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CVS Health

LTSS Medical Director Aetna Better Health of Kansas

Hays, KS

Job Description
Aetna Better Health of Kansas is looking for an LTSS (long-term services and supports) clinical officer / medical director to join our team. This physician directs healthcare services for individuals of any age with physical, intellectual, and/or developmental disabilities.

The LTSS CO / MD oversees and is responsible for all primary physical and behavioral health services provided to individuals receiving LTSS, and to comparable populations enrolled in KanCare, as well as all clinical activities pertaining to the operation of LTSS programs and services, including preventive care and the management and coordination of primary and other physical health services for these members.

The LTSS CO / MD is also responsible for working with the CMO, behavioral health medical director, pharmacy director, and behavioral supports director to ensure integration of physical and behavioral health services and supports and LTSS, as applicable, for individuals in each of these populations, and to oversee quality improvement initiatives regarding behavioral supports and the appropriate use of psychotropic medications in these individuals.

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The LTSS Medical Director would ideally live in the state of Kansas or be willing to relocate to Kansas and obtain a Kansas medical license.

Responsibilities:

Perform daily review of individual cases from concurrent review and prior authorization processes, including denial decisions for cases that do not meet established evidence- based criteria Conduct daily hospital admission and complex discharge rounds.

Direct LTSS population activities, including evaluating the need for these services and ensuring collaboration among providers.

Conduct peer to peer discussions as well as perform high dollar deep dive reviews.

Participate in QM/UM monthly meetings as well as provide
medical review and support for case management and care coordination staff to ensure optimal care is rendered to our members according to the terms of the benefit members receive.

Identify opportunities to implement best practice approaches and introduce innovations to better improve outcomes.

Assess developmental needs and collaborate with others to identify and implement action plans that support the development of high performing teams.

Consistently demonstrate the ability to serve as a model change agent and lead change efforts.

Be responsible for maintaining compliance with policies and procedures and implement them at the employee level.

Reinforce clinical philosophy, programs, policies, and procedures.

Evaluate and interpret data, identify areas of improvement, and focus on interventions to improve outcomes.

Pay Range
The typical pay range for this role is:
Minimum: 169,000
Maximum: 364,000

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 addition to the base pay range listed above. This position also includes an award target in the company's equity award program.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit
jobs.CVSHealth.com/benefits

Required Qualifications
Experience with the long-term special services (LTSS) management is required.

Specialty in Geriatrics is preferred with Five (5) years of experience in clinical practice/health care industry.

Education: The minimum level of education desired for candidates in this position is an M.D. or D.O. License and

Certifications: M.D. or D.O., Board Certification in an ABMS or AOA recognized specialty, including post-graduate direct patient care experience.

Active and current Kansas State medical license without encumbrances (must obtain if do not currently have)

Preferred Qualifications
Medicaid managed care experience preferred.

Education
MD/DO

Business Overview
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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

Client-provided location(s): Kansas, USA
Job ID: CVS-2467650BR
Employment Type: Other

Perks and Benefits

  • Health and Wellness

    • Health Insurance
    • Dental Insurance
    • Vision Insurance
    • Life Insurance
    • HSA
    • HSA With Employer Contribution
    • Pet Insurance
    • Mental Health Benefits
  • Parental Benefits

    • Fertility Benefits
    • Adoption Assistance Program
    • Family Support Resources
  • Work Flexibility

    • Flexible Work Hours
    • Remote Work Opportunities
    • Hybrid Work Opportunities
  • Vacation and Time Off

    • Paid Vacation
    • Paid Holidays
    • Personal/Sick Days
  • Financial and Retirement

    • 401(K) With Company Matching
  • Professional Development

    • Tuition Reimbursement
  • Diversity and Inclusion

    • Employee Resource Groups (ERG)
    • Diversity, Equity, and Inclusion Program

This job is no longer available.

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