Associate Manager, Clinical Health Services
2 weeks ago
Bring 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.
**Job Title** Associate Manager, Clinical Health Services
**Program 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 life-changing impact on our **Fully Integrated Dually Eligible Plan** (FIDE plan) 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 markets across the country.
**Position Summary**
The Associate Manager of Clinical Health Services will oversee the implementation of healthcare management services for their 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 or participate in staff observation in the field.
- 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
- Communicate 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)
**Background Experience**
- Minimum of 4 years experience serving enrollees with special needs
- Managed Medicare experience preferred
- Bilingual Preferred
- Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
**Education and Certification Requirements**
- Bachelor’s Degree in Nursing; and
- Active unrestricted NJ State Licensure (RN)
- New Jersey Residency Preferred
**Pay Range**
The typical pay range for this role is:
$84,357.00 - $181,700.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addit
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