Manager, Clinical Health Services

Job DescriptionThis is a remote position with expected travel of 10-25%. Schedule is Monday-Friday, standard business hours, 8:00am-5:00pm in the time zone that you reside. This position is for Northeastern Region. Candidates must resides in one of the following counties in Kentucky: Bath, Boyd, Bracken, Carter, Elliott, Fleming, Greenup, Lawrence, Lewis, Mason, Menifee, Montgomery, Morgan, Robertson, Rowen or in a county immediately adjacent to one of these counties.Develop, implement, support, and promote Health Services strategies, tactics, policies, and programs that drive the delivery of quality healthcare to establish competitive business advantage for Aetna. Health Services strategies, policies, and programs are comprised of utilization management, quality management, network management and clinical coverage and policies. Oversight and Management of clinical team processes including the organization and development of high performing teams.Responsibilities include: 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 RangeThe typical pay range for this role is:Minimum: 82,000Maximum: 176,800Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.Required Qualifications- Minimum 5 years of overall clinical experience required- Minimum 1 year(s) experience or detailed knowledge of the Foster Care and juvenile justice systems, Adoption Assistance, the delivery of Behavior Health Services, Trauma-informed Care, ACEs, Crisis Intervention Services, or evidence-based practices applicable to the Kentucky SKY populations.- Must have an active and unrestricted RN licensure in the state of KY (will allow compact state licensures) OR an active and unrestricted clinical Behavioral Health licensure (LPCC, LCSW, or LMFT) in the state of KY.-Minimum 1 year of leadership experience managing teams.-Willing and able to travel 10-25% of their time using their own vehicle for occasional state required visits or onsite meetings/trainings to Frankfort KY or surrounding areas.-Valid driver's License.COVID RequirementsCOVID-19 Vaccination RequirementCVS 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.Preferred Qualifications- Certified Case Management preferred.- 1+ year(s) of experience with personal computers, keyboard and multi-system navigation, and MS Office Suite applications (Outlook, Word, Excel, SharePoint).EducationAssociate's degree with RN licensure required, BSN preferred OR a Master's level clinician in behavioral health or human services field with independent clinical licensure required.Business OverviewBring your heart to CVS HealthEvery 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.

Created: 2025-10-04