Position Summary
The Account Relationship Liaison will serve as the Dedicated Single Point of Contact for Aetna Medicare Advantage servicing to our CT Teachers’ Retirement Board Plan Sponsor benefit administration personnel while supporting Group Center of Excellence Call Center in additional to all Aetna back-office teams. Controls daily communication between departments or individual policyholders regarding benefit plan administration. Directs workflow to respond, manage, and resolve escalated and complex global issues for Claims/Calls, PSS, and health plan back-office operations. The Account Relationship Liasion dedicated role has responsibility for a random ID card quality review, standard customization requests and updates to the Plan Sponsor Profile Page, customer reporting for membership and patterns and trends of inquires.
A Brief Overview
Controls daily communication between departments or individual policyholders regarding benefit plan administration. Directs workflow to respond, manage, and resolve escalated and complex global issues for Claims/Calls, PSS, Aetna Medicare Account Management Team, Aetna Commercial Account Management Teams and back-office departments regarding benefit plans, eligibility, claims, billing, and general benefit plan administration.
What you will do
- Assists with establishing and implementing results-based programs and innovative initiatives for the Plan Sponsors, under general supervision.
- Applies in-depth knowledge of the Plan Sponsor / back-office areas to offer feedback for decisions and innovation strategies that enhance organizational growth, visibility, member retention and customer satisfaction and trust.
- Examines escalated member-specific issues and/or broader plan administration matters as the single point of contact to provide swift resolution.
- Develops complex customer service account management plans for assignment and implements plan for dedicated account.
- Coordinates service delivery of dedicated account by attending implementation planning and process meetings, while supporting customer.
- Responsible for ID card Quality, timeliness, and Performance Guarantee for assigned dedicated account.
- Responsible for Plan Sponsor Profile Page, supports Group Contact Center of Excellence for projects, workflow support and to enhance the member experience and customer satisfaction.
- Assists with Member Open Enrollment Meetings and customer site visits, including local union meetings with CT Teachers’ Retirement Board staff.
- Proactively resolve issues with account managers, sales representatives, and other Aetna back-office teams as appropriate.
- Identifies most urgent business problems, obtains necessary information, accurately identifies root causes, and generates solutions. Initiates and maintains partnerships with others throughout the organization.
- Encourages cooperation by promoting common goals and building trust. Inspires, supports, and initiates cross-functional activities.
Required Qualifications
For this role you will need Minimum Requirements
- 3 years’ experience in Group Medicare Business and Medicare Advantage Plans and Products
- Strong Leadership and Communication skills [verbal, written and presentation]
- Critical thinking, problem solving and decision-making skills
- Demonstrate prior experience in consultative skills and the ability to influence -constituents for positive outcomes and initiatives
- Customer Service experience required
- Working knowledge of execution and delivery (planning, delivering, and supporting) skills
- Working knowledge of business intelligence
- Ability to work with cross-functional business units and vendors to support the customer’s needs; promotes collaboration among constituents and represents a professional image of the company
Preferred Qualifications
- Strong project management skills are strongly preferred
- Claim adjudication knowledge is strongly preferred
- Adept at growth mindset (agility and developing yourself and others) skills
- 5-7 years work experience
We support a hybrid work environment. If selected and you live near a suitable work location, you may be expected to comply with the hybrid work policy. Under the policy, all hires for in-scope populations should be placed into a hybrid or office-based location, working onsite three days a week.
Aetna Service Operations office/hub locations will be discussed with the selected candidate.
Anticipated Weekly Hours 40
Education
Bachelor’s degree or equivalent experience
Anticipated Weekly Hours40
Time TypeFull time
Pay Range
The typical pay range for this role is:$46,988.00 – $112,200.00
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.
