Lead Member Liaison, Aetna Better Health (Florida)

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position Summary Aetna Better Health of Florida (ABH-FL) is searching for a Lead Member Liaison whose duties will be primarily focused on members under the Medicaid and Florida Healthy Kids contracts. As a member of the contract management team, this colleague will develop adequate expertise in these contracts to assist members in resolving grievances and obtaining benefits and incentives. Your duties may also include assisting the primary Medicaid contract manager with special projects. This role reports to and works at the direction of the health plan’s Director of Contract Management. Job duties: Communicates (both written & verbal) with members (and/or parents & guardians) when required to fulfill regulatory requests or follow up on a complaint or need that is identified by a regulator. Converses with members as needed, and advocates for these members until the member’s benefits or other issues are resolved. Assists functional leader(s) with the set-up, agenda planning, and promotion of member attendance at member-facing meetings (such as Member Advisory Councils and Member Activity Meetings). Attends member meetings as needed. Facilitates system input and see process through to delivery of benefit or incentive of member, related to member benefits and incentives aligned to vendors/external parties. Interfaces with all functional area serving ABH-FL, as needed, to resolve issues or complete duties. May work closely with the appeals and grievances team when needed to resolve a member complaint. Maintains a high response rate (timely, accurate, pleasant) to the member’s and regulator’s requests. Establishes a positive rapport with all members; demonstrates helpfulness and partnership to achieve member goals. Keeps director promptly notified of priority issues or issues failing to receive proper cooperation to achieve the resolution. Exercises professionalism and quality control on all written and verbal communications to members and regulators. Maintains records of all communications, at direction of director. Ensures participation and/or leadership as needed for special projects that are specific to serving members. Required Qualifications 3+ years of experience in member advocacy, call center, health care environment, health benefits, or a Medicaid-related program. Working knowledge of Microsoft Office products (Word, Excel, PowerPoint, Outlook). Must reside in Florida.

Preferred Qualifications

Interpersonal and relational skills; patience and a customer-first disposition. Strong time management and organizational skills. Keen ability to stay adaptable and fluid in an evolving environment. Ability to take initiative and spearhead work independently. Associate’s or Bachelor’s degree. Education High school diploma or GED. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $46,988.00 - $91,800.00 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. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: 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. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 08/26/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area. Apply tot his job Apply To this Job