Member Engagement Benefit Specialist

CVS Health · Orlando · $43,888–$85,068 (stated in the posting)

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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

The Member Engagement Benefit Specialist at CVS Health, you will play a critical role in supporting client satisfaction, retention, and engagement for the City of Orlando by serving as a trusted onsite representative. This field-based role focuses on delivering responsive, high-touch support to the City of Orlando benefits team and its employees, resolving issues, and building strong, collaborative relationships throughout the life of the account.

You will act as a key liaison between CVS Health and the City of Orlando, providing in-person support across City worksites, handling complex benefit and claims inquiries, and delivering education during open enrollment and health-related events. This role is ideal for someone with excellent communication skills, strong healthcare benefits knowledge, and a passion for supporting municipal employees and their families.

Primary Job Duties & Responsibilities

• Research and Resolve: Handle City of Orlando member inquiries and escalations related to benefits, claims, eligibility, pharmacy services, and policy interpretation by identifying root causes, coordinating with internal departments, and delivering timely, accurate solutions.

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• Client Relationship Management: Serve as the dedicated onsite liaison between Aetna and the City of Orlando, building strong relationships with Human Resources, Benefits Administration, labor representatives, and key stakeholders.

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• Onsite Engagement: Maintain a visible presence at City of Orlando worksites by providing real-time support to employees, retirees, and their families while delivering a high-touch service experience through accessibility and responsiveness.

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• Event Management & Representation: Plan and lead open enrollment meetings, employee information sessions, wellness events, benefit fairs, and other onsite and virtual engagements that promote awareness and understanding of available healthcare benefits and programs.

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• Reporting & Analytics: Review and interpret claims, utilization, service, and engagement data. Share insights and trends with City leadership and benefits teams to support informed decision-making and identify opportunities to improve the member experience.

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• Benefits Expertise: Maintain in-depth knowledge of City of Orlando benefit plans, eligibility requirements, provider networks, pharmacy programs, wellness offerings, and Aetna resources to serve as a trusted advisor and subject matter expert.

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• Issue Escalation & Follow-up: Partner with internal Aetna teams, including Eligibility, Claims, Pharmacy, Clinical, and Care Management, to resolve complex member issues and ensure timely follow-through and communication.

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• Compliance & Documentation: Ensure all member interactions and account activities comply with HIPAA, contractual requirements, and company policies. Maintain accurate records and documentation of member and stakeholder interactions.

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• Travel & Site Management: Regularly travel between City of Orlando worksites and designated locations. Independently manage scheduling, onsite coverage, outreach activities, and stakeholder communications.

• Provider Network Navigation: Proactively assist City of Orlando employees, retirees, and eligible dependents in identifying and selecting in-network medical, behavioral health, and pharmacy providers. Guide members through provider selection and network navigation to help maximize benefit coverage, reduce out-of-pocket costs, and improve access to care.
• Resource Advocacy: Serve as a dedicated advocate for City of Orlando members by promoting awareness and utilization of Aetna programs, digital tools, care management services, wellness initiatives, and support resources. Provide personalized guidance to help members access and fully utilize the comprehensive benefits available to them.

Success in the role

Success in this role is driven by ownership, collaboration, and service excellence. You thrive in a client-facing environment and take pride in the direct impact your work has on the City of Orlando and its employees. Indicators of success include:

• Client Trust & Retention: Building strong, trusted relationships with the City of Orlando through consistent, knowledgeable, and reliable support.
• Member Experience: Resolving employee issues efficiently and empathetically so City of Orlando members feel supported and confident in their benefits.
• Collaboration & Teamwork: Partnering effectively with internal CVS Health teams to resolve issues and continuously improve service delivery.
• Proactive Problem Solving: Identifying trends and opportunities early and taking action before issues escalate.
• Ownership & Accountability: Following through on commitments and representing CVS Health with professionalism and care.
• Visible Impact: Seeing tangible results through positive City feedback, improved service outcomes, and meaningful support of City employees.

Required Qualifications:

• 1-2 years of customer service experience
• Active Florida Health Insurance License 2-15 Life & Health or 2-40 Health Only (or ability to obtain within 120 days of hire).
• Comfortable with regular travel to City of Orlando worksites.
• Strong oral and written communication skills with a customer-first mindset.

Preferred Qualifications:

• 1–2 years of experience in health insurance, healthcare services, or client/account management.
• Familiarity with managed care processes, healthcare sales, or pharmacy benefits.
• Experience supporting municipal, public sector, or union-sponsored benefit plans
• Knowledge of managed care processes and pharmacy benefits
• Strong presentation and relationship-building skills
• Excellent organizational and time management skills; ability to manage multiple priorities simultaneously.
• Exceptional interpersonal and relationship-building skills, both internally and externally.
• Proficiency with Microsoft Office Suite (Word, Outlook, Excel).
• Must be able to work independently and exercise sound judgment in problem-solving.
• Associates Degree
• Additional healthcare, insurance, or customer service training

Education

• High School diploma or GED.

Anticipated Weekly Hours

Time Type

Pay Range

The typical pay range for this role is:

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.  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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

Additional details about available benefits are provided during the application process and on Benefits Moments.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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