Health Survey Specialist / Service Advocate - Work Job
Job Description Job Attributes+
Portland, OR, US
Help us elevate our patient care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our Dual Eligible Special Needs Plan (DSNP) members, who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand DSNP to change lives in new markets across the country.
The Health Survey Specialist plays a critical role within the DSNP team. The Health Survey Specialist outreaches DSNP members via phone to introduce the DSNP services and complete the Health Risk Assessment (HRA). The HRA is the first step in creating the member’s Individualized Care Plan and sets the foundation for follow up care management by assessing a member’s medical, functional, cognitive, psychosocial, and mental health needs.
Uses motivational interviewing and other consultative techniques to gather comprehensive information about a member’s medical, functional, cognitive, psychosocial, and mental health needs
Accountable to the highest level of compliance integrity
Champions for the member by connecting members with urgent needs to the appropriate Aetna team, including DSNP’s interdisciplinary care team and customer service
Initiates engagement with assigned members to introduce the program and drive active participation in completion of their Health Risk Assessment
Builds a trusting relationship with the member by engaging the member in meaningful and relevant conversation, prior to and during assessment
Effectively supports members during enrollment calls, appropriately managing difficult or emotional member situations, responding promptly to member needs, and demonstrating empathy and a sense of urgency when appropriate
Conducts triage, connecting members with appropriate care team personnel including care managers and customer service when needed
Accurately and consistently documents each call in the member’s electronic record, thoroughly completing required actions with a high level of detail to ensure we meet our compliance requirements
Protects the confidentiality of member information and adheres to company policies regarding privacy/ HIPAA
Ability to be agile, manage multiple priorities, and adapt to change with enthusiasm
Determined to build strong relationships with peers and our DSNP members
Demonstrates an outgoing, enthusiastic, and caring presence over the telephone
At least 3 years of experience in health care, customer service, telemarketing and/or sales
Familiarity with basic medical terminology, health care, and the concepts of care management
Medicare/Medicaid/DSNP experience preferred
Experience with computers, including knowledge of Microsoft Word, Outlook, and Excel required
Strong organizational skills, including effective verbal and written communications skills required
Data entry and documentation within member records is strongly preferred
Flexibility with work schedule to meet business needs
Education and Certification Requirements
High School diploma or G.E.D. required
Associates/Bachelor’s degree preferred
Additional Job Information
Strong communications skills.Strong analytical skills focusing on accuracy and attention to detail.Computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word.Understanding of medical terminology.Ability to maintain accuracy and production standards.Negotiation skills.Problem solving skills.
High School diploma, G.E.D. or equivalent experience
Percent of Travel Required
0 - 10%
Who We Are
We’re a values-based organization focused on helping people on their path to better health. Here, you’ll work alongside former members of the military and current reservists and members of the National Guard. Bring your unique skills to our industry, and we look forward to helping you grow your career.
We offer opportunities at all levels for U.S. Veterans and will enforce the Uniformed Service Employment and Reemployment Rights Act (USERRA).
Also, if you’re a Reservist member of the National Guard, be assured that you’ll have a job at CVS Health when you return from deployment. And, even though your civilian job may differ from your military job, we have many opportunities that may be right for you.
We recognize the value of military spouses bring to our company and continue to look for ways to help you find employment.
Explore our career areas and learn more about continuing your mission to help others.