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Role Description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

This position is for CST candidates and the working schedule is 8am-5pm CST.

Aetna’s Medicaid Care Management Engagement Outreach Hub is a new initiative focused on prioritizing Medicaid member interaction, maximizing inbound and outbound touchpoints to solve members’ needs and create behavioral change. This team has a drive to exceed the delivery of Medicaid Health care services.

• Supports comprehensive coordination of healthcare services through telephonic outreach to and enrollment of eligible members.
• Demonstrates a highly energetic blend of salesperson, healthcare navigator and health plan customer support representative.
• Responsible for direct member outreach and engagement, facilitating case assignment, and connecting identified members to care managers immediately through a warm transfer.
• Successfully enrolls members into care management to support the implementation of care plans promoting effective utilization of healthcare services.
• Provides support services to team members by answering telephone calls, taking messages, researching information and assisting in solving problems.
• Adheres to compliance with policies and procedure/regulatory standards.
• Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
• Protects the confidentiality of member information and adheres to company policies regarding confidentiality.

Qualifications

• 2-4 years’ experience in healthcare field (i.e. experienced in medical office, hospital setting, medical billing/coding).
• Demonstrates ability to meet daily metrics with speed, accuracy and a positive attitude.
• Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues.
• Completes documentation of each member call in the electronic record, thoroughly completing required actions with a high level of detail.
• Works independently and competently, meeting deliverables and deadlines while demonstrating an outgoing, enthusiastic and caring presence telephonically.

Requirements

• Experience with computers including knowledge of Microsoft Word, Outlook, and Excel – data entry and documentation within member records preferred.
• Familiarity with basic medical terminology and concepts used in care management preferred.
• Effective communication, telephonic and organization skills with ability to be agile, managing multiple priorities at one time.
• Ability to effectively participate in a multi-disciplinary team including internal and external participants.
• Flexibility to work occasional nights and weekends outside of standard business hours which can span from 8:00 am to 8:00 pm.
• Strong organizational skills, including effective verbal and written communication skills.
• Bilingual (Spanish) preferred.

Education

• High School diploma, G.E.D. or equivalent.

Benefits

• Affordable medical plan options.
• 401(k) plan (including matching company contributions).
• Employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

Pay Range

The typical pay range for this role is: $18.50 - $31.72. 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.

We anticipate the application window for this opening will close on: 03/15/2026.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.