Clinical Health Services Lead - ICM & LTSS (Remote)

4004 Aetna Medicaid Administrators; Illinois; Hybrid; USD 88,000 - 190,000; Full time

Job summary

CVS Health is seeking a senior clinical health services leader to oversee ICM and LTSS case management staff. You will guide clinical interventions for members, collaborate with Health Services managers, and help drive financial and quality outcomes while ensuring compliance with applicable health regulations.

The role requires 5+ years of clinical experience and an active RN/LCSW/LCPC license in the resident state.

Qualifications

• 5+ years clinical work experience.
• Active and unrestricted license/certification (RN, LCSW or LCPC) in their state of residence.

Responsibilities

• Oversees Integrated Care Management (ICM) and LTSS healthcare case management staff.
• Collaborates with Health Services managers to ensure consistent and accurate clinical interventions for members.
• Executes tasks to meet financial, operational, and quality objectives of the unit.
• Serves as a resource on government and regulatory acts (COBRA, EMTALA, Medicare) as applicable.
• Helps implement and sustain action plans and policies for Clinical Health Services.

Skills

Clinical experience

Education

Associate's Degree (REQUIRED)

Bachelor's Degree (PREFERRED)

RN/LCSW/LCPC license

Job description

CVS Health is seeking a senior clinical health services leader to oversee ICM and LTSS case management staff. You will guide clinical interventions for members, collaborate with Health Services managers, and help drive financial and quality outcomes while ensuring compliance with applicable health regulations.

The role requires 5+ years of clinical experience and an active RN/LCSW/LCPC license in the resident state.