Manager Health Services
CVS Pharmacy - Newark, DE
Apply NowJob Description
Job DescriptionNormal working hours are 8:00am-5:00pm EST. There are no evenings, weekends or holidays expected with this role.There is minimal travel expected with this role.Candidates can apply from any state as the position is remote. There are no direct reports in this role.The Manager of Health Services will support all aspects of Commercial Care Management (FI Core, Aetna One Essentials, Specialty, etc.) and serves as a resource and content expert to team members regarding performance improvement methods and standards, quality, problem resolution, and critical thinking. The Manager of Health Services provides day to day oversight and leadership to ensure continuous improvement of team processes and resources, and performance management including turn-around-time reporting and audit support. The position requires expert knowledge of policy and procedures, workflow, and applicability to plan sponsors and integrated models. This includes an in depth understanding of all areas of Commercial Care Management to include both fully and self-insured lines of business, and a functional knowledge of the clinical support role. The Manager of Health Services role includes (but is not limited to):-Responsible for the development, implementation, and ongoing monitoring of program initiatives to address the needs of members who are receiving services along the continuum of care. -Collaborate with various business partners across the organization to support new and ongoing CCM initiatives-Ability to focus, engage, and manage multiple workstreams across the CCM spectrum-Support professional development of staff: Identifies training needs through observation, audit results and evaluation of reports, and collaborates to ensure development and implementation of training programs as needed.-Participates in Enterprise efforts (such as Clinical Platform processes, Utilization Management and Clinical Program Design, etc.) representing Commercial Care Management operational considerations -Presents findings and recommended clinical actions to Commercial Care Management leadership and works collaboratively to resolve issues and improve performance and clinical outcomes -Drives and tracks progress of initiatives-Ability to facilitate gathering of business requirements, and to articulate for use with analytic and technology teams-Executive presence, demonstrated proficiency in team leadership and motivation-Models the Aetna values-Well organized, strong communicator with a variety of audiences to include Senior and Executive leadership-Supportive of a positive work environment and teamwork-Strong data analysis and clinical skills with the ability to utilize data to as a tool to assist in tracking and trending clinical outcomes and clinical information.-Strong ability to function independently and identify the necessary resources to support the customer. -Strong understanding of clinical decision support platforms, electronic medical record, and other technologies and data sources used by Commercial Care Management Operations-Excellent oral communication skills, both in small group meetings and in large meetings of 50 or more persons, including the ability to prepare and present effective and compelling power point slides.-Excellent writing skills, including the ability to prepare high quality written reports from diverse materials and inputs.-Ability to work collaboratively and consultatively with executive level customers.-Ability to effectively prioritize and execute tasks in a high-pressure environment based on changing priorities.Required Qualifications-RN with current unrestricted state licensure required-5 years clinical practice as an RNCOVID RequirementsCOVID-19 Vaccination RequirementCVS 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.Preferred Qualifications-BSN-Certified Case Manager (CCM)-Experience with ATV/ASD-Experience utilizing pivot tables within MS Excel-Ability to communicate effectively with Providers, Members, Staff, and other Leaders both in oral and written formats-Ability to evaluate and interpret data, identifies areas of improvement-Time efficient and highly organized-Exceptional communication skills-Ability to mentor and support staff to meet business needs-Proficient computer skills which includes navigating multiple systems and keyboarding-Experience utilizing Microsoft Office SuiteEducationAssociate Degree in NursingBusiness OverviewBring your heart to CVS HealthEvery 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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
Created: 2024-09-07