Our Ability Jobs

Job Information

CVS Health Supervisor Clinical Health Services (LMSW, RN) in Kentwood, Michigan

Job Description

The Supervisor, Clinical Health Service will oversee the implementation of healthcare management services for Care Management-Implements clinical policies & procedures in accordance with applicable regulatory and accreditation standards (e.g., NCQA, URAC, state and federal standards and mandates as applicable)-Serve as a content model expert and mentor to the team regarding practice standards, quality of interventions, problem resolution and critical thinking-Ensure implementation and monitoring of best practice approaches and innovations to better address the member's needs across the continuum of care-May act as a liaison with other key business areas.-May develop/assist in development and/review new training content-May collaborate/deliver inter and intra-departmental training sessions-Protects the confidentiality of member information and adheres to company policies regarding confidentiality-Manages resources responsible for identification of members, development and implementation of care plans, enhancement of medical appropriateness and quality of care and monitoring, evaluating, and documenting of care-Evaluate and interpret data, identify areas of improvement, and focus on interventions to improve outcomes-Develop, initiate, evaluate, monitor, and communicate performance expectations-Ensures the team's understanding and use of information system capability and functionality-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 andimplement action plans that support the development of high performingteams-Establish an environment and work style that promotes the conceptof teamwork, cross product integration, and continuum of care thinking thatresults in strong performance-Consistently demonstrates the ability to serve as a model change agent and lead change efforts-Create a positive work environment by acknowledging team contributions, soliciting input,and offering personal assistance, when needed Accountable for maintaining compliance with policies and procedures and implements them at the employee level-Communicate effectively with Providers, Members, Staff and other Leaders (e.g., may provide support to the sales staff & network staff via onsite customer visits and/or presentation

Required Qualifications

  • Registered Nurse (RN) or Licensed Master Social Worker (LMSW) with an active unrestricted license in state of Michigan- 3+ years in clinical area of expertise- 3+ years experience in managed care expertise- 3+ years of previous leadership expertise- Must possess or have the ability to obtain high speed internet access for remote work

COVID Requirements

COVID-19 Vaccination Requirement

CVS Health requires its Colleagues in certain positions 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, pregnancy, or religious belief that prevents them from being vaccinated.

  • If you are 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 within the first 30 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 60 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.

  • If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 30 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.

Preferred Qualifications

  • Commercial experience- Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually- BSN Preferred- CCM preferred

Education

Masters degree required or if RN BSN preferred

Business Overview

At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. 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.

DirectEmployers