About CVS Health and Aetna Better Health Louisiana
CVS Health is a leading health care company that is committed to delivering enhanced human-centric health care for a rapidly changing world. Our purpose is to bring our heart to every moment of your health, and we strive to make health care more personal, convenient, and affordable. Aetna Better Health Louisiana is a part of CVS Health, and we are dedicated to providing high-quality care management services to our members in Louisiana. We are seeking a highly skilled and experienced Director of Care Management to lead our clinical operations and drive business success in this dynamic and growing organization.
Job Summary
The Director of Care Management will oversee the implementation and on-going execution of the strategic and operational business plan for our clinical operations, inbound/outbound call queue, implementation, and/or plan sponsor operations. This role will coordinate business segment policies and procedures in support of financial, operational, and service requirements. The successful candidate will lead a clinical team that supports timely Health Risk Screenings, Comprehensive Assessments, Care Plan development, and Enrollee interventions in accordance with the State contracts. This position requires a strong and diverse skillset in relevant areas to drive success, and we are looking for a passionate and experienced leader to join our team.
Key Responsibilities
- Lead a clinical team that supports timely Health Risk Screenings, Comprehensive Assessments, Care Plan development, and Enrollee interventions in accordance with the State contracts.
- Develop and manage clinical operations focused on improving clinical and financial outcomes, member engagement, member satisfaction, and use of best practices and standards.
- Serve as liaison with regulatory and accrediting agencies and other health business units.
- Formulate and implement strategies for achieving applicable department/unit metrics and provide operational direction.
- Responsible for cross-functional integration of care management, program operations with core organization-wide business functions including claims, member services, compliance, quality, utilization management, and network/provider services.
- Serve as technical, professional, and business resource (may cross multiple business functions).
- Support quality improvement projects through successful implementation.
- Develop and participate in presentations and consultations to existing and prospective stakeholders.
- Direct/provide enhancements to business processes, policies, and infrastructure to improve clinical operational efficiency (may cross multiple business functions).
- Develop, implement, and evaluate policies and procedures, which meet business needs (may cross multiple business functions).
- Implements and monitors business plan and oversees any implementations or business transitions impacting clinical operations.
- Collaborate and partner with other business areas across/within regions or segments and within other centralized corporate areas to ensure all workflow processes and interdependencies are identified and addressed on an on-going basis.
- Synthesize program performance and clinical outcomes.
- Promote a clear vision aligned with company values and direction; sets specific challenging and achievable objectives and action plans; motivates others to balance customer needs and business success; challenges self and others to look to the future to create quality products, services, and solutions.
Essential Qualifications
- Active, current, and unrestricted licensure in the state of Louisiana (LCSW, LCPC, RN, LMFT).
- Nationally recognized case management certification, or ability to obtain within 90 days.
- 5+ years of clinical practice experience in physical or behavioral healthcare.
- 5+ years of management or clinical leadership.
- Ability to synthesize program performance and clinical outcomes.
- 3+ years of experience with personal computer, keyboard navigation, and MS Office Suite applications.
- Must possess reliable transportation and be willing and able to travel in-state up to 15% of the time.
Preferred Qualifications
- Master's degree preferred.
- Medicaid, insurance, managed care, experience.
Skills and Competencies Required for Success
The successful candidate will possess a strong combination of clinical, leadership, and business skills, including:
- Strong clinical knowledge and expertise in physical or behavioral healthcare.
- Leadership and management skills, with experience in managing clinical teams and operations.
- Business acumen and ability to drive business success.
- Excellent communication and interpersonal skills, with ability to work effectively with internal and external stakeholders.
- Ability to analyze data and synthesize program performance and clinical outcomes.
- Strong problem-solving and decision-making skills.
- Ability to work in a fast-paced environment and prioritize multiple tasks and responsibilities.
Career Growth Opportunities and Learning Benefits
CVS Health is committed to the growth and development of our employees, and we offer a range of opportunities for career advancement and professional growth. As a Director of Care Management, you will have the opportunity to:
- Develop and implement clinical operations and business strategies that drive business success.
- Lead a clinical team and develop the skills and expertise of your team members.
- Collaborate with other business areas across/within regions or segments and within other centralized corporate areas to ensure all workflow processes and interdependencies are identified and addressed on an on-going basis.
- Participate in quality improvement projects and implement successful solutions.
- Develop and participate in presentations and consultations to existing and prospective stakeholders.
- Enjoy a range of benefits, including medical, dental, and vision benefits, 401(k) retirement savings plan, and employee stock purchase plan.
Work Environment and Company Culture
CVS Health is a dynamic and growing organization that is committed to delivering enhanced human-centric health care for a rapidly changing world. We are a diverse and inclusive workplace that values collaboration, innovation, and customer service. As a Director of Care Management, you will have the opportunity to work in a fast-paced environment and contribute to the growth and success of our organization. We offer a range of benefits and perks, including:
- A competitive salary and bonus structure.
- A range of benefits, including medical, dental, and vision benefits, 401(k) retirement savings plan, and employee stock purchase plan.
- A dynamic and inclusive workplace culture that values collaboration, innovation, and customer service.
- Opportunities for career advancement and professional growth.
- A range of perks, including free development courses, CVS store discount, and discount programs with participating partners.
Compensation, Perks, and Benefits
The typical pay range for this role is $99,420.75 - $214,137.00. 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.
How to Apply
If you are a passionate and experienced leader who is committed to delivering enhanced human-centric health care for a rapidly changing world, we encourage you to apply for this exciting opportunity. Please submit your application through our website, and we look forward to reviewing your qualifications.
Seize this opportunity to make a significant impact. Apply now and take the first step towards a rewarding new role.
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