Aetna Medicare Dual-Eligible Outreach Specialist in Sunrise, Florida

Req ID: 44765BR

No Telework; Candidate is expected to work full time from the Sunrise, FL office.


Medicare is a high growth and fast moving segment within Aetna. The Medicare Dual-Eligible Outreach Specialist is part of the Florida Medicare Operations team located at the health plan in Sunrise, Florida. As a member of the Medicare Operations Team, you will be responsible for providing outreach services to Medicare members to educate and assist them in applying for state and/or federal government programs.

Fundamental Components:

-Conducts outreach to members and provides assistance to apply for state and federal government benefit programs

-Assists members with the completion of applications to ensure all eligible benefits are received

-Gathers and submits the required documentation to the appropriate government office

-Obtains Authorization to Represent form to complete and submit the applications on behalf of the member

-Provides follow-up on all pending applications to ensure timely processing.

-Offers guidance to members on how to proceed with other government programs that may be available

-Maintains individual production levels and quality goals on a consistent basis

-Adherers to compliance within CMS guidelines.

-Performs other duties as required.


3+ years Customer Service Experience is REQUIRED.

Call center experience is preferred.

Dual-Eligible Medicare, Medicaid, and managed care experience is preferred.

Health insurance HMO experience is preferred.

-Knowledge of the Medicare Savings and Low Income Subsidy programs

-Ability to understand the needs of the dual-eligible population

-Excellent verbal and written communication skills

-Bi-lingual English/Spanish fluency


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


-Independent thinker who can work with minimal supervision

-Attention to detail, accuracy, and the ability to proof-read documents to ensure compliance with government requirements

-Strong analytical, critical thinking, and problem-solving skills

-Experience working in a matrix environment

-Thorough understanding of Medicare and CMS regulations.

-Business and/or data analytics

-College degree in Health Care Administration, Business, Finance, or a related field from an accredited college or university preferred

-Microsoft Office Suite to include: Access, Word, Excel, Outlook, PowerPoint, SharePoint

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.

Job Function: Customer Service