Senior Clinical Strategist

Job DescriptionFully remote role with requirement to reside in either New York state, Northern New Jersey, or Southern Connecticut.Travel up to 25% possible in support of VBC groups. Schedule is Monday - Friday EST standard business hours. No nights, no weekends and no holidays.The Senior Clinical Strategist works with assigned Aetna Medicare Provider Collaboration groups to drive improved performance by leading clinical performance improvement projects and managing multiple complex deliverables through to implementation. Projects will support population health and will primarily impact Stars and quality but will also focus on improvements in utilization and cost. The Senior Clinical Strategist works to drive clinical performance of assigned Medicare Provider Collaboration groups by: - Establishing trusting relationships with provider partners to promote open communication- Serving as clinical expert on actionable opportunities related to CM, gap closure, workflow discussions, and partnering with case manager supervisor/manager and CMs- Serving as internal and external liaison and clinical resource, interpreting data and educating regarding how to utilize data for PC performance improvement-Strategizing with SMEs and clinical teams both internally and externally to drive outcomes and improve efficiencies-Coordinating and conducting clinically focused meetings to identify opportunities target and prioritize goals and interventions to close gaps in care and achieve optimal stars performance -Collaboratively working across multiple functions and/or segments to obtain agreement from all impacted parties ( e.g., up and downstream effects often impact multiple functions and/or segments)- Collaborating with Engagement Managers, Local Market Team, Data Team, Medical Operations and others on initiatives for Stars/quality improvementRequired Qualifications- Registered Nurse with active and unrestricted license in the state the candidate resides-4+ years of case management experience-3+ years clinical experience-1+ year leadership or supervisory experience Technology Experience:- 4+ years of Outlook experience - 4+ years of Microsoft Power Point experience- 4+ years of Microsoft Excel experience- 1+ years of SharePoint experienceCOVID 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-Strong communication and interpersonal skills.-Proven track record in meeting project milestones and -negotiating for resources.-Proven negotiation skills.-Proven project management skills.-Proven success while working in a matrixed environment.-1+ year managed care experience- Creating accountability, developing and executing strategy and driving changeEducationBachelor's degree requiredBusiness 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: 2024-11-02