Remote RN Strategy Lead – Medicare Stars

CVS Health; Provo (UT); Remote; USD 78,000 - 206,000; Full time

Job summary

CVS Health is seeking a Senior Clinical Strategist to lead clinical performance improvement across Medicare Provider Collaboration groups. The role requires an RN license, 4+ years of case management, and experience coordinating multi-functional teams to drive Stars performance and cost/utilization improvements.

The position supports population health initiatives with travel up to 25% and a 40-hour work week, primarily remote with residence in the Northwest/Mountain area.

Qualifications

• Registered Nurse with active and unrestricted license in the state of residence.
• 4+ years of case management experience.
• 3+ years clinical experience.
• 1+ year leadership or supervisory experience.

Responsibilities

• Establishing trusting relationships 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.
• Interpreting data and educating regarding how to utilize data for PC performance improvement.
• Coordinating and conducting clinically focused meetings to identify opportunities and prioritize goals and interventions to close gaps in care and achieve optimal stars performance.
• Collaborating with Engagement Managers and other teams on initiatives for Stars/quality improvement.

Skills

Case management

Clinical experience

Leadership

Communication skills

Education

RN license

Bachelor's degree preferred

Tools

Outlook

PowerPoint

Excel

SharePoint

Job description

CVS Health is seeking a Senior Clinical Strategist to lead clinical performance improvement across Medicare Provider Collaboration groups. The role requires an RN license, 4+ years of case management, and experience coordinating multi-functional teams to drive Stars performance and cost/utilization improvements.

The position supports population health initiatives with travel up to 25% and a 40-hour work week, primarily remote with residence in the Northwest/Mountain area.