Senior Manager Clinical Health Services

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.

Job Summary

This is a remote position with the Aetna Better Health of Illinois Long-Term Services and Support supporting the Long-Term Care team. Minimal travel required for onsite trainings, escalations, or meetings as needed. Qualified candidate must hold an active and unrestricted Illinois State License (RN, APN, LCSW, LCPC, LMFT) and reside in the state of Illinois.

• Develops and manages clinical operations focused on improving clinical and financial outcomes, member engagement, and satisfaction.
• Develops strategies to mitigate high cost/high need utilization of services and assist members with assuming self-management of their conditions.
• Serves as liaison with regulatory and accrediting agencies and other health business units.
• 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).
• Develops and participates in presentations and consultations to existing internal and external stakeholders and existing/prospective customers.
• Directs/provides enhancements to business processes, policies, and infrastructure to improve operational efficiency (may cross multiple business functions).
• Participates in internal and external health industry development efforts.
• 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 service operations.
• Collaborates and partners with other business areas across/within regions or segments and within other centralized corporate 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.
• Collaborates with licensed staff from other areas that assist with oversight of clinical staff and activities of licensed personnel.

Minimum Requirements

• 3+ years of experience in providing direct care management activity oversight or managed care experience.
• 5+ years' of 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 for the purpose of developing new programs and processes to meet business demands.
• Ability to synthesize program performance and clinical outcomes.

Preferred Requirements

• Long-term care experience
• Registered Nurse (RN)

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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:

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

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through [email protected] If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.