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
Candidates must reside within 50 miles of Hartford, Connecticut.
The Plan Sponsor Liaison [PSL] will serve as the Single Point of Contact for Aetna Medicare Advantage servicing to our Plan Sponsors human resources personnel [their TPA's, Brokers and Consultants] in additional to all Aetna back-office teams. The Plan Sponsor Liaison will work onsite at the customer's location in Hartford, Connecticut. Controls daily communication between departments or individual policyholders regarding benefit plan administration. Directs workflow to respond, manage, and resolve escalated and complex global issues for Claims/Calls, PSS, and health plan back-office operations. The PSL role has responsibility for a random ID card quality review, standard customization requests and updates to the Plan Sponsor Profile Pages for their book of business.
A Brief Overview
Controls daily communication between departments or individual policyholders regarding benefit plan administration. Directs workflow to respond, manage, and resolve escalated and complex global issues for Claims/Calls, PSS, and health plan back-office operations. The Plan Sponsor Liaisons serve as primary liaison between Plan Sponsors, their TPA's, Brokers, Consultants, Aetna Medicare Account Management Team, Aetna Commercial Account Management Teams and back-office departments regarding benefit plans, eligibility, claims, billing, and general benefit plan administration.
What you will do
- Assists with establishing and implementing results-based programs and innovative initiatives for the Plan Sponsors, under general supervision.
- Applies in-depth knowledge of the Plan Sponsor / back-office areas to offer feedback for decisions and innovation strategies that enhance organizational growth, visibility, member retention and customer satisfaction and trust.
- Examines escalated member-specific issues and/or broader plan administration matters as the single point of contact to provide swift resolution.
- Develops complex customer service account management plans for each account and implements plan for both new and existing accounts.
- Coordinates service delivery of new and existing accounts by attending implementation planning/process meetings.
- Responsible for ID card Quality, timeliness, and Performance Guarantee for assigned book of business.
- Responsible for Plan Sponsor Profile Page, supports Group Contact Center of Excellence for projects, workflow support and projects to enhance the member experience and customer satisfaction.
- Assists with Member Open Enrollment Meetings and customer site visits.
- Proactively identify and surface customer and plan issues for resolution while acting as a liaison to communicate workflow results, ideas, and solutions.
- Proactively resolve issues with account managers, sales representatives, and other Aetna back-office teams as appropriate.
- Identifies most urgent business problems, obtains necessary information, accurately identifies root causes, and generates solutions. Initiates and maintains partnerships with others throughout the organization. Encourages cooperation by promoting common goals and building trust. Inspires, supports, and initiates cross-functional activities
Required Qualifications
- Candidates must reside within 50 miles of Hartford, Connecticut
- 3 years experience in Group Medicare Business and Medicare Advantage Plans and Products
- Strong Leadership and Communication skills [verbal, written and / or presentation]Critical thinking, problem solving and decision-making skills
- Demonstrate prior experience in consultative skills and the ability to influence constituents for positive outcomes and initiatives
- Customer Service experience required
- Working knowledge of execution and delivery (planning, delivering, and supporting) skills Working knowledge of business intelligence Ability to work with cross-functional business units and vendors to support the customer’s needs; promotes collaboration among constituents and represents a professional image of the company
Preferred Qualifications
- Strong project management skills are strongly preferred
- Claim adjudication knowledge is strongly preferred
- Adept at growth mindset (agility and developing yourself and others) skills 5-7 years work experience
Education
- Bachelor's degree preferred/specialized training/relevant professional qualification.
We support a hybrid work environment. If selected and you live near a suitable work location, you may be expected to comply with the hybrid work policy. Under the policy, all hires for in-scope populations should be placed into a hybrid or office-based location, working onsite three days a week.
Aetna Service Operations office/hub locations will be discussed with the selected candidate.
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$46,988.00 - $112,200.00This 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: 01/30/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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What We Do
CVS Health is the leading health solutions company that delivers care in ways no one else can. We reach people in more ways and improve the health of communities across America through our local presence, digital channels and our nearly 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses and nurse practitioners. Wherever and whenever people need us, we help them with their health – whether that’s managing chronic diseases, staying compliant with their medications, or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day.
