At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.This position is eligible for telework anywhere in the US within Eastern Standard Time Zone (EST). Position Summary The Nurse Educator utilizes their clinical skills to develop and incorporate frontline staff trainings that have direct impact on improving Aetna members' health care, outcomes and social determinant needs. The Nurse Educator collaborates with clinical and audit leadership to set goals for educational programs and needs, while continually investigating methods for improving member care and safety.
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Help us elevate our patient care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members, who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members' health care and social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country.Additional responsibilities to include but not limited to the following:- Drive team expansion and development to meet the ongoing needs of the business while optimizing operational excellence within the education team.
- Contribute to the implementation of clinical oversight practices within education team that promotes delivery of high impact and high quality educational performance to best meet the needs of the MMP/FIDE Plans.
- Empower and support MMP/FIDE Plans in delivering optimal clinical experiences including driving member engagement, improving clinical quality, and reducing barriers to care through ongoing collaboration between Duals leadership, audit, and education teams.
- Achieve our audit and education commitments through operating efficiencies. Streamline processes while promoting collaboration between the audit and education teams to improve member outcomes and best support health plan and market needs.
- Foster a culture of trust, transparency, and collaboration within the education teams to promote creativity, development of process improvement initiatives and encourage a reignited engagement and drive within the role to heighten support to our health plan and market colleagues, leading to better outcomes for our members.
- Provide ongoing education and remedial trainings that correlate with changes/updates from our governing bodies (CMS, Individual State Medicaid Benefits), contract changes, workflow creation and adjustments, and regulatory requirements for the MMP/FIDE markets.
- Collaborate, organize and facilitate reviews with health plan leaders to develop and revise workflows as needed
- Support Duals internal audit team with ongoing trainings based on updates and collaboration with audit and health plan leadership during Quarterly Reviews of audit workflows
- Develop audit workflows, train and support newly hired auditors as needed through instructor led training.
- Develop/create and successfully implement new hire onboarding for all MMP/FIDE contingent team employees for the MMP/FIDE health plans to more effectively streamline the onboarding process for new team members.
- Support needs of MMP and FIDE teams by contributing to trainings focused on improving staff morale and team building exercises. Required Qualifications - 1 year of experience in a managed care clinical operation environment in case management required.
- 6 months Dynamo experience required
- Unrestricted RN licensure required
- 6 months FIDE/MMP experience required Preferred Qualifications - Med compass experience
- Excellent verbal and written communication skills
- Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
- Ability to use standard corporate software packages and corporate applications.
- Experience teaching others in the classroom setting, either in person or virtually
- MI MMP CM experience preferred
- Bachelor of Science in Nursing Education Associates Degree in Nursing Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:$66,575.00 - $142,576.00This 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 peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
- Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
- Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.