National Accounts Lead Director, Clinical Program Consultant (CPC)

CVS Health•Work At Home-Connecticut, MA

22h•$100,000 - $231,540•Remote

About The Position

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. The National Accounts Lead Director, Clinical Program Consultant (CPC) serves as consultative strategic partner who reviews clinical data and trends, helps evaluate clinical program effectiveness and identifies clinical cost drivers. Analyze high-cost claimants and engage with medical directors and clinical resources as needed. Their primary goal is to make recommendations that help to improve the overall health of customer populations. The CPC leader will partner with business owners to optimize the achievement of strategic business objectives, to include profitable growth and improved organization effectiveness. You will partner with account team to make recommendations for clinical programs that help mitigate medical cost trends and optimize return on investment. Have access to a market-leading analytic platform to support identification of key cost and utilization drivers, including medical and behavioral conditions in your population.

Requirements

7+ years experience in healthcare industry, well-being, healthcare consulting, client reporting and analytics, clinical operations and business management.
Minimum 7+ years of diverse clinical and well-being experience.
Ability to lead and collaborate across teams.
Prior experience managing and/or leading teams.

Nice To Haves

Un-restricted RN/ LCSW license

Responsibilities

The Lead Director will lead a team of approximately 7-8 Clinical Program Consultants
Provide day-to-day oversight of the customer-facing work that the team of Clinical Program Consultants provide
Set priorities for that work, ensuring that appropriate resources are aligned to the needs of our Field partners and their customers
Effectively collaborate with Field leaders, making certain to understand their business retention and growth objectives and how the work of the CPCs can best support those objectives
Provide coaching and development to ensure that each team member is maximizing their potential
As needed, work directly with customers in a strategic advisory role.
Collaborates with Aetna National Accounts Field Sales and Service staff to identify customers who may best benefit from Aetna’s medical, dental, pharmacy, behavioral health, and disability clinical management programs
Proactively evaluates and analyzes medical, pharmacy, behavioral health, and disability trend drivers and proposes clinical programs and/or improvements to effectively manage these trends for their book of business
In collaboration with existing Aetna account teams, consults with clients on trends identified within their employee base and works to tailor the most effective cost management strategy possible
Seeks to maximize clinical and financial outcomes for customers from the clinical programs and/or improvements recommended
Identifies and helps rectify clinical program gaps at customers who are utilizing Aetna clinical management programs to ensure best in class clinical management of members
Manages to completion a variety of ever-changing projects and priorities during the course of the year; effectively mitigates negative outcomes that may arise due the ever changing dynamics of the market and competitive landscape
Serves as a key resource on all clinical programs to all Aetna National Accounts
Evaluate performance through regular, timely feedback to ensure delivery of exceptional services and engagement, motivation and team development