using several computer-based programs to service the members' needs and will need to be able to work in a metric-based production environment.  

We encourage bilingual applicants to apply. 

A Medicare Member Advocate:  

• Educates plan benefits, answers questions, and resolves issues based on campaign outreach. 

• Documents and tracks contacts with members. 

• Educates members on our self-service options 

• Follows campaign guidelines for exceptional service 

• Exceeds member expectations  

• Ensures that every caller is treated with respect, kindness and all questions are thoroughly answered 

• Respond to inquiries from our Medicare Advantage members  

• Connects with members to diminish service disruption and educate members on plans 

• Takes ownership and follows through on commitments 

• Create lasting relationships with our members 

• Work in a team and production-based environment to create world class service 

• Ability to navigate multiple systems 

• Acts as an advocate for our members 

Required Qualifications

• Ability to creatively solve members’ problems and have desire to help and advocate for them 

• Problem solving with demonstrated ownership qualities 

• Demonstrated empathy, compassion and listening skills 

• Window based application knowledge 

Preferred Qualifications

• Proven leadership skills 

• Demonstrate ability to de-escalate situations 

• Effective communication and documentation skills 

• Ability to quickly