Manager, OhioRISE Clinical Health Services

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary
This is a full-time remote teleworker position in Ohio. Travel is required up to 10%% of the time to surrounding regions in Ohio, corporate office in New Albany, Ohio, or support to areas in Ohio to assist with member, stakeholder, or direct report needs. 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 OhioRISE. Health Services strategies, policies, and programs which are comprised of quality management and clinical coverage to support current and emerging policies. The Manager, Clinical Health Services is responsible for oversight and management of clinical team processes including the organization and development of high performing teams.

The Manager, Clinical Health Services is responsible for the oversight and management of clinical team processes, and the organization and development of high performing teams. Core business hours are Monday-Friday, 8AM-5PM

Position Responsibilities

• Reinforces clinical philosophy, programs, policies, and procedures.

• Communicates strategic plan and specific tactics to meet plan.

• Ensures implementation of tactics to meet strategic direction for cost and quality outcomes.

• Creates direction and communicates a business case for change by focusing on and addressing key priorities to achieve business results.

• Identifies opportunities to implement best practice approaches and introduce innovations to better improve outcomes.

• Accountable for meeting the financial, operational, and quality objectives of the unit.

• Accountable for the day-to-day management of assigned team for appropriate implementation and adherence with established practices, policies, and procedures.

• Works closely with functional area managers to ensure consistency in clinical interventions supporting our plan sponsors.

• Develop, initiate, monitor and communicate performance expectations.

• May act as a single point of contact for the customer and the Account Team which includes 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.

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

• Accountable for maintaining compliance with policies and procedures and implements them at the employee level.

• Ability to evaluate and interpret data, identify areas of improvement, and focuses on interventions to improve outcomes.
• Ability to proactive address any performance management needs for direct reports
• Ability to met or exceed KPI and business metrics for the direct team that is being managed
• Working with internal, external, and state regulatory personnel with professionalism and provide prompt remediation processes

• Some travel required per organizational needs as applicable to role and responsibilities not limited to home base office in New Albany, OH.

Required Qualifications

• Resides in Ohio
• Active Ohio unrestricted state independent licensure in applicable functional area such as RN (BSN/MA), LPCC, LPCC-S, LISW, LISW-S (Master's degree in behavioral health field
• 5+ years’ experience in clinical area of expertise
• 2+ years’ experience leading and managing large teams
• 2+ years’ experience with personal computer, keyboard, mouse, multi-system navigation; and MS Office Suite applications (i.e Outlook, Word, Excel, Sharepoint, Teams)
• Must possess reliable transportation and be willing and able to travel in the assigned region up to 10% of the time.

Preferred Qualifications

• • Managed care experience
• • Medicaid experience
• • Familiarity with QuickBase
• Remote work experience
• Experience working with children, adolescent, and young adults

Education
Active Ohio unrestricted state independent licensure in applicable functional area such as RN (BSN/MA), LPCC, LPCC-S, LISW, LISW-S (Master's degree in behavioral health field)

Work from Home Requirements:

• You must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of your computer and a minimum

download speed of 25 mbs download and 3 mbs upload.

…