Senior Manager Clinical Health Services - OhioRISE

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

The OhioRISE (Resilience through Integrated Systems and Excellence) plan is a Medicaid managed care program that provides and coordinates behavioral health care for eligible children and youth.  The Senior Manager, Clinical Health Services is responsible for the oversight and management of team processes and the organization and development of high performing teams. This position will support OhioRISE members with complex behavior health, multisystem, care coordination needs. This position will also support any additional needs of the of the Director for all lines of OhioRISE CM business.

Hours for this position are Monday-Friday 8:00am-5:00pm, may require after hours to support staff as needed.

Minimal travel required for onsite trainings, escalations, or meetings as needed.

Must have knowledge of OhioRISE Program and contractual requirements.

Candidate must reside in the state of Ohio.

Fundamental Components

• Leadership and development of high performing teams, responsible for leading people leaders, supports growth and development of colleagues, and promotes a positive work culture.
• Develops and manages clinical operations focused on improving clinical and financial outcomes, member engagement, and satisfaction.
• 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).
• 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.

Required Qualifications

• Ohio resident
• Active unrestricted OH Licensure in one of the following clinical areas: LISW, LPCC, LMFT or RN
• 5+ years' experience in clinical areas of expertise
• 2 years’ experience managing programs and multiple direct reports including other managers
• 3+ years' MCO experience to include management and oversight of behavioral health related teams and projects
• 3+ years' experience in children’s mental health, developmental disabilities, juvenile justice or a public sector human services or behavioral healthcare field, providing community-based services to children and youth, and their family/caregiver
• Must have knowledge of OhioRISE Program and contractual requirements
• Experience in one or more of the following areas of expertise: family systems, community systems and resources, case management, child and family counseling/therapy, child protection or child development
• Demonstrated willingness to be hands-on with action-oriented problem solving in a role that is demanding and requires a high level of energy and professionalism
• Demonstrated ability to promote a positive work culture and collaborate within and across departments to accomplish goals
• Demonstrated business skills including business development, business planning, and operations.
• Communicates effectively both verbally and in writing such that messages are understood; that is, understanding the essence and subtleties of the communication and