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Aetna Inc.

Outreach Coordinator

Aetna Inc. - Louisville, KY

POSITION SUMMARY

Coordinates member outreach to ensure effective use of health plan benefits and to improve member health outcomes within the Medicaid or Medicare population. Responds to member inquiries in person, via telephone, and in writing. Facilitates provider and member outreach to ensure member receipt of important clinical services to improve member health outcomes. Provides support for Healthcare Effectiveness Data and Information Set (HEDIS) quality initiatives and regulatory/contractual requirements.

*This position covers 20 counties in Western Kentucky. The counties for Region 1 are as follows: Ballard, Caldwell, Calloway, Carlisle, Crittenden, Fulton, Graves, Hickman, Livingston, Lyon, and McCracken. The counties for Region 2 are as follows: Christian, Daviess, Hancock, Henderson, Hopkins, McLean, Muhlenberg, Ohio, Todd, Trigg, Union, and Webster.*

Fundamental Components:

Identifies potential resources and initiates collaboration with community centers, mental health centers, faith/ethnic-based social service organizations, and school organizations to improve member health outcomes and HEDIS measures.

Distributes educational information to members by most appropriate method (mailings, social media, automated calls, etc.) to help them utilize benefits more effectively.

Develops educational/outreach materials including, but not limited to, incentive documents, call scripts, event flyers, social media text, etc.

Identifies opportunities to partner with community organizations on special events and presentations (i.e., health fairs and community events) to heighten awareness of Aetna's name; works with internal staff to schedule, organize, and staff these events.

Documents complaints and grievances from members and refers them to the appropriate department for timely resolution.

Identifies potential resources and initiates collaboration with providers to improve member health outcomes and HEDIS measures.

Assists in the development and standardization of outreach documentation and manages the data flow process to complete HEDIS documentation.

Documents member participation in outreach activities in accordance with abstraction and audit standards.

Performs other related duties as required.

BACKGROUND/EXPERIENCE desired:

Minimum of three years recent and related outreach experience working with providers or members, and/or government program managed care product experience

Customer Service experiences in a transaction based environment such as a call center or retail location preferred

Experience with Microsoft Office products (Word, Excel, Project, PowerPoint, Outlook)

EDUCATION

The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.

TECHNOLOGY EXPERIENCES

Technical - Computer Operations//1-3 Years/End User

Telework Specifications:

Telework is a requirement for this position; no physical work location.

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 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.

13 days 7 hours ago

Aetna Inc.

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Outreach Coordinator Aetna Inc. - Louisville, KY, United States

   

Location: Louisville, KY

Company Profile:
Aetna Inc. operates as a diversified health care benefits company in the United States. The company operates in three segments: Health Care, Group Insurance, and Large Case Pensions. The Health Care segment provides medical, pharmacy benefit management, dental, behavioral health, and vision plans on an insured basis, and an employer-funded or administrative basis. This segment also provides Medicare and Medicaid products and services, as well as other medical products, such as medical management and data analytics services, medical stop loss insurance, workers' compensation administrative services, and products that provide access to its provider networks in select markets. This segment offers its products and services to multi-site national, mid-sized, and small employers, as well as individual customers. The Group Insurance segment provides life insurance products comprising group term life insurance, voluntary spouse and dependent term life insurance, group universal life, and accidental death and dismemberment insurance; disability insurance products; and long-term care insurance products, which offer benefits to cover the cost of care in private home settings, adult day care, assisted living, or nursing facilities. This segment provides insurance products principally to employers that sponsor its products for the benefit of their employees and their employees’ dependents. The Large Case Pensions segment manages various retirement products, including pension and annuity products for tax-qualified pension plans. The company’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups, and expatriates. Aetna Inc. was founded in 1853 and is headquartered in Hartford, Connecticut.