Remote Manager, Clinical Health Services- Behavior Health

CVS Health

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Remote
OH – Work from home
Full time
R0136183

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.

 

 

 

Position Summary

 

Business Overview

As part of the bold vision to deliver the “Next Generation” of managed care in Ohio Medicaid, Ohio RISE will help struggling children and their families by focusing on the individual with strong coordination and partnership among MCOs, vendors, and ODM to support specialization in addressing critical needs.  The OhioRISE Program is designed to provide comprehensive and highly coordinated behavioral health services for children with serious/complex behavioral health needs involved in, or at risk for involvement in, multiple child-serving systems.

 

The UM Clinical Services Manager conducts oversight and management of clinical team processes including the organization and development of high performing teams.

  • 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.
  • Will be accountable for the day-to-day management of team(s) for appropriate implementation and adherence with established practices, policies and procedures
  • Works closely with other 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.

Required Qualifications

  • Active and unrestricted Ohio State Licensure in a behavioral health field, including RN with behavioral health experience. (e.g., LISW, LPCC, IMFT, RN).
    – 5+ years of clinical experience
    – 2+ years of utilization management experience
    – 2+ years of healthcare management experience required, in a managed care setting preferred
  • Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment
  • Must reside in Ohio State
  • Schedule is Monday-Friday, standard business hours, with flexibility for occasional weekend work required, as needed

Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding

Preferred Qualifications

Managed care/utilization review experience preferred
-Experience in a behavioral health inpatient setting

 

Education
Master’s Level of Education resulting in independent Behavioral Health licensure (LISW, LPCC, IMFT,) or a Registered Nurse (RN) with unrestricted state license In Ohio with psychiatric specialty, certification, or experience Please replace this section with the Education Requirements

 

 

Pay Range

The typical pay range for this role is:

 

$87,035.00 – $187,500.00

 

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.

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.