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Associate Manager, Clinical Health Services

Aetna, a CVS Health Company

South Cook county,/Will/Kankakee Counties, IL

Experience Level
Entry-Level
Work Style
Hybrid
Opportunity Type
Full-time

Qualified candidates may be eligible for a Sign-on bonus of up to $8000.

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 Group Summary:

The dedication of talented and caring health care professionals drives the
delivery of high quality, cost effective products and services. They make it
possible for members to get the right health care treatment for their needs
– and for Aetna to keep its competitive edge.
Develop, implement, support, and promote Health Services strategies,
tactics, policies, and programs that drive the delivery of quality healthcare
to establish competitive business advantage for Aetna. Health Services
strategies, policies, and programs are comprised of utilization management,
quality management, network management and clinical coverage and
policies.

The Supervisor is responsible for oversight of LTC healthcare case management staff including the organization and development of high performing teams. Works closely with functional area managers to ensure consistency in clinical interventions supporting our members. Accountable for meeting the financial, operational and quality objectives of the unit.

Oversees the implementation of healthcare management services for
assigned functional area Implements clinical policies & procedures in
accordance with applicable regulatory and accreditation standards (e.g.
NCQA, URAC, state and federal standards and mandates as applicable)
Serve as a content model expert and mentor to the team regarding practice
standards, quality of interventions, problem resolution and critical thinking
Ensure implementation and monitoring of best practice approaches and
innovations to better address the member's needs across the continuum of
care May act as a liaison with other key business areas. May develop/assist
in development and/review new training content May collaborate/deliver
inter and intra-departmental training sessions Protects the confidentiality of
member information and adheres to company policies regarding
confidentiality Manages resources responsible for identification of members,
development and implementation of care plans, enhancement of medical
appropriateness and quality of care and monitoring, evaluating and
documenting of care Develop, initiate, monitor and communicate
performance expectations Ensures the team's understanding and use of
information system capability and functionality May have responsibility for
their own case load work May act as a single point of contact for the
customer and the Account Team including: participation in customer
meetings, implementation and oversight of customer cultural requirements,
and support implementation of new customers. Participate in the
recruitment and hiring process for staff using clearly defined requirements
in terms of education, experience, technical and performance skills
Assesses developmental needs and collaborates with others to identify and
implement action plans that support the development of high performing
teams 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 an model change agent and lead change efforts Create a positive
work environment by acknowledging team contributions, soliciting input,
and offering personal assistance, when needed Accountable for maintaining
compliance with policies and procedures and implements them at the
employee level.

Required Qualifications :

-Minimum 5 years post master’s degree clinical experience required for BH License and 5 years post bachelor's clinical experience for RN License.

– Active unrestricted State Licensure in applicable functional area. (eg RN, LCPC, LCSW) in the state of IL.

– Willing and able to travel 25-50% of their time within the South cook county, Will and Kankakee Counties and surrounding areas for field staff supervision or as needed for business needs.

-Reliable transportation required; Mileage is reimbursed per our company expense reimbursement policy.

Preferred Qualifications:

-Managed Medicare/Medicaid experience preferred.

-Previous leadership experience strongly preferred.

– Computer literacy and experience with Microsoft Excel, Word, and web-based applications.

– Ability to work with people in such a manner as to build high morale and group commitment to goals and objectives.

– Ability to evaluate and interpret data, identify areas of improvement, and focus on interventions to improve outcomes.

– Ability to communicate effectively with Providers, Members, Staff and other Leaders both in oral and written formats (e.g., may provide support to the sales staff & network staff via onsite customer visits and/or presentations).

Education:

Master's Degree required for BH License
Bachelor's Required for RN License.

Pay Range

The typical pay range for this role is:

$84,357.00 – $181,700.00

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

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 ColleagueRelations@CVSHealth.com 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.

Compensation
$84,357.00 – $181,700.00/year
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