Regional Clinical Manager - Aetna SKY Northern Bluegrass Region - RN or BH

CVS Health•Work At Home-Kentucky, KY

12d•$78,331 - $168,714•Remote

About The Position

The Regional Clinical Manager oversees a regional care management team of remote and field-based staff, driving high performance, accountability, and operational excellence. The role is responsible for achieving health plan goals and contractual deliverables while leading person-centered care management services for Kentucky SKY members, including youth involved in foster care and juvenile justice, children receiving adoption assistance, and members with complex behavioral health needs. The Manager collaborates with providers, community partners, and interdisciplinary care teams to help members and families receive appropriate care and support. The role oversees quality and compliance activities, monitors key performance metrics, and communicates team performance and improvement opportunities to leadership. Strong relationship-building, strategic thinking, and people leadership skills are essential. This is a remote position. Candidates must reside in the SKY Northern Bluegrass Region: Boone, Bourbon, Campbell, Carroll, Gallatin, Grant, Harrison, Kenton, Nichols, Owen, Pendleton, or Scott counties. Some regional travel is required for supervisory visits and meetings with state partners.

Requirements

Active, unrestricted Kentucky clinical license in the applicable discipline, such as RN, LPCC, or LCSW.
5–7 years of experience in the clinical area of expertise.
At least 2 years of experience managing direct reports.
Strong performance management experience, including coaching, developing, and holding team members accountable to quality, productivity, and outcome expectations.
Demonstrated experience and/or comprehensive knowledge of foster care and juvenile justice systems, adoption assistance, behavioral health services, trauma-informed care principles, adverse childhood experiences (ACEs), crisis intervention services, and evidence-based practices relevant to Kentucky SKY members and their families.
Experience using data and performance metrics to drive operational improvements, achieve contractual deliverables, and improve member outcomes.
Experience building collaborative relationships with providers, state agencies, community organizations, and interdisciplinary care teams.
For Behavioral Health candidates: a master's degree in a field leading to independent Behavioral Health licensure.
For Registered Nurse candidates: a master's degree or equivalent experience; MSN preferred.
Equivalent experience may be used under CVS policy: candidates with an associate’s degree need 4 additional years of experience; candidates with a bachelor’s degree need 2 additional years of experience.

Nice To Haves

Demonstrated change management experience, including successfully leading teams through organizational and operational change.
Advanced problem-solving and critical-thinking skills, with the ability to identify barriers, develop solutions, and drive results.
Advanced collaboration and relationship-building skills to engage providers, community partners, state agencies, and cross-functional teams.
For Registered Nurse candidates, an MSN is preferred.

Responsibilities

Oversee a regional care management team of remote and field-based staff.
Drive team performance, accountability, and operational excellence.
Achieve health plan goals and contractual deliverables.
Lead person-centered care management services for Kentucky SKY members and their families.
Collaborate with providers, community partners, and interdisciplinary care teams.
Oversee quality and compliance activities.
Monitor key performance metrics and communicate team performance and improvement opportunities to leadership.
Conduct regional supervisory visits and attend meetings with state partners.