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CVS Health Senior Clinical Strategist (RN) in Virginia

Job Description

Fully remote role. Applicants must reside in one of the following states: Pennsylvania, New Jersey, Delaware, Maryland, Virginia, North Carolina, South Carolina, or Eastern Tennessee.Travel up to 25% within Virginia, South Carolina, Tennessee and other areas in support of VBC groups once travel is reinstated.Schedule is Monday-Friday EST standard business hours. 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 costs. The Senior Clinical Strategist works to drive clinical performance of assigned Provider Collaboration groups by: -Establishing trusting relationship 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 SME’s 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

Required Qualifications

  • Registered Nurse active & unrestricted in the state the candidate resides.- 4+ years of Case Management experience - 1+ year clinical experience- 1+ year managed care- 1+ year leadership or supervisory experience- Creating accountability, developing and executing strategy, and driving changeTechnology Experience: Microsoft Outlook 4 years end userMicrosoft PowerPoint 4 years end userTE Microsoft Excel 4 years end user,Microsoft SharePoint 1 years end userStrong 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. Supervisory or leadership experience.

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

  • 3 Years of supervisory experience


Bachelor's degree or equivalent experience.

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.