Medicare Strategic Solutions Team: Problematic Caller and Escalations • Sr. Service Advocate
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
Position Summary
Are you driven to make a meaningful impact while navigating complex and high-stakes situations? Do you excel in environments that demand resilience, empathy, and strategic thinking? If so, we invite you to join our Strategic Solutions Team as a Senior Service Advocate, where your expertise will directly contribute to protecting our colleagues and ensuring our most challenging members receive appropriate service.
About The Role
Certain Medicare members exhibit a consistent pattern of inappropriate or abusive behavior. These interactions require specialized handling to protect our teammates while maintaining high standards of service. As a Senior Service Advocate on the SST, you will be at the forefront of this mission, managing inbound and outbound interactions with problematic callers and supporting executive-level escalations.
Key Responsibilities
• Handle inbound calls from members flagged for abusive or problematic behavior, ensuring minimal exposure of frontline colleagues to inappropriate conduct.
• Make outbound calls to follow up on escalated or unresolved issues involving high-risk members.
• Conduct in-depth research and root cause analysis to resolve complex issues and prevent recurrence.
• Participate in unique project opportunities that have a direct impact on business operations and member satisfaction.
• Exercise intestinal fortitude and emotional resilience when dealing with highly abusive or inappropriate callers.
• Collaborate with leadership and cross-functional teams to identify trends and recommend process improvements.
• Support executive-level escalations and contribute to strategic initiatives aimed at improving member and colleague experiences.
• Coordinate closely with corporate security and key leadership to manage sensitive member interactions and ensure appropriate handling.
What We Offer
• A mission-driven team focused on protecting our colleagues and improving member outcomes.
• Opportunities to work on high-impact projects and executive escalations.
• A supportive environment that values your resilience, judgment, and strategic thinking.
• Comprehensive training and ongoing support to ensure your success.
Schedule Expectations
• Flexible availability required between 8:00 AM – 11:00 PM EST, including weekends from October 1st to March 31st.
• Potential compensation for working during designated premium hours.
Required Qualifications
• 1+ years of Medicare benefits and system knowledge.
• 1+ years of experience in GPS systems or similar operational environments.
• Exceptional communication and de-escalation skills.
• Proven ability to manage high-pressure interactions with professionalism and empathy.
• Strong problem-solving skills with demonstrated ownership and accountability.
• Experience handling executive-level escalations or high-risk member interactions.
• Intermediate proficiency in Windows-based applications and online communication tools.
• Resilience and emotional intelligence in handling abusive or inappropriate behavior.
Preferred Qualifications
• Prior experience in customer service, care coordination, or a related field is a plus.
• Proven leadership skills.
• Demonstrate ability to de-escalate situations.
• Effective communication and documentation skills.
• Ability to quickly learn new skills and apply them.
• Demonstrated skills to multitask and problem solve.
Education
High School diploma, G.E.D. or equivalent experience.
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The Typical Pay Range For This Role Is
$18.50 - $35.29
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.
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 th
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Position Summary
Are you driven to make a meaningful impact while navigating complex and high-stakes situations? Do you excel in environments that demand resilience, empathy, and strategic thinking? If so, we invite you to join our Strategic Solutions Team as a Senior Service Advocate, where your expertise will directly contribute to protecting our colleagues and ensuring our most challenging members receive appropriate service.
About The Role
Certain Medicare members exhibit a consistent pattern of inappropriate or abusive behavior. These interactions require specialized handling to protect our teammates while maintaining high standards of service. As a Senior Service Advocate on the SST, you will be at the forefront of this mission, managing inbound and outbound interactions with problematic callers and supporting executive-level escalations.
Key Responsibilities
• Handle inbound calls from members flagged for abusive or problematic behavior, ensuring minimal exposure of frontline colleagues to inappropriate conduct.
• Make outbound calls to follow up on escalated or unresolved issues involving high-risk members.
• Conduct in-depth research and root cause analysis to resolve complex issues and prevent recurrence.
• Participate in unique project opportunities that have a direct impact on business operations and member satisfaction.
• Exercise intestinal fortitude and emotional resilience when dealing with highly abusive or inappropriate callers.
• Collaborate with leadership and cross-functional teams to identify trends and recommend process improvements.
• Support executive-level escalations and contribute to strategic initiatives aimed at improving member and colleague experiences.
• Coordinate closely with corporate security and key leadership to manage sensitive member interactions and ensure appropriate handling.
What We Offer
• A mission-driven team focused on protecting our colleagues and improving member outcomes.
• Opportunities to work on high-impact projects and executive escalations.
• A supportive environment that values your resilience, judgment, and strategic thinking.
• Comprehensive training and ongoing support to ensure your success.
Schedule Expectations
• Flexible availability required between 8:00 AM – 11:00 PM EST, including weekends from October 1st to March 31st.
• Potential compensation for working during designated premium hours.
Required Qualifications
• 1+ years of Medicare benefits and system knowledge.
• 1+ years of experience in GPS systems or similar operational environments.
• Exceptional communication and de-escalation skills.
• Proven ability to manage high-pressure interactions with professionalism and empathy.
• Strong problem-solving skills with demonstrated ownership and accountability.
• Experience handling executive-level escalations or high-risk member interactions.
• Intermediate proficiency in Windows-based applications and online communication tools.
• Resilience and emotional intelligence in handling abusive or inappropriate behavior.
Preferred Qualifications
• Prior experience in customer service, care coordination, or a related field is a plus.
• Proven leadership skills.
• Demonstrate ability to de-escalate situations.
• Effective communication and documentation skills.
• Ability to quickly learn new skills and apply them.
• Demonstrated skills to multitask and problem solve.
Education
High School diploma, G.E.D. or equivalent experience.
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The Typical Pay Range For This Role Is
$18.50 - $35.29
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.
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 th
Apply tot his job
Apply To this Job