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Health Concierge

| Chicago

Job Description

Health Concierge is the face of Aetna to provide targeted, personalized service based on a holistic view of the member, benefits, health information, and through engagement. Handles customer service inquiries and problems via telephone and internet.

Fundamental Components

 

  • Answers questions and resolves issues as a “single-point-of-contact” based on phone calls, plan sponsors, PSS/ISO, members and providers.
  • Provides customized interaction based on customer preference and individualized needs, creating an emotional connection with our members by understanding and engaging the member to the fullest.
  • Fully understands the member’s needs by building a trusting and caring relationship with the member. 
  • Anticipates customer needs.
  • Provides the customer with related information to answer the unasked questions, e.g. additional plan details, benefit plan details, member self-service tools, etc.
  • Uses customer service threshold framework to make financial decisions to resolve member issues.
  • Educates and assists customers on various elements of benefit plan information and available services created to enhance the overall customer service experience with the company (i.e., assistance with member self-service tools, Consultation Opportunities – Simple Steps, Cost of Care Tools, Natural Alternatives Program, etc.).
  • Utilizes all relevant information to effectively influence member engagement.
  • Takes immediate action when confronted with a problem or made aware of a situation.
  • Takes ownership of each customer contact to resolve their issues and connect them with additional services as appropriate.
  • Identifies member needs beyond the initial inquiry by answering the unasked questions.
  • Resolves issues without or with limited management intervention. 
  • Provides education to members to support them in managing their health.
  • Responds quickly to meet customer needs and resolve problems while avoiding over-committing.
  • Other activities may include: providing claim status information, benefit coverage interpretations, and explaining plan eligibility.
  • Processes claim referrals, new claim hand-offs, and escalates issues as appropriate through the system for grievances and appeals.
  • Initiates out-reach/welcome calls to ensure constituents expectations are met or exceeded.
  • Identifies trends and any emerging customer service issues and works to develop solutions to address potential problems and/or plan features of interest as an approach to improve understanding of benefit plans and increase post-enrollment member satisfaction.
  • Partners with other departments to deliver client specific presentations.
  • Coordinates efforts both internally and across departments to successfully resolve service issues and develop process improvement intended to enhance the overall delivery of service.Works collaboratively with colleagues to deliver the best customer experience. 
  • Seeks to understand the customer, including circumstances, problems, expectations and needs. 
  • Asks probing questions to identify the underlying customer needs. 
  • Appropriately transitions conversations to explore possibilities for extending customer interactions. 
  • Guides members to the appropriate health resource. 
  • Offers alternatives where appropriate. 
  • Acts with the best interest of customer in mind and central to all interactions.
  • Collaborates with colleagues and co-workers to deliver a world class customer experience. 
  • Serves as SME providing technical assistance when needed on call related issues, products, and/or system applications delivery matters.
  • May participate in preparation and presentation of client specific presentations. 
  • May track and trend data.Coaches, trains and assists in the development of call center staff, as required.
  • Participates in and/or leads special projects/initiatives addressing service issues, as necessary. 
  • Provides technical or subject matter expertise concerning policies, procedures, and function-related applications/systems tools as needed.
  • Delivers internal quality reviews. 
  • Provides appropriate support in third party audits when required.
  • Documents and tracks all contacts, events, and outcomes with clients using appropriate systems and processes.

Background Experience

 

  • Customer Service experiences in a transaction based environment such as a call center or retail location preferred, demonstrating ability to be empathetic and compassionate.
  • Effective organizational skills and ability to manage multiple tasks.
  • Effective communication skills, both verbal and written.
  • Associate's degree or equivalent work experience.

Additional Job Information


Innovative Thinking and “Change Agent” - Looks for, identifies and acts on opportunities to improve how we design, develop, and deliver products and services.
Strong analytical skills and innovative problem solving abilities.
Strong negotiation and collaboration skills.
In-depth knowledge of benefits program and system design (Health and Welfare, Wealth, other employee benefits), related financials, legal/regulatory requirements.
Empathy towards customers' needs and concerns.
Ability to maintain accuracy and production standards.
Technical skills.
Attention to detail and accuracy.

Read Full Job Description

Location

10 S Riverside Plaza, Suite 1100, Chicago, IL 60606

What are bswift Perks + Benefits

Health Insurance & Wellness Benefits
Flexible Spending Account (FSA)
A flexible spending account lets you set aside pretax dollars to help pay for certain types of health care and/or dependent care expenses.
Dental Benefits
Choose between a dental maintenance organization plan and preferred provider organization plan. Both cover certain preventive care services at 100%. They also offer coverage for basic services.
Vision Benefits
You can enroll in a separate vision plan. It covers eyeglasses and contact lenses. Preventive vision exams are covered through the Aetna medical plan.
Health Insurance Benefits
You can choose from three types of medical plans: a health savings account, a health reimbursement arrangement or a hybrid health plan. Certain preventive care services are covered at 100 percent when
Life Insurance
All employees get term life insurance and business travel accident insurance at no added cost. You have the option to buy: Supplemental term life insurance Accidental death and personal loss insura
Wellness Programs
Our employee wellness program offers services such as wellness campaigns, weight-management programs and educational seminars.
Onsite Gym
Retirement & Stock Options Benefits
401(K)
You can save a percentage of your pay in the 401(k) plan, on a pretax and/or Roth after-tax basis. You may participate in the 401(k) plan immediately following your hire.
401(K) Matching
We match a portion of your contribution. You can invest your contributions among various options offered in the plan.
Company Equity
You can purchase Aetna stock at a discount through a payroll deduction. In order to participate, eligible employees must enroll during the enrollment period announced by Aetna.
Vacation & Time Off Benefits
Generous PTO
During your first 3 years at Aetna, you receive the equivalent of 18 days off per year. The longer you work at Aetna, the more time you accrue per month.
Paid Volunteer Time
One of our values is to improve the quality of life in communities through employee volunteerism.
Paid Holidays
Perks & Discounts
Casual Dress
Commuter Benefits
Stocked Kitchen
Happy Hours
Professional Development Benefits
Job Training & Conferences
Tuition Reimbursement
We encourage professional development. That's why we provide financial support for continuing education. This program covers a portion of tuition and registration fees for a college course.

Additional Perks + Benefits

The following programs, activities, and amenities are available to employees at bswift: complimentary fresh fruit, on-site flu shots, massages during open enrollment season, walking treadmill desk, foosball and ping-pong tables, casual attire, zen room for relaxation and nursing mothers, full week of employee appreciation, and proximity to public transportation • Healthy lifestyle incentive programs - This incentive program is offered to all eligible employees. You can earn up to $500 for healthy eating, physical activity and other healthy behaviors. Family members can also earn incentives • During your first 3 years at bswift, you receive the equivalent of 18 days off per year. The longer you work at bswift, the more time you accrue per month. Company holidays, jury duty, military leave, bereavement and community service time are in addition to your paid time off • You can purchase company stock at a discount through a payroll deduction.

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