National Accounts: Dedicated Field Services 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.

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 includes 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; both are 100% dedicated to our clients and the NY‑based role will be expected to be onsite in NYC 2–3 times per week and at the customer’s request for activities such as wellness fairs and annual enrollment.

• 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 member’s health ambition, using predictive analytics to build a 360° view of the member, and by providing multi‑channel support in line with member preferences.

• 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…