Senior Manager Clinical Health Services - Aetna Better Health IL

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

This is a remote position. Candidate must reside in IL.

Minimal travel may be required for onsite trainings or meetings as needed.

Qualified candidate must hold an active and unrestricted Clinical License in IL.

• Develops strategies to mitigate high cost/high need utilization of services.

• Serves as liaison with other key business areas.

• Formulates and implements strategy for achieving applicable department/unit metrics and provides operational direction.

• Serves as technical, professional, and business resource (may cross multiple business functions).

• Directs/provides enhancements to business processes, policies, and infrastructure to improve operational efficiency (may cross multiple business functions).

• Evaluate and interpret data, identify areas of improvement, and focus on interventions to improve outcomes

• Develops, implements, and evaluates policies and procedures, which meet business needs (may cross multiple business functions).

• Implements and monitors business plan and oversees any implementations or business transitions impacting UM operations.

• Collaborates and partners with other business areas to ensure all workflow processes and interdependencies are identified and addressed on an on-going basis.

• Promotes a clear vision aligned with company values and direction; sets specific challenging and achievable objectives and action plans; motivates others to balance customer needs and business success; challenges self and others to look to the future to create quality products, services, and solutions.

• Establish an environment and work style that promotes the concept of teamwork, cross product integration, and continuum of care thinking that results in strong performance

• Consistently demonstrates the ability to serve as a model change agent and lead change efforts

• Create a positive work environment by acknowledging team contributions, soliciting input, and offering personal assistance, when needed

• Communicate effectively with Providers, Members, Staff and other Leaders

Required Qualifications

• Must have active, current and unrestricted Licensure in state of residence (LCSW, LCPC, RN, LMFT)

• 3+ years of experience as a licensed clinician

• 3+ years of Managed Care experience

• Ability to travel minimally as needed (up to 25%)

Preferred Qualifications

• Prior management or clinical leadership experience.

• Ability to communicate in a highly effective manner with internal and external constituents in both written and oral format.

• Ability to evaluate and interpret data

• Ability to synthesize program performance and clinical outcomes.

• Experience with LTSS and/or HCBS

• Long-term care experience

• Registered Nurse (RN)

Education

• Bachelor's' degree required for RN license or master's degree in social services/clinical counseling for BH License.

Pay Range

The typical pay range for this role is:

$105,446.25 - $227,100.00

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.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 07/29/2024