Plan Sponsor Liaison
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Position Summary 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 addition to all Aetna back-office teams. 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 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 preferred Claim adjudication knowledge is strongly preferred Adept at growth mindset (agility and developing yourself and others) skills 5-7 years work experience
We support a hybrid work environment. If selected and you live near a suitable work location, you may be expected to comply with the hybrid work policy. Under the policy, all hires for in-scope populations should be placed into a hybrid or office-based location, working onsite three days a week.
Aetna Service Operations office / hub locations will be discussed with the selected candidate.
Education Bachelor's degree preferred / specialized training / relevant professional qualification.
Anticipated Weekly Hours 40
Time Type Full time
Pay Range The typical pay range for this role is : $46,988.00 - $112,200.00
This pay range represents 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 a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include :
Analyst Plan Must Be • Hartford, CT, US