Manager, Clinical Health Services - Aetna Better Health of WV - RN or BH

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.Business Overview:
The Aetna Better Health of West Virginia (ABHWV) plan has a successful, 26+ year history of partnering with the State to provide West Virginia's Medicaid population with top notch health care coordination and service. The plan also has been chosen to provide care coordination to complex foster care children of the state. Through a strong, localized team, an innovative care management model, and creative provider and community advocacy partnerships, ABHWV has successfully assisted the State in achieving high quality standards and outcomes for the Medicaid population across the state. The health plan truly embodies the commitment of West Virginian's helping West Virginian's. At ABHWV, you can be the very best you can be working with strong teams committed to helping our members and with opportunities for career growth. We will support you all the way!

Position Summary:

This is a full-time remote teleworker position based in West Virginia. The role may require up to 25% travel, primarily within the Central Region of the state.

Qualified candidates must be residents of West Virginia, with their home located in or near the Central Region-specifically within 60 miles of one of the following counties: Gilmer, Calhoun, Roane, Kanawha, Clay, Braxton, Fayette, Nicholas, or Webster.The Manager, Clinical Health Services is responsible for the oversight and management of clinical team processes, and the organization and development of high performing teams. Core business hours are Monday-Friday, 8AM-5PM.Fundamental Components

• Reinforces clinical philosophy, programs, policies, and procedures.
• Communicates strategic plan and specific tactics to meet plan.
• Ensures implementation of tactics to meet strategic direction for cost and quality outcomes.
• Creates direction and communicates a business case for change by focusing on and addressing key priorities to achieve business results.
• Identifies opportunities to implement best practice approaches and introduce innovations to better improve outcomes.
• Accountable for meeting the financial, operational, and quality objectives of the unit.
• May be accountable for the day-to-day management of teams for appropriate implementation and adherence with established practices, policies, and procedures if there is not supervisor position.
• Works closely with functional area managers to ensure consistency in clinical interventions supporting our plan sponsors.
• Develop, initiate, monitor, and communicate performance expectations.
• May act as a single point of contact for the customer and the Account Team which includes participation in customer meetings, implementation and oversight of customer cultural requirements, and support implementation of new customers.
• Participate in the recruitment and hiring process for staff using clearly defined requirements in terms of education, experience, technical and performance skills.
• Assesses developmental needs and collaborates with others to identify and implement action plans that support the development of high performing teams.
• Consistently demonstrates the ability to serve as a model change agent and lead change efforts.
• Accountable for maintaining compliance with policies and procedures and implements them at the employee level.
• Ability to evaluate and interpret data, identify areas of improvement, and focuses on interventions to improve outcomes.

• Resides in WV, within the Central region
• Active WV unrestricted state licensure in applicable functional area such as RN, LICSW, LPC, LMFT, and LGSW.
• 5+ years' experience in clinical area of expertise
• 2+ years' experience leading and managing teams
• 2+ years' experience with personal computer, keyboard, mouse, multi-system navigation; and MS Office Suite applications (Outlook, Word, Excel, SharePoint, Teams), Dynamo and EMR.
• Experience or detailed knowledge of the foster care and juvenile justice systems, adoption assistance, the delivery of behavioral health services, trauma-informed care, ACEs, Crisis Intervention Services, and evidence-based practices.
• Must possess reliable transportation and be willing and able to travel in the assigned region up to 25% of the time. Mileage is reimbursed per our company expense reimbursement policy.

• Managed care experience
• Medicaid experience
• Familiarity with QuickBase
• Certified Case Manager (CCM) certification

• RN: BSN preferred
• Behavioral Health Clinician: Master's degree in behavioral health and active clinical license required

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an 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.