Aetna Health

  • Fresno, CA, United States

Finding the cure for the common health care system

Aetna is about more than just doing a job. This is our opportunity to re-shape health care for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come. We care about each other and our customers. We are inspired to make a difference, and we are committed to integrity and excellence. Together we’ll empower people to live healthier lives. 

Aetna is an equal opportunity and affirmative action employer- People of Color, Women, Veterans, and Individuals with Disabilities.

$30,000 - $45,000 yearly
Aetna Health Fresno, CA, USA
Feb 11, 2019
Full time
POSITION SUMMARY Provides 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, internet, web-chat or written correspondence. Engages, consults and educates members by delivering individualized programs based upon the members unique needs and preferences. Utilizes resources to assist customers in understanding components of the Aetna products including claims, accumulators, usage and balances, and cost sharing. Fundamental Components: A Health Concierge answers questions and resolves issues as a single-point-of-contact based on phone calls from plan sponsors and members. We provide a customized interaction based on customer preference and individualized needs. Takes ownership of each customer contact to resolve their issues and connect them with additional services as appropriate and responds quickly to meet customer needs and resolve problems while avoiding over-committing. A Health Concierge takes immediate action when confronted with a problem or made aware of a situation and identifies member needs beyond the initial inquiry by answering the unasked questions. Coordinates efforts both internally and across departments to successfully resolve service issues and develop process improvement intended to enhance the overall delivery of service and works collaboratively with colleagues to deliver the best customer experience. 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 Aetna Navigator, Consultation Opportunities Simple Steps, Cost of Care Tools, Natural Alternatives Program, etc). Through in-depth analysis, 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. May participate in preparation and presentation of client specific presentations. BACKGROUND/EXPERIENCE desired: 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 communication skills, both verbal and written Effective organizational skills and ability to manage multiple tasks. EDUCATION The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience. FUNCTIONAL EXPERIENCES Functional - Customer Service/Customer Service - Member Services - Traditional products/1-3 Years TECHNOLOGY EXPERIENCES Technical - Desktop Tools/Microsoft Outlook/1-3 Years/End User Technical - Desktop Tools/Microsoft Word/1-3 Years/End User Technical - Desktop Tools/Microsoft SharePoint/1-3 Years/End User REQUIRED SKILLS Service/Demonstrating Service Discipline/ADVANCED Service/Handling Service Challenges/ADVANCED Service/Providing Solutions to Constituent Needs/FOUNDATION DESIRED SKILLS Leadership/Creating Accountability/FOUNDATION Leadership/Driving a Culture of Compliance/FOUNDATION Service/Creating a Differentiated Service Experience/FOUNDATION ADDITIONAL JOB INFORMATION Our Government Services team is hiring Health Concierge to support growth in our Public Sector & Labor membership. Customer Service is the important first-line of contact with customers, setting the tone for how members, doctors and plan sponsor groups view our company. It provides members with the right information at the right time to help them make better decisions about their health and health care. Must be able to work an 8-hour shift between 7:00 AM to 7:00 PM, Monday through Friday, schedules may rotate. Excellent attendance and punctuality are requirements of this position. Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come. We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence. Together we will empower people to live healthier lives. Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities. We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.     Team C Gary Munson
Aetna Health San Diego, CA, USA
Feb 08, 2019
Full time
Aetna Better Health of California is hiring 2 Network Relations Consultant out of our San Diego Offices! Acts as the primary resource claims and/or provider data analytics for high profile providers or groups (i.e. local, individual providers, small groups/systems) to establish, oversee, and maintain positive relationships by assisting with or responding to complex issues regarding policies and procedures, plan design, contract language, service, claims, credentialing, medical management or compensation issues. Fundamental Components: - Data Analytics related to provider data and/or claims - Solutions focused on provider data and/or claims - Communicate/translate plan needs data optimization and positive outcomes BACKGROUND/EXPERIENCE desired: -Highly organized with the ability to management multiple projects -SQL Experience EDUCATION The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. LICENSES AND CERTIFICATIONS Managed Care/Managed Healthcare Professional is desired Project Management/Six Sigma Trained is desired FUNCTIONAL EXPERIENCES Functional - Information Management/Business information analysis/4-6 Years Functional - Management/Management - Data analysis and interpretation/4-6 Years Functional - Network Management/Provider data services/1-3 Years Functional - Project Management/Project Manager/1-3 Years Functional - Claims/Claim processing - Medical or Hospital- HMO/1-3 Years TECHNOLOGY EXPERIENCES Technical - Database/SQL Server/4-6 Years/End User Technical - Network/Provider data management/1-3 Years/End User Technical - Database/Intuit QuickBase/1-3 Years/End User Technical - Aetna Applications/QNXT/4-6 Years/End User ADDITIONAL JOB INFORMATION Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come. We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence. Together we will empower people to live healthier lives. Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities. We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard. Benefit eligibility may vary by position. Click  here  to review the benefits associated with this position.  Aetna takes our candidates's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.       James
Aetna Health Fresno, CA, USA
Feb 08, 2019
Full time
POSITION SUMMARY The liaison role will be a key member of our benefits service delivery team spanning across our service center and client services team. The role will be a key driver in representing the voice of the customer across all service towers. The ideal candidate will have deep core HW knowledge and an equally matching expertise in service center delivery operations. Exceptional communication skills and ability to navigate and influence change across a highly matrixed organization is a must. Ability to work and thrive in a high growth and rapid change environment is key! This role is available to sit at one of three office locations with no preference to any - Chicago IL, North Point NC, or Fresno CA.  Fundamental Components: -Educating Client Services on Service Center process/procedures/expectations  -Identify and drive service delivery process improvements  -Represent the voice of the customer in every interaction across our delivery teams  -Educating Service team members on client expectations, commitments, SLAs, PGs, etc.  -Educate and drive to standard core service delivery model  -Participating in internal and external client meetings as needed  -Researching trends to identify root cause and work with Service Center and/or CS team on strategy and solution(s)  -Analyze data and trends to drive change  -Identify opportunities for process and technology enhanced solutions  -Drive domain expertise across the service center  -Coach and mentor service center personnel  -Work directly with service Center Operations Leader and COE lead to improve employee and client experience  -Assist with development of CSR training materials and modifying CS and Service Center workflows revision of portal instructions/text for better clarification, etc.  -Monitor client SLAs / PGs to ensure bswift meets contractual obligation  -Assist CS team and Client to understand SLA reporting results Client OE Planning (i.e., communications, timelines, training, staffing, overall delivery)  -Support Service Center supervisor in client implementations, training, coaching and auditing others work  -Support new prospective client meetings  -Manage 5 to 10 client alignments BACKGROUND/EXPERIENCE desired: Results driven leader with 5 years experience in benefits administration, client delivery and implementations, people management, training and service center operations. EDUCATION The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. ADDITIONAL JOB INFORMATION Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come. We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence. Together we will empower people to live healthier lives. Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities. We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard. Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come. We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence. Together we will empower people to live healthier lives. Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities. We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.         James
Aetna Health Walnut Creek, CA, USA
Feb 08, 2019
Full time
POSITION SUMMARY Overall mission of Actuarial is to protect Aetna's financial integrity with sound reserving and risk management practices as well as product designs that meet customer needs and pricing that produces returns to shareholders commensurate with the risks undertaken. Actuarial is responsible for anticipating and recognizing matters that materially affect financial integrity and making sound, unbiased reports on these issues. Fundamental Components: Opportunity to be in a leadership role on a market team Will get exposure to all the markets in the Big Sky, including CO, UT, and NV Will get exposure to all commercial lines of business, including AFA, SG, 51-99, Key, and Select Opportunity to work directly with senior leadership, including the senior LRB actuarial team and the health plan team, including the market CFO and CEO Opportunity to work with a variety of internal departments, including product, network contracting, ACO strategy, and finance Strong emphasis on communication skills and ability to communicate technical ideas clearly in addition to strong technical skills BACKGROUND/EXPERIENCE desired: Bachelor's degree along with 5+ years relevant experience Must have your Associates of the Society of Actuary Prior experience in the healthcare field Excellent communication skills Strong technical skills EDUCATION The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. ADDITIONAL JOB INFORMATION Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come. We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence. Together we will empower people to live healthier lives. Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities. We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard. Benefit eligibility may vary by position. Click to review the benefits associated with this position.  Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.       James