Description

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:

The Field Services Advocate is empowered to serve as a bridge between an Aetna National Accounts client's members, the customer Benefit Service Center, HR colleagues and Total Rewards Team to promote available health and wellness programs, tools, and resources, including those offered by Aetna as well as the client's other vendors. This can include providing both administrative and clinical support to members as well as navigating them through the health system, providing support on claims issues, and answering coverage-level questions.

**We have two of these roles to fill and both roles are 100% dedicated to our clients and our NY based role will be expected to be onsite in NYC 2 - 3 times per week and upon the customer's request for things like wellness fairs and annual enrollment as needed.**

The Field Services Advocate will engage, educate, promote, and influence members to enable decisions related to achieving and maintaining optimal health status. They will collaborate with members, the customer Benefit Service Center and Total Rewards team, and Aetna on ways to deliver the best member experience and optimize the benefits offered through the employer sponsored benefit plans.

The Field Services Advocate will:

• Function as primary contact for day-to-day escalations of benefit-related issues brought forward by the customer's Human Resources (HR) representatives, Total Rewards Team or by members themselves. Provide excellent customer service and a positive member experience to all inquirers.
• Work with members, HR representatives and the Total Rewards Team to help them understand their benefits and connect them to available resources.
• Assist members in identifying modifiable risk factors by referring to and leveraging the resources provided by the customer on lifestyle change, including weight management, quitting tobacco, stress reduction, nutrition and increasing physical activity.
• Recommend, create, and deliver content for health education newsletters, new hire orientation, Annual Enrollment, and other communication initiatives in line with the customer's Value Proposition.

• Plan and execute health awareness tables and other onsite events requested by the Total Rewards team.
• Be accountable for resolving any benefits related issues including answering routine questions, addressing denied claims, preauthorization, and providing support to both the employees and the customer Total Rewards team on appeals.
• Assist the Total Rewards team with the administration of the customer Wellness program and other programs as needed.

The Field Services Advocate is an empathetic and accountable individual responsible for providing end-to-end support to the customer's members through an 'Apple Store genius bar'-like experience. As a single point-of-contact, this person builds trust with members, demonstrates ownership for the resolution of issues, and acts with fast knowledge using integrated service tools. This person develops a deep understanding of individual members' needs by determining a members health ambition, using predictive analytics to build a 360˚ view of the member, and by providing multi-channel support in line with member preferences. Field Services Advocates engage members through personalized, effective, and frequent touchpoints to deliver a simple, powerful, and initiative-taking experience.

Key Responsibilities:

• This person is an extension of both the customer's Total Rewards Team and Aetna.
• Strives for a superior member experience and operational excellence. Identify areas to continuously improve and enhance the customer's programs.
• Acts as a single-point-of-contact for the member and the customer's HR and Benefits teams. Explains benefits, rights, and responsibilities in accordance with contracts and contracted arrangements, claim status information, plan coverage, plan eligibility, medical, dental, vision, pharmacy, spending and savings accounts, tool usage, and available programs and resources such as care management.
• Creates an emotional connection with members by understanding and engaging them to the fullest.
• Assists members in finding their health ambition.
• Guides members' use of digital and clinical resources, including CVS Health Hubs and other community resources.
• Provides high-quality, customer-focused engagement using knowledge of procedures and systems to meet and/or exceed customer satisfaction while educating members on Aetna's policies and programs.
• When required, coordinates the member's Care Plan, and conducts adherence follow-up.
• Works with Aetna's care team for members who require urgent or emergent service, or services rendered in a setting other than a practitioner's office
• Serves as subject matter expert for non-routine calls that require deviation from standard responses.
• Handles sensitive member information with discretion.
• Resolves issues with no or limited management intervention.
• Responsible for all levels of member engagement.
• Coordinates and/or delivers health education, program seminars, workshops, and webinars within Aetna and the customer.
• Attends and participates in meetings with the customer and Aetna Account teams as requested including training and information sharing.
• Partners with Data Analytics team to determine opportunities for targeted engagement and focused program utilization to positively impact future benefits spend, including preparing dashboards, reporting to the customer Total Rewards team, and measuring success through improved member health as evidenced through Data Analytics.
• Assists the customer's Wellness Representative(s) in managing all aspects of the wellness program, including but not limited to coordinating health fairs, assisting with employee communications, serving as an advocate for the program and the wellness champions at each location. Would also include keeping a current roster of wellness champions and recruiting for locations when/where there is a need.

Key Qualifications:

• Showcases a passion about health, benefits, and member experience.
• Deep problem-solving skills, demonstrates ownership of issue resolution - accountability.
• Demonstrates the ability to build a trusting relationship with members by fully understanding their needs from beginning to end.
• Lends Subject Matter Expertise to the customer's Total Rewards team and acts as a resource for day-to-day processes and provides direction on routine and difficult issues.
• Collaborates with colleagues and co-workers to deliver a world class customer experience.
• Possesses top-notch people skills - actively listens, cares, connects, shows empathy, and is supportive.
• Highly perceptive individual with strong self-awareness and empathy in interacting at various levels with different audiences.
• Ability to make independent decisions.
• Demonstrates responsiveness and a sense of urgency when dealing with members.
• Utilizes influencing and motivational skills to ensure maximum member engagement to promote lifestyle and behavior changes to achieve optimum level of health.
• Competency in public speaking and interpersonal engagement with members.
• Willingness to support members in the Eastern time zone.

Background and Experience:

• 5+ years' experience working directly with consumers delivering a highly experiential interaction.
• CEBS, SPHR, or PHR preferred.
• Clinical background a plus.
• Experience with Aetna and CVS products, claim systems, and digital member applications.
• Associate degree or equivalent work experience.
• Appropriate education relevant to clinical background.
• Knowledge of benefit rules, regulations, policies, and procedures including federal, state, and local regulations related to benefits, including COBRA, ERISA, HIPAA, and Section 125.
• Demonstrated ability to uphold the customer's and Aetna's values of caring, inspiration, integrity, and excellence in each member interaction.
• Outstanding organizational ability including keen attention to detail, strong follow-up skills; deadline-oriented and demonstrated ability to prioritize and multi-task in a fast-paced changing environment.
• Organizational and communication skills necessary.
• Competency with MS Office products - Word, PowerPoint, Excel.

Anticipated Weekly Hours
40

Time Type
Full time

Pay Range

The typical pay range for this role is:

$66,330.00 - $159,120.00

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:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 12/04/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.