Job Information

CVS Health Senior Consultant, Member Experience in High Point, North Carolina

Job Description

This role will be office based in High Point, NC once COVID restrictions are lifted.Standard business hours Monday-Friday are required.Aetna One Advocate is at the forefront of what’s possible for health care navigation, leveraging deep analytics, integrated technology, local solutions and predictive outreach. By combining clinical support with member services into one co-located team, we’re better able to find those who need help the most in a manner that’s meaningful to them and to their health goals. Using a proprietary approach, Aetna One Advocate removes barriers to care and provides the right support to encourage our members to achieve their health goals and stay on a path to better health. The mission of this model is designed to meet each member at every aspect of their health care journey. Our data analytics, high-touch service and end-to-end ownership of member support creates a trusted partner in health care.This is an exciting time to join Aetna a CVS Health company in our journey to change the way healthcare is delivered today. We are healthcare innovators.Mission of this position: Improve the member experience through consultative awareness, education and support where identified Consult on advocate performance evaluations: (35%)Focus is on “soft spots” that are impacting the member experience. Consults with individuals and their coaches where there are challenges with quality and the member experience. Listen to calls, deliver feedback, work side by side to support advocates who are not meeting targets.Close the loop with the advocates to share information that will improve the member experience when after action reviews are completed for member escalations.Partner with analytics to understand trend and post call survey results and utilize the data as support and reinforcement for quality review discussions with advocates: (25%)Drive improved results and increase scores across the advocates balanced scorecard.Improve Voice of the Customer feedback as delivered through the post call survey for Member Satisfaction, Customer Effort and Recommendation Scores.Improve Quality of the member experience by focusing on keeping the commitment, delivering accurate information and conducting and engaging conversations with members.Become and ambassador to those advocates who are on a Performance Improvement plans, by supporting their development, knowing the workflows, tools, and best practices across the business.

Required Qualifications

-3+ years of customer/member facing experience-2+ or more years of leadership or mentoring experience-LPN or clinical certification-1+ year experience developing, mentoring and coaching individuals (formally or informally)-Customer / Member facing experience in a contact center environment-Excellent communication skills and feedback techniques-Coaches on work procedures, proper call handling and best practices for the integrated team of service and clinical advocates-Possess the ability to apply new innovative approaches to delivering best in class experiences and understand the right health care treatment for our members needs-Good understanding of metrics and the measurement of activities-Ability to work collaboratively in a cross–functional team environment to solve challenging issues and identify opportunities for improvement

Preferred Qualifications

-Six Sigma as preferred


-LPN or healthcare certification

Business Overview

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.