Senior Principal Clinical Leader – RN, BH

Job not on LinkedIn

🔥 12 minutes ago

🚗 Michigan – Remote

🚗 Michigan – Remote

💵 $123.9k - $266.8k / year

⏰ Full Time

🟠 Senior

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Provide strategic leadership and operational oversight for clinical care management across Aetna's Michigan and Illinois Integrated Plans • Lead strategic growth and enhancement of applicable care management program capabilities • Inform model of care and workflow best practices for new technology platforms and tools • Collaborate with executive leadership to develop and implement program strategies meeting business, CMS, federal and state regulations, and accrediting agency requirements • Integrate care and case management, utilization management, and program operations • Lead cost savings and quality improvement projects • Manage projects and programs using formal project plans and collaborative workgroups • Deliver operational performance and compliance • Manage relationships with state authorities and develop, vet, and report state compliance and quality measures • Manage internal and external processes, communications, and results • Lead policies, procedures, practice guidelines, and alignment of clinical and business processes • Implement and revise medical management letters for regulatory and accreditation compliance • Manage vendor relationships and ensure targets and medical management goals are achieved • Lead recruitment and operating model development for operational growth • Develop compliant, cost-effective staffing models • Oversee workforce and operational readiness for clinical system migrations and implementations • Lead, develop, motivate, and manage a high-performing team • Lead effectively in a matrixed environment with shared service divisions • Lead virtually integrated clinical and non-clinical staff across multiple geographic markets • Foster professional development, mobility, and operational excellence

🎯 Requirements

• Active unrestricted clinical license in applicable functional area (e.g. RN, LCPC, LCSW) • 10+ years Managed Care experience required • Medicare and Medicaid experience including LTSS and DSNP highly preferred • 7+ years of Care Management operations and leadership experience, including leading leaders and developing high-performing teams • Experience leading change in a growth business • Experience leading the strategic design, execution, and outcomes management of Care Management programs • Demonstrated ability to drive clinical and financial performance • Experience planning, leading and organizing resources of a large and growing team and developing talent • Ability to synthesize program performance and clinical outcome • Ability to evaluate and interpret data to develop new programs and processes • Ability to communicate effectively with internal and external constituents in written and oral format • If Behavioral Health: Master's degree in a field leading to independent Behavioral Health licensure • If Registered Nurse: Master's degree or equivalent experience; MSN preferred • For an associate’s degree, an additional 4 years of experience is needed • For a bachelor’s degree, an additional 2 years of experience is required • Eligible candidates may live anywhere in the contiguous United States

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program • Award target in the company’s equity award program • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being