Assoc MgrClin Health Services
CVS Pharmacy - Monmouth Junction, NJ
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Job DescriptionHours: 8:00am - 5:00 pm ESTThis is a remote position with up to 10% travel required as neededProgram Overview Help us elevate our patient care to a whole new level Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have a life-changing impact on our Dual Eligible Special Needs Plan (DSNP) members, who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members' health care and social determinant needs."¯Join us in this exciting opportunity as we grow and expand DSNP to change lives in new markets across the country. Position Summary The Associate Manager, Clinical Health Services will oversee the implementation of healthcare management services for assigned functional area. Fundamental Components Implements clinical policies & procedures in accordance with applicable regulatory and accreditation standards (e.g., NCQA, URAC, state and federal standards and mandates as applicable) Serve as a content model expert and mentor to the team regarding practice standards, quality of interventions, problem resolution and critical thinking Ensure implementation and monitoring of best practice approaches and innovations to better address the member's needs across the continuum of care May act as a liaison with other key business areas. May develop/assist in development and/review new training content May collaborate/deliver inter and intra-departmental training sessions Protects the confidentiality of member information and adheres to company policies regarding confidentiality Manages resources responsible for identification of members, development and implementation of care plans, enhancement of medical appropriateness and quality of care and monitoring, evaluating, and documenting of care Evaluate and interpret data, identify areas of improvement, and focus on interventions to improve outcomes Develop, initiate, evaluate, monitor, and communicate performance expectations Ensures the team's understanding and use of information system capability and functionality 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 Establish an environment and work style that promotes the concept of teamwork, cross product integration, and continuum of care thinking that results in strong performance Consistently demonstrates the ability to serve as a model change agent and lead change efforts Create a positive work environment by acknowledging team contributions, soliciting input, and offering personal assistance, when needed. Accountable for maintaining compliance with policies and procedures and implements them at the employee level Communicates effectively with Providers, Members, Staff and other Leaders (e.g., may provide support to the sales staff & network staff via onsite customer visits and/or presentations)Pay RangeThe typical pay range for this role is:Minimum: 78,000Maximum: 168,000Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.Required Qualifications 3+ years in clinical area of expertise. Must possess active and unrestricted RN Licensure in the state of New Jersey Must reside in the state of New Jersey Must obtain and maintain New Jersey Choice CertificationPreferred Qualifications Managed Medicare experience preferred Bilingual Preferred Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtuallyEducationRegistered Nurse (BSN preferred); and Active unrestricted State Licensure in applicable functional area. (RN); and Must obtain and maintain New Jersey Choice CertificationBusiness OverviewBring 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. 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. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
Created: 2024-09-07