CVS Health-posted 3 months ago
$95,738 - $206,206/Yr
Full-time • Senior
Work at Home, NY
5,001-10,000 employees
Ambulatory Health Care Services

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Fully remote role with requirement to reside in the state of New York, New Jersey. 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.

  • 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
  • Collaborating with Engagement Managers, Local Market Team, Data Team, Medical Operations and others on initiatives for Stars/quality improvement
  • Registered Nurse with active and unrestricted license in state the candidate resides
  • 4+ years of case management experience
  • 3+ years clinical experience
  • 1+ year leadership or supervisory experience
  • 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 change
  • Affordable medical plan options
  • 401(k) plan (including matching company contributions)
  • Employee stock purchase plan
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
  • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility
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