Aetna Jobs – Member Advocate

Job Description:

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.

Job Responsibilities:

• Researches other general Medicaid programs, benefits and services the members are eligible for and initiate process to inform members of these benefits.
• Educates and assists members on various elements of Medicaid benefits and services , benefit plan information and available services created to enhance the overall member experience with the company. Utilizes all relevant information to effectively influence member engagement.
• Coordinates and sends annual reminders for members at risk of losing LIS, Medicaid, or DSNP eligibility.
• Initiates contact with members who have lost their Medicaid eligibility and fall into the DSNP grace period, to remind them to follow through with their Medicaid and LIS recertification. Assists members with finding resources to help them reapply if necessary.
• Takes ownership of each customer contact to anticipate customer needs, resolve their issues and connect them with additional services as appropriate.
• Works with National DSNP Program Office Medicaid Policy Manager and State Contract Manager to provide general assistance with Medicaid benefits and entitlements.
• Tracks member’s Medicaid certification and eligibility dates and MCO plan information, as well as Medicaid status.
• Completes accurate case documentation as needed.

Job Requirements:

• Knowledge of Medicaid benefits, services, program and system design (Health and Welfare, Wealth, other benefits), legal/regulatory requirements.
• Knowledge and understanding of state policy or Medicaid eligibility and low-income state resources.
• Strong collaboration skills and innovative problem-solving abilities.
• Strong verbal and written communication skills
• Ability to work independently, accurately, and efficiently
• Associate’s degree or equivalent work experience

Job Details:

Company: Aetna

Vacancy Type:  Full Time

Job Location: Cincinnati, OH, US

Application Deadline: N/A

Apply Here

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