[Hiring] Senior Clinical Strategist @CVS Health

Role Description

Fully remote role with requirement to reside in the state of Illinois with preference of Chicago Metro area and be a Registered Nurse (RN) licensed in the state of residency. Travel up to 25% possible in support of Value Based Care groups. Schedule is Monday - Friday 8am to 5pm Eastern Standard Time. No nights, no weekends and no holidays.

The Senior Clinical Strategist works with assigned Aetna Medicare Provider Collaboration groups to drive improved performance by leading clinical performance improvement projects and managing multiple complex deliverables through to implementation. Projects will support population health and will primarily impact Stars and quality but will also focus on improvements in utilization and cost.

The Senior Clinical Strategist works to drive clinical performance of assigned Medicare Provider Collaboration groups by:

• Establishing trusting relationships with provider partners to promote open communication
• Serving as clinical expert on actionable opportunities related to CM, gap closure, workflow discussions, and partnering with case manager supervisor/manager and CMs
• Serving as internal and external liaison and clinical resource, interpreting data and educating regarding how to utilize data for PC performance improvement
• Strategizing with SMEs and clinical teams both internally and externally to drive outcomes and improve efficiencies
• Coordinating and conducting clinically focused meetings to identify opportunities, target and prioritize goals and interventions to close gaps in care and achieve optimal stars performance
• Collaboratively working across multiple functions and/or segments to obtain agreement from all impacted parties (e.g., up and downstream effects often impact multiple functions and/or segments)
• Collaborating with Engagement Managers, Local Market Team, Data Team, Medical Operations and others on initiatives for Stars/quality improvement

Qualifications

• Registered Nurse with active and unrestricted license in the state the candidate resides
• 4+ years of case management experience
• 3+ years clinical experience
• 1+ year leadership or supervisory experience

Requirements

• 4+ years of Outlook experience
• 4+ years of Microsoft Power Point experience
• 4+ years of Microsoft Excel experience
• 1+ years of SharePoint experience

Preferred Qualifications

• Strong communication and interpersonal skills
• Proven track record in meeting project milestones and negotiating for resources
• Proven negotiation skills
• Proven project management skills
• Proven success while working in a matrixed environment
• 1+ year managed care experience
• Creating accountability, developing and executing strategy and driving change

Education

• Registered Nurse / Bachelor’s Degree required

Benefits

• Comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families
• Medical, dental, and vision coverage
• Paid time off
• Retirement savings options
• Wellness programs and other resources, based on eligibility