Senior Manager Clinical Health Services MLTSS - Aetna Better Health New Jersey

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.Position SummaryThe Senior Manager Clinical Health Services is a key member of the Aetna Better Health of New Jersey leadership team and is responsible for oversight and management of clinical team processes including the organization and development of high performing teams. The Senior Manager is also responsible for ensuring the functioning of care management and care coordination activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring, and evaluating). The Senior Manager reports to the Lead Principal Clinical Leader.This is a remote position. Eligible candidates may live anywhere in the contiguous United States. Position Responsibilities

• Accountable for the day-to-day management of care management teams for appropriate implementation and adherence with established practices, policies, and procedures.
• Participates in the recruitment and hiring process for staff using clearly defined requirements in terms of education, experience, technical and performance skills.
• Develops, initiates, monitors, and communicates performance expectations.
• Assesses and identifies departmental needs and collaborates with others to implement action plans that support the development of high performing teams.
• Supports the management of complex physical and behavioral health cases by being clinically and culturally competent with appropriate training and experience.
• Utilizes critical thinking and sound judgment to make informed decisions in complex and high pressure situations.
• Conducts regular leadership meetings with a focus on operational and regulatory compliance, while creating a space that promotes autonomy, accountability, and professional growth.
• Champions a leadership approach rooted in empowerment, fostering a culture where team members are encouraged to take initiative and contribute to innovative solutions.
• Provides clear, strategic direction to a multidisciplinary team of leaders and care management staff
• Guides the team in aligning their efforts with organizational goals, ensuring both individual and collective success.
• Identifies and escalates quality of care issues through established channels.
• Conducts all administrative duties in accordance with established standards for supporting and managing a team.
• Identifies opportunities to implement best practice approaches and introduce innovations to better improve outcomes.
• Ability to communicate in a highly effective manner with internal and external constituents in both written and oral format.
• Accountable for meeting the clinical operational and quality objectives of the contract.
• 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.

• Active unrestricted State License in applicable functional area. (e.g. RN , LPC, LCSW).
• 5+ years in clinical area of expertise
• 2+ years experience managing direct reports
• 3+ years care management experience including with a managed care organization
• 3+ years of experience with personal computer, keyboard navigation, and MS Office Suite applications
• Must be willing to travel for state required meetings and trainings (up to 20% travel estimated)

• Managed Care experience
• Long Term Services and Support experience
• Knowledge of the regulations, standards, and policies which relate to Medicaid Care Management
• Certified Case Manager (CCM)

• If RN: BSN preferred
• If Behavioral Health Clinician: Master's degree in behavioral health and active 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.