[Hiring] Senior Clinical Strategist @CVS Health

Role Description

The OhioRISE (Resilience through Integrated Systems and Excellence) plan is a Medicaid managed care program that provides and coordinates behavioral health care for eligible children and youth. The Senior Clinical Strategist is a Behavioral Health leader for the Aetna state Medicaid plan. This may include:

• Substance Use Disorder (SUDS)
• Applied Behavioral Analysis (ABA)
• Trauma Informed Care
• Person Centered services

The Senior Clinical Strategist functions as the Behavioral Health Subject Matter Expert (SME) for the plan and works across various departments including:

• Care Management
• Utilization Management
• Quality Management
• Medical Management

Position works closely with the state Executive leadership team related to Behavioral Health and its integration across the state plan.

The Senior Clinical Strategist is an individual contributor and serves as the primary point-of-contact with ODM for any state escalations on member issues. This position supports the Behavioral Health Clinical Director, Chief Clinical Oversight Officer, Chief Executive Officer, Contract Administrator, and other OhioRISE leaders in working with stakeholders to handle all state escalations on member issues. Responsibilities include:

• Developing, maintaining, and reporting on the complete inventory of all state escalations on member issues.
• Ensuring timely resolution of member escalation issues.
• Prioritizing meeting the clinical needs of our members.

This is a fully remote position. Eligible candidates must live and be licensed in Ohio.

Qualifications

• Ohio resident
• Active and unencumbered independent Ohio Behavioral Health License in one of the following - LPCC, LISW, LMFT, or Psychologist
• Minimum 5 years demonstrated experience in Behavioral Health service delivery or administration
• Demonstrated experience in the oversight and/or delivery of behavioral health services, care management, or utilization management
• Knowledge and experience with public youth serving systems including Child Welfare, Developmental Disabilities, Mental Health and Recovery, Juvenile Justice
• Knowledge of, and experience accessing, service, placements, and funding
• Proven communication skills both written and verbal
• Work collaboratively with internal and external teams
• Group facilitation/presentation skills
• Deep knowledge of Medicaid services in Ohio to multisystem involved youth
• Understanding and experience working with Ohio Department of Medicaid
• Willing and able to travel in-state up to 10% of the time with a personal vehicle

Requirements

• Ability to manage multiple timelines and produce evidence of driving toward success
• Participate in strategic projects and process improvements
• Profound understanding of clinical workflows and best practices
• Ability to effectively manage client expectations and inspire confidence
• Demonstrated experience in managing large and complex clinical initiatives and projects
• Proven communication skills both written and verbal
• Experience in successfully building, maintaining, and supporting effective relationships across cross-functional teams
• Group facilitation/presentation skills that inform and influence internal and external parties

Education

• Master’s degree in behavioral health or related fields with active Ohio independent licensure (LPCC, LISW, or LMFT)
• OR Earned doctorate in psychology with active Ohio licensure as a psychologist

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is: $87,035.00 - $187,460.00. 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.

Benefits

• Comprehensive and competitive mix of pay and benefits
• Medical, dental, and vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Other resources, based on eligibility

Additional details about available benefits are provided during the application process.