Principal Clinical Leader

Job DescriptionThis is a telework position with upto 25% travel required within the state of Ohio.Position Responsibilities: Develops and manages clinical operations focused on improving clinical and financial outcomes, member engagement, and satisfaction. Develops strategies to mitigate high cost/high need utilization of services and assist members with assuming self-management of their conditions. Serves as liaison with regulatory and accrediting agencies and other health business units. Formulates and implements strategy for achieving applicable department/unit metrics and provides operational direction. Serves as technical, professional, and business resource (may cross multiple business functions). Develops and participates in presentations and consultations to existing internal and external stakeholders and existing/prospective customers. Directs/provides enhancements to business processes, policies, and infrastructure to improve operational efficiency (may cross multiple business functions). Participates in internal and external health industry development efforts. Develops, implements, and evaluates 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 service operations. Collaborates and partners 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. Promotes 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. Collaborates with licensed staff from other areas that assist with oversight of clinical staff and activities of licensed personnel.Pay RangeThe typical pay range for this role is:Minimum: 99,400Maximum: 214,000Please 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- Ohio State licensed as a registered nurse, independent social worker, psychologist, professional clinical counselor, independent marriage and family therapist, independent chemical dependency counselor, or school psychologist in good standing. -Minimum 3 years' of management or clinical leadership experience.-Minimum 3 years of experience in providing direct behavioral health care coordination or oversight for children and adolescents with complex behavioral health needs.- Minimum 3 years of Specialty experience with children and adolescents with complex behavioral health needs, multi-system experience, and understanding of managed care.-Must be a resident of Ohio state.-Willing and able to travel up to 25% within the state of Ohio as need basis.Preferred Qualifications-Designation as a Certified Case Manager (CCM) from the Commission for Case Manager Certification preferred.-5+ years' of clinical practice experience in a physical or behavioral healthcare. -5+ years of experience in managed care. -Ability to communicate in a highly effective manner with internal and external constituents in both written and oral format. -Ability to evaluate and interpret data for the purpose of developing new programs and processes to meet business demands. -Ability to synthesize program performance and clinical outcomes.EducationBachelors' degree required for RN licenseMaster's degree required for Independent BH License.Business OverviewBring 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.

Created: 2025-11-15