Senior Clinical Strategist
About The Position
The Senior Clinical Strategist works with assigned Aetna Medicare Provider Collaboration groups to improve clinical performance by leading clinical performance improvement projects and managing complex deliverables through implementation. Projects support population health and primarily affect Stars and quality, while also targeting improvements in utilization and cost. This is a fully remote role for candidates residing in WA, OR, ID, UT, WY, MT, NV, AZ, TX, NM, or OK. Travel of up to 25% may be required in support of Value Based Care groups. The schedule is Monday through Friday, 8 a.m. to 5 p.m., with no nights, weekends, or holidays.
Requirements
- Registered Nurse with an active, unrestricted license in the state where the candidate resides.
- At least 4 years of case management experience.
- At least 3 years of clinical experience.
- At least 1 year of leadership or supervisory experience.
- At least 4 years of Outlook experience.
- At least 4 years of Microsoft PowerPoint experience.
- At least 4 years of Microsoft Excel experience.
- At least 1 year of SharePoint experience.
Nice To Haves
- Strong communication and interpersonal skills.
- Track record of meeting project milestones and negotiating for resources.
- Proven negotiation skills.
- Proven project management skills.
- Proven success working in a matrixed environment.
- At least 1 year of managed care experience.
- Ability to create accountability, develop and execute strategy, and drive change.
- Bachelor’s degree in nursing or equivalent experience.
Responsibilities
- Build trusting relationships with provider partners to promote open communication.
- Serve as a clinical expert on actionable opportunities related to case management, gap closure, and workflow discussions, partnering with case manager supervisors, managers, and case managers.
- Serve as an internal and external liaison and clinical resource, interpreting data and educating partners on how to use it for Provider Collaboration performance improvement.
- Develop strategies with subject matter experts and clinical teams, internally and externally, to drive outcomes and improve efficiencies.
- Coordinate and conduct clinically focused meetings to identify opportunities, prioritize goals and interventions, close gaps in care, and achieve optimal Stars performance.
- Collaborate across functions and segments to obtain agreement from impacted parties, accounting for downstream and upstream effects.
- Collaborate with Engagement Managers, Local Market Team, Data Team, Medical Operations, and others on Stars and quality improvement initiatives.
Benefits
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources, based on eligibility
- Eligible for a CVS Health bonus, commission, or short-term incentive program
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What This Job Offers
Job Type
Full-time
Career Level
Senior
