Provides comprehensive healthcare management to facilitate delivery of appropriate quality healthcare, promote cost effective outcomes and improve program/operational efficiency involving clinical issues.
Supports comprehensive coordination of medical services including intake, screening and referrals to Aetna Medical Services Programs. Promotes/supports quality effectiveness of Healthcare Services.
-Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members.
-Computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word.
-Ability to effectively participate in a multi-disciplinary team including internal and external participants.
-Familiarity with basic medical terminology and concepts used in care management.
-Effective communication, telephonic and organization skills.
-Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone, and typing on the computer.
-Typical office working environment with productivity and quality expectations.
-2-4 years' experience as a medical assistant, office assistant or other clinical experience.
-Previous experience working with providers and provider networks preferred.
-Previous call center experience working on telephone queue is strongly preferred.
High School Diploma or G.E.D or work equivalency.
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. 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.
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