Health Plan Client Support Specialist at CVS Health

Remote
CVS Health

Health Plan Client Support Specialist

Location: USA

Job Description
The Health Plan Client Support (HPCS) Specialist is the important first-line of contact for our Health Plan clients, setting the tone for how they view our company and services; while providing them with information to help resolve member related issues and concerns. The Client Support Team is vital within the organization as a liaison between our clients and participants. A HPCS Specialist will be required to effectively handle our clients and resolve issues/complaints while consistently demonstrating a high level of quality and professionalism that contributes to Client Supports achievement of service level goals. The HPCS Specialist promotes a positive team environment, continuously seeking opportunities for developing professional expertise that support the goals and objectives of the company. Mentoring, coaching, and intensive oversight is provided throughout the first 6 months.

Job responsibilities include:

  • Working collaboratively with internal/external business partners to provide solutions to member level issues
  • Receiving and responding to client issues in a timely manner via email, fax, cases, and phone
  • Providing plan benefit override support at client request
  • Partnering with Account Management teams to ensure maximum client satisfaction and issue resolution
  • Facilitate pharmacy outreach to resolve access to care issues

Health Plan Client Support operating hours: Monday – Friday 8:00AM – 8:00PM EST

This can be a work from home position.
(Occasional need for overtime, weekend, and holiday support as determined by seasonal business needs)

Required Qualifications:

  • 3+ years of experience in a complex, high-impact customer interfacing role

Preferred Qualifications:

  • Health Care/PBM Experience
  • Strong working knowledge of PeopleSafe, RxClaim, and SalesForce
  • Strong knowledge of plan designs and client programs
  • Strong self-management skills and abilities to handle multiple issues/projects simultaneously while meeting and maintaining deadlines
  • Team-oriented with the ability to work effectively with others
  • Ability to positively deal with changes in a complex and rapidly changing work environment
  • Strong oral and written communication skills
  • Client service focused; ability to identify process improvements and to multi-task
  • Demonstrates strong analytical skills with the ability to evaluate, develop, and deliver alternative courses of action

Education:

  • High School Diploma or GED required
  • Bachelor’s degree preferred

Business Overview
Its a new day in health care.
Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nations premier health innovation company. Through our health services, insurance plans and community pharmacists, were pioneering a bold new approach to total health. As a CVS Health colleague, youll be at the center of it all.

At CVS Health, we work every day to help people on their path to better health. Never has it been more important for us to deliver on our purpose to our valued customers, patients, members, and employees. With a presence in communities across the country, CVS Health colleagues are and will continue to be a critical piece of the countrys health care solution. The health and safety of our employees, patients, customers, and members is our top priority as we face the impact of COVID-19 together. If you would like to learn about the actions we are taking as a company as we learn more about COVID-19 and its spread, we encourage you to visit our COVID-19 resource center at https://cvshealth.com/covid-19

We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.

CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran we highly value and are committed to all forms of diversity in the workplace. 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. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. Please note that we only accept applications for employment via this site.

We provide reasonable accommodations to qualified individuals with disabilities.

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