Aetna Member Representative/ Advocate in Princeton, New Jersey
Req ID: 45795BR
The position is dedicated to work with the health plans members and providers to facilitate the provision of benefits. The Member Advocate is responsible for making recommendations to the care management team regarding any changes needed to improve either the actual care provided to the member or the manner in which the care is delivered. The person assigned to this position must have substantial at least two  years experience in health care working with the Medicaid population preferable working with low income populations, and have demonstrated cultural sensitivity.
A full-time designated MLTSS Member Representative responsible for internal representation of the interests of MLTSS Members including but not limited to input into planning and delivery of long term services and supports, participation in QM/QI activities, assistance with program monitoring and evaluation, and provision of education to enrollees, families, and providers on issues related to the MLTSS program. The MLTSS Member Representative shall assist MLTSS Members in navigating the Aetna's system. This shall include, but not be limited to, helping MLTSS Members by providing information, making referrals to appropriate staff Members, and facilitating resolution of any issues. The MLTSS Member Representative shall make
recommendations to the MLTSS management staff on any changes needed to improve the Contractors system for MLTSS Members, and participate as an ex officio Member of Aetna's Consumer Advisory Committee. Additional responsibilities include attending interdisciplinary team meetings, attending meetings with the state of NJ, assisting members find housing, assisting members with securing community resources.
Effective telephone, oral and written communication skills. Bilingual preferred. Ability to successfully interact with members, medical professionals and health plan and government representatives. Proficiency with word processing, spreadsheet applications, database management and graphics experience. Microsoft Suite experience required. Travel to multiple counties in NJ as needed.
The highest level of education desired for candidates in this position is a Associate'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 here to review the benefits associated with this position.
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