Employer: CVS Health
Fully remote role. Work anywhere in the U.S.
- Schedule is 11a-9:30p Sun Mon Thurs Sat
- Call center is a 24/7 operation.
- Holiday work is expected
- Schedules may be adjusted based on business need
- We are looking for high-performing individuals to join our team.
- This team will support members as their front-door to Mental Health Wellbeing.
- Our goal is to deliver an integrated experience across the breadth of RFL, Behavioral Health and Medical products to ensure every member and their families get the right support for their unique mental wellbeing needs.
- Responsible for supporting the provision and use of worklife, employee assistance and management consultant resources.
Fundamental Components/Job Description:
- Member Support
- Determines purpose of call by actively listening and interacting with callers, triages call in a in a professional and timely manner.
- Assesses client s needs; researches and articulately communicates information regarding pertinent EAP/Worklife services and resources.
- Recognizes crisis situations and evaluates for needed action to minimize risk.
- Performs appropriate research in internal databases and online to identify potential providers and resources.
- Enters member information into the appropriate EAP system to initiate the case and documents comments and information thoroughly and professionally.
- Team Member Support – Receive calls transferred from counselors and provides immediate member assistance.
- Schedules appointment for members with counselors.
- Assists team members with necessary activities to effectively respond to member inquiries about and requests for services and resources related to various life skills such as finding childcare, finding eldercare, etc.
- Communicates effectively with all internal stakeholders.
- Utilizes relevant Aetna databases to research and identify validated, appropriate member resources.
- Makes outbound calls as appropriate to identify and assist with securing member resources and/or services.
- Assists team members with printing and fulfillment needs related to relevant materials, including provider profiles, letters, selection of appropriate guidebooks, collating
- materials for mailing, documenting fulfillment completion in the appropriate EAP system, maintaining an inventory of materials.
- Provides miscellaneous support functions including administrative support, follow-up calls, and other duties as assigned.
- Compliance with Policies and Regulatory Standards
- Protects the confidentiality of member information and adheres to enterprise policies, and EAP and Worklife policies and procedures.
- Maintains accurate and complete internal documentation of required information that meets risk management and regulatory requirements. (*)
- Proactively listens to members and anticipates their needs, taking full ownership of each member interaction.
- Address inquires and resolve issues as a “single-point-of contact” based on phone calls, digital and written correspondence.
- Provide customized interaction based on customer preference and individualized needs.
- Resolves complex issues without or with limited management intervention.
- Administers structured pre-screening assessment based on triggers to assure urgent needs are directed appropriately.
- Identifies triggers for additional resources and support connections to such responses.
- Assesses for social determinants/needs and offers and connects members with viable resources to address those needs.
- Experience in a social, psychological or human service field providing client support.
- 1-years experience in call center environment preferred or BH experience
- Insurance/ medical knowledge preferred
- Associate’s degree or equivalent experience