CVS Health Clinical Liaison in Michigan
-Partners with Plan executive leadership team to provide overall vision and leadership across all Plan activities. -Serves as a key resource regarding any issues related to the integration of member care across departments.-Consults with Plan executive management regarding physical and behavioral health clinical issues as they relate to medical management (UM, CM) provider and system of care issues, behavioral health and human services system issues including critical stakeholders such as various departments of state government, provider organizations, advocacy organizations, etc.-Partners with Aetna Medicare regional psychiatrist(s) to manage and oversee CM within the health plan. -Provides consultation to support physicians at other Medicare Plans.-Participates in organizational planning, including strategic plans, business plans, and new product development.-Elicits staff input related to their job functions and leverages errors and failure to reach performance targets as opportunities for organizational learning and improvement.-Supports and encourages CM, UM staff to function as interdisciplinary team, with requisite range and depthof subject matter expertise to meet the needs of the covered population. -Represents Plan to relevant externalstakeholders, such as state government officials, providers/vendors, & advocacy groups with regard to quality improvement initiatives, integrating member care, health plan success, and innovative care strategies.-Co-facilitates interdisciplinary case rounds to address the needs of members with complex clinical presentations, identifies opportunities for improving rounds, and works with the clinical leadershipteam to optimize the value of rounds to the clinical staff.-Participate in and support process improvement initiatives within care management and across broader Plan operations.
-3-5+ years complex case work experience, preferably in managed care environment in a community or institutional setting.-5-10+ years experience in a clinical setting.-6-8+ years management experience.-Experience with third party relationships, including local community building efforts, governmental and regulatory authorities.-Experience working with Executive level management required. -Supervisory, management and administrative experience, excellent consultative and communication skills, analyticalability, decisiveness, strong judgment and the ability to work effectively with client and IT management and staff and vendors.-Strong verbal and written communication skills and the ability to communicate effectively with all levels of management
-Managed care/utilization review experience preferred-Previous supervisory and management experience required.-Management experience in a clinical setting desired.-For Clinical Services Managers in other areas: 5+ years experience including clinical, supervisory and/or administrative role-Experience in handling mental health and psychiatric care, family situations, relationship concerns preferred-Experience working with managed and non-managed health care benefits.
-Associates RN with current unrestricted MI state licensure.-Masters degree in social work and license required (LCSW, LPC,LMFT, PhD,or Psy.D)
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.
- CVS Health Jobs