Medicare Member Advocate

CVS HealthSaint Louis Park, MN
1dHybrid

About The Position

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. Position Summary As a Medicare Member Advocate supporting the Allina Health | Aetna plan, you will engage with members, by telephone or in person, to support them in understanding and getting the most value from their Medicare plan, enhancing member experience and retention. Apply problem solving skills while collaborating with internal colleagues and external entities to bring complex issues to resolution. Drive member engagement and retention by delivering a positive member experience through all interactions. Define and track program success measures, identify trends, and participate in designing and implementing solutions. Conduct audit and monitoring activities as part of service oversight Prepare and deliver training topics for the market team and other organizational partners to address education gaps and improve member experience and retention. Provide accurate, timely and insightful analysis in response to ad hoc requests Participate in member outreach to drive plan performance. Support community development, member education, and other activities as requested by the Director of Medicare Operations and as customer service demands allow. Examples may include annual member meetings or other member-focused events. In this role you will work in a hybrid environment with some days in the Allina Health | Aetna joint venture office and others working from home.

Requirements

  • Minimum of 2+ years of experience in Medicare insurance, including Medicare Advantage and/or Part D
  • Minimum of 2+ years of customer service or member-facing experience, preferably in a healthcare or insurance environment
  • Demonstrated ability to communicate effectively with diverse audiences through telephone, virtual, written, and in‑person interactions
  • Experience delivering live and virtual presentations, trainings, or educational sessions
  • Proven ability to resolve complex member issues by collaborating cross‑functionally with internal teams and external partners
  • Strong analytical and problem‑solving skills, with the ability to identify trends and support performance improvement initiatives
  • Proficiency with Microsoft Office applications (Outlook, Word, Excel, PowerPoint)
  • Ability to work effectively in a hybrid work environment, managing time independently while meeting performance expectations
  • Ability to handle confidential and sensitive information in accordance with HIPAA and company policies

Nice To Haves

  • Working knowledge of Medicare regulations, CMS requirements, and service oversight expectations
  • Associate’s or Bachelor’s degree in Healthcare Administration, Public Health, Business, Social Services, or a related field, or equivalent experience
  • Knowledge of Medicare quality programs such as Stars Ratings, CAHPS, HEDIS, or retention initiatives
  • Experience supporting member engagement, outreach, or community-based programs
  • Demonstrated experience developing or delivering training materials to internal teams or external partners

Responsibilities

  • Engage with members to support them in understanding and getting the most value from their Medicare plan
  • Enhance member experience and retention
  • Apply problem solving skills while collaborating with internal colleagues and external entities to bring complex issues to resolution
  • Drive member engagement and retention by delivering a positive member experience through all interactions
  • Define and track program success measures, identify trends, and participate in designing and implementing solutions
  • Conduct audit and monitoring activities as part of service oversight
  • Prepare and deliver training topics for the market team and other organizational partners to address education gaps and improve member experience and retention
  • Provide accurate, timely and insightful analysis in response to ad hoc requests
  • Participate in member outreach to drive plan performance
  • Support community development, member education, and other activities as requested by the Director of Medicare Operations and as customer service demands allow

Benefits

  • Affordable medical plan options, a 401(k) plan (including matching company contributions), and an 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.

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What This Job Offers

Job Type

Full-time

Career Level

Mid Level

Number of Employees

5,001-10,000 employees

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