Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.Position SummaryThe OhioRISE (Resilience through Integrated Systems and Excellence) plan is a Medicaid managed care program that provides and coordinates behavioral health care for eligible children and youth. The OhioRISE Director of the Psychiatric Residential Treatment Facility (PRTF) Hub is responsible for the management and oversight of all activities that support PRTF clinical and administrative operations. The director of the PRTF Hub reports to the Children's System of Care Executive Director and works in close partnership with the CEO, COO, CMO, CFO, Care Coordination Director and other Aetna teams, all matrixed growth partners to effectively support our PRTF implementation and oversight.This is a fully remote position. Eligible candidates can live anywhere in the United States, Ohio resident preferred.Responsibilities include:

• Supervises PRTF Clinical Administrator and PRTF Administrator on the specific jobs and tasks related to supporting the clinical administration and implementation and oversight of the PRTF Program.
• Leads the overall implementation process of all PRTF programs, quality improvement, PRTF Oversight and reporting, clinical support and integration with Aetna teams, ODM teams, PRTF teams, and other Ohio based teams supporting PRTF programming.
• Coordinates with Director, CME Alliance Hub to ensure continuity of care between CMEs and PRTF providers.
• Leads the Aetna internal implementation process for all PRTF Programming.
• Supports the PRTF contracting process with Provider Relations and Contracting.
• Maintains the PRTF Manual content and updates.
• Coordinates training needs with Aetna Training Manager and Education and Learning Alliance with ODM.

• Five years management experience
• Five or more years of experience in public sector, managed behavioral health care.
• Knowledge and understanding of the Ohio Medicaid managed care market and familiarity with PRTF and residential treatment.
• Experience with relevant stakeholders including the Ohio Department for Medicaid and the Ohio behavioral health provider community.
• Persuasive communication skills, both written and verbal
• Excellent organization and time management skills
• Understanding of system of care process - OMAS, juvenile justice, youth services, developmental disabilities
• Understanding of health plan operations, including contracting, claims processing, encounter data processing, and Medicaid eligibility and enrollment. Experience navigating a matrixed organization.
• Ability to travel to Ohio at least once monthly for visits to PRTFs

• Ohio resident
• Experience working in congregate setting for 3 or more years
• Clinical degree and experience, i.e. Social Work, Professional Counseling, Marriage and Family