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Experienced Health Concierge (Remote) - Delivering Personalized Healthcare Services with Compassion and Empathy

Remote, USA Full-time Posted 2025-11-03

About CVS Health

CVS Health is a leading healthcare company that is dedicated to delivering enhanced human-centric healthcare for a rapidly changing world. Our purpose is to bring our heart to every moment of your health, and we strive to make healthcare more personal, convenient, and affordable. At CVS Health, we believe that our employees are the heart of our organization, and we are committed to empowering them to make a meaningful impact in the lives of our customers.

Job Summary

We are seeking an experienced Health Concierge to join our team. As a Health Concierge, you will be the face of Aetna, providing targeted, personalized service to our members based on a holistic view of their needs, benefits, health information, and engagement. You will handle customer service inquiries and problems via telephone, internet, web-chat, or written correspondence, and engage, consult, and educate members to help guide them along a clear path to care.

Key Responsibilities

  • Handles customer service inquiries and problems via telephone, internet, web-chat, or written correspondence.
  • Engages, consults, and educates members based on their unique needs, preferences, and understanding of Aetna plans, tools, and resources.
  • Utilizes resources to assist customers in understanding components of the Aetna products, including claims, accumulators, usage, and balances, and cost sharing.
  • Answers questions and resolves issues as a "single-point-of-contact" based on phone calls, plan sponsors, PSS/ISO, members, and providers.
  • Provides customized interaction based on customer preference and individualized needs, creating an emotional connection with our members.
  • Builds a trusting and caring relationship with members, anticipating their needs and providing related information to answer unasked questions.
  • Uses customer service threshold framework to make financial decisions to resolve member issues.
  • 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.
  • Utilizes all relevant information to effectively influence member engagement.
  • Takes immediate action when confronted with a problem or made aware of a situation, taking ownership of each customer contact to resolve their issues and connect them with additional services as appropriate.
  • Identifies member needs beyond the initial inquiry by answering the unasked questions, resolving issues without or with limited management intervention.
  • Provides education to members to support them in managing their health, responding quickly to meet customer needs and resolve problems while avoiding overcommitting.
  • Processes claim referrals, new claim hand-offs, and escalates issues as appropriate through the system for grievances and appeals.
  • Initiates out-reach/welcome calls to ensure constituents' expectations are met or exceeded.
  • 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.
  • Partners with other departments to deliver client-specific presentations.
  • Coordinates efforts both internally and across departments to successfully resolve service issues and develop process improvement intended to enhance the overall delivery of service.
  • Works collaboratively with colleagues to deliver the best customer experience, seeking to understand the customer, including circumstances, problems, expectations, and needs.
  • Asks probing questions to identify the underlying customer needs, appropriately transitioning conversations to explore possibilities for extending customer interactions.
  • Guides members to the appropriate health resource, offering alternatives where appropriate, and acting with the best interest of the customer in mind and central to all interactions.
  • Collaborates with colleagues and co-workers to deliver a world-class customer experience, serving as a Subject Matter Expert (SME) providing technical assistance when needed on call-related issues, products, and/or system applications delivery matters.
  • May participate in preparation and presentation of client-specific presentations, track and trend data, coach, train, and assist in the development of call center staff, as required.
  • Participates in and/or leads special projects/initiatives addressing service issues, as necessary, and provides technical or subject matter expertise concerning policies, procedures, and function-related applications/systems tools as needed.
  • Delivers internal quality reviews and provides appropriate support in third-party audits when required.
  • Documents and tracks all contacts, events, and outcomes with clients using appropriate systems and processes.

Essential Qualifications

  • Customer Service experience in a transaction-based environment such as a call center or retail location, demonstrating ability to be empathetic and compassionate.
  • Effective organizational skills and ability to manage multiple tasks.
  • Effective communication skills, both verbal and written.
  • Ability to sit anywhere in the US but will be working Central Time Zone.

Preferred Qualifications

  • Microsoft Office Suite.

Education

High School Diploma Plus Experience Required. Bachelor's preferred.

Compensation

The typical pay range for this role is $17.00 - $28.46. 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.

Benefits

CVS Health offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long-term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year.

Career Growth Opportunities and Learning Benefits

CVS Health is committed to the growth and development of our employees. We offer a range of training and development opportunities, including on-the-job training, coaching, and mentoring. We also provide opportunities for advancement and career growth, both within the company and across the industry.

Work Environment and Company Culture

CVS Health is a dynamic and fast-paced work environment that is committed to delivering exceptional customer service. We value diversity, equity, and inclusion, and we strive to create a workplace culture that is inclusive and respectful of all employees. We offer a range of benefits and perks, including flexible work arrangements, employee recognition programs, and community involvement opportunities.

How to Apply

If you are a motivated individual ready to contribute to a thriving team, we encourage you to apply now! We are excited to review your application.

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