Senior Clinical Strategist

ISHE; Idaho; Remote; USD 78,000 - 206,000; Full time

Job summary

ISHE, a remote-friendly clinical strategy role, seeks a Registered Nurse with leadership and case management experience to drive Medicare provider collaboration performance. The Senior Clinical Strategist will lead clinical improvement projects, coordinate meetings, and partner with care managers to close gaps in care and improve Stars metrics.

Role requires residence in Northwest/Mountain US states, RN license in home state, and up to 25% travel for Value Based Care initiatives.

Qualifications

• Active RN license in the state of residence.
• 4+ years of case management experience.
• 3+ years clinical experience.
• 1+ year leadership or supervisory experience.
• RN with Bachelor's degree preferred or equivalent experience.

Responsibilities

• Establish trusting relationships with provider partners to promote open communication.
• Serve as clinical expert on CM, gap closure, workflow discussions, and partner with case managers.
• Interpret data and educate regarding how to utilize data for provider performance improvement.
• Strategize with SMEs and clinical teams to drive outcomes and improve efficiencies.
• Coordinate and conduct clinically focused meetings to identify opportunities and prioritize goals for stars performance.
• Collaborate across functions to align on up- and downstream effects.

Skills

Communication

Negotiation

Project management

Matrixed environment

Managed care experience

Education

RN with BSN preferred or equivalent experience

Tools

Outlook

PowerPoint

Excel

SharePoint

Job description

Position Summary

Fully remote role with requirement to reside in the Northwest/Mountain area (ID, MT, NV, OR, UT, WA, WY) and be a Registered Nurse (RN) licensed in the state of residence.

Travel up to 25% possible in support of Value Based Care groups.

Schedule is Monday - Friday 8am to 5pm. 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 cost.

The Senior Clinical Strategist works to drive clinical performance of assigned Medicare Provider Collaboration groups by:

• 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
• Serving as internal and external liaison and clinical resource, interpreting data and educating regarding how to utilize data for PC performance improvement
• Strategizing with SMEs 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 with active and unrestricted license in the state the candidate resides
• 4+ years of case management experience
• 3+ years clinical experience
• 1+ year leadership or supervisory experience

Technology Qualifications

• 4+ years of Outlook experience
• 4+ years of Microsoft Power Point experience
• 4+ years of Microsoft Excel experience
• 1+ years of SharePoint experience

Preferred Qualifications

• Strong 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.
• 1+ year managed care experience
• Creating accountability, developing and executing strategy and driving change

Education

Registered Nurse / Bachelor 's Degree preferred or equivalent experience.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$78,331.00 - $206,206.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.

The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.

This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 11/26/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.