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.

This is a full-time telework role with 10-20% travel required.

Hours for this role are M-F 8am-5pm EST.

We are building on an exciting new team to address barriers to care in our multicultural communities and are enhancing the member experience at Aetna. Community Care is a member centric, team-delivered, community-based multicultural model that joins members where they are.

The Manager, for the team is responsible for business, and operational performance and oversees the direct supervision, guidance, and job performance of a group of Community Health Care Workers. The team serves at risk Medicare Advantage members in a new innovative community-based program. This position provides leadership and oversight of productivity and quality performance to optimize member well-being, clinical and cost-effective outcomes.

FUNDAMENTAL COMPONENTS

Provides direct supervision and guidance to a team of Community Health Care Workers in nine states. Teams are remote based throughout the States of, Florida, Georgia, New York, New Jersey, North Carolina, Ohio, Pennsylvania Illinois and Texas
Prepares, analyzes and applies pertinent data, metrics and reports to monitor and enhance quality, productivity, and assure adherence to policy and procedures
Contributes to associates on-boarding, coaching and ongoing education to build individual and team competencies and performance
Responsible for the teams administrative oversight, i.e. team meetings, time and attendance, caseload balance and associate performance
Ability to manage a remote a team and/or an office based team
Conducts individual and team quality reviews/audits as required, monitoring associate performance and adherence to documentation procedures
Provides guidance and serves as an expert resource to the care team and assists with member care management case reviews and consultations
Participates in the continuous quality improvement and actively contributes to care team best practice standards and strategies
Effectively facilitate team building and inter-disciplinary collaboration
Provides expertise and business direction to drive the effective execution of care team services through best practices
Adheres quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures
Maintains a comprehensive working knowledge of managed care, benefits and services for target population to maximize member and program outcomes

Required Qualifications:

• 5+ years of health care experience working with populations with chronic health issues
• 2+ years Supervisory or Lead experience required, preferably in a managed care environment
• Must be willing and able to travel up to 20%. Reliable transportation required. Mileage is reimbursed per our company expense reimbursement policy.
• 2+ years of Microsoft Office applications experience

Preferred Qualifications:

• Understanding of a local, community based, care management model, delivered both in person and telephonically
• Experience in managing a remote-based team
• Quality review experience
• Medicaid/Medicare experience
• Understanding diverse cultures and the ability to address barriers to care to Leadership and to the TeamMaster

Educational requirements

• Required Masters Degree in Community Health, Psychology or other relevant experience like Social Work, Nursing.

Pay Range

The typical pay range for this role is:

$78,331.50 - $168,700.00

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 a