Remote Hybrid Manager Clinical Health Services – Central, Eastern, Northern Regions

CVS Health

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Job ID: 2538943BR
Category: Nurse
Remote: Fully Remote

Job Description
The Aetna Better Health of West Virginia 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, Aetna Better Health of West Virginia 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 Aetna Better Health of West Virginia, 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 teleworker position in West Virginia. Travel is required up to 25% of the time in the assigned regions of WV.

Qualified candidates must reside in the Central, East or North regions. Central region counties include: Braxton, Calhoun, Clay, Fayette, Gilmer, Kanawha, Nicholas, Roane, and Webster. East region counties include: Berkeley, Grant, Hampshire, Hardy, Jefferson, Mineral, Morgan, Pendleton, Preston, Randolph, and Tucker. North region counties include: Hancock, Wetzel, Doddridge, Taylor. Brooke, Tyler, Lewis, Harrison, Ohio, Pleasants, Upshur, Marion, Marshall, Ritchie, Barbour, and Monongalia. Candidates in bordering OH (Jefferson, Belmont, Monroe) and PA (Washington and Greene) counties may also apply.

Core business hours are Monday-Friday, 8AM-5PM. There may be an occasional need to flex beyond the core working hours to meet business/member needs.

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.

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.

Pay Range
The typical pay range for this role is:
Minimum: 84,500
Maximum: 182,000

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.

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

Required Qualifications
• Resides in WV, in Central, East, or North regions; or bordering OH/PA counties..
• 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, and Teams).
• Must possess reliable transportation and be willing and able to travel in-state up to 25% of the time. Mileage is reimbursed per our company expense reimbursement policy.

Preferred Qualifications
• Foster Care Experience.
• Managed care experience
• Medicaid experience
• Experience with Dynamo or Electronic Medical Records (EMR)
• Familiarity with QuickBase
• Certified Case Manager (CCM) certification

• Master’s degree in behavioral health field required with behavioral health licensure.
• Associate’s Degree or Nursing Diploma required with RN licensure; BSN is preferred.

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.