Remote Manager, Care Management – Oklahoma

About the job

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.This is a full-time field-based teleworker opportunity in Oklahoma.The Care Management, Manager develops, implements, supports, and promotes health services strategies, tactics, policies, and programs that drive the delivery of quality healthcare to Aetna Better Health of Oklahoma members. The Manager is responsible for oversight and management of clinical team processes including the organization and development of high performing teams. 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).

• Accountable for the day-to-day management of assigned care management team 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 developmental needs and collaborates with others to identify and 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 judgment to collaborate and inform the care management process in order to facilitate appropriate healthcare outcomes for members.
• Ensures access to primary care, behavioral health, and coordination of health care services for members as needed.
• Provides clinical leadership and assists care management staff in supporting members’ understanding of service recommendations based on member need.
• Conducts regularly scheduled individual and team meetings with a focus on member service delivery, completion of administrative duties, and meeting established productivity standards.
• Using a holistic approach consults with care managers, medical directors, system of care, social support teams and/or other market staff to overcome barriers to meeting goals and objectives.
• 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.
• Communicates strategic plan and specific tactics to meet plan needs and ensures implementation of tactics to meet strategic direction for cost and quality outcomes.
• 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 unit.
• Consistently demonstrates the ability to serve as a model change agent and lead change efforts.

Required Qualifications:

• Must reside in Oklahoma
• RN with current unrestricted Oklahoma state licensure or Oklahoma-licensed mental health professional- Licensed Professional Counselor (LPC), Licensed Marriage& Family Therapist (LMFT), Licensed Behavioral Practitioner (LFP), or Licensed Clinical Social Worker (LCSW) with current unencumbered license.
• 5+ years in clinical area of expertise
• 3+ years supervisory/managerial experience required
• 3+ years of care management experience required
• 2+ years of experience with regulations, standards, and policies which relate to medical management
• Managed care experience preferred
• Must complete the Behavioral Health Case Manager certification training provided through the Department of Mental Health and Substance Abuse Services within 6 month of hire date
• 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 30% of the time. Mileage is reimbursed per our company expense reimbursement policy.

Preferred Qualifications:

• If Registered Nurse, BSN preferred
• Certified Case Manager (CCM) preferred

Education:

• If RN, minimum of Associates or Diploma nursing degree or a Masters’ degree in behavioral health field (e.g., counseling, social work, marriage& family therapy).

Pay RangeThe typical pay range for this role is:$76,050.00 – $163,800.00This 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 Companypolicies.For more detailed information on available benefits, please visitjobs.CVSHealth.com/benefitsCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health colleagues can initiate a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through myHR (1-888-694-7287, or through myLeave at myHR). If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.