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Senior Manager Clinical Health Services - OhioRISE

AT CVS Health
CVS Health

Senior Manager Clinical Health Services - OhioRISE

Columbus, OH

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.Position Summary

The 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 Senior Manager, Clinical Health Services is responsible for the oversight and management of team processes and the organization and development of high performing teams. This position will support OhioRISE members with complex behavior health, multisystem, care coordination needs. This position will also support any additional needs of the of the Director for all lines of OhioRISE CM business.Hours for this position are Monday-Friday 8:00am-5:00pm, may require after hours to support staff as needed.Minimal travel required for onsite trainings, escalations, or meetings as needed.Must have knowledge of OhioRISE Program and contractual requirements.Candidate must reside in the state of Ohio.Fundamental Components

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  • Leadership and development of high performing teams, responsible for leading people leaders, supports growth and development of colleagues, and promotes a positive work culture.
  • Develops and manages clinical operations focused on improving clinical and financial outcomes, member engagement, and satisfaction.
  • Serves as liaison with regulatory and accrediting agencies and other health business units.
  • Formulates and implements strategy for achieving applicable department/unit metrics and provides operational direction.
  • Serves as technical, professional, and business resource (may cross multiple business functions).
  • Develops and participates in presentations and consultations to existing internal and external stakeholders and existing/prospective customers.
  • Directs/provides enhancements to business processes, policies, and infrastructure to improve operational efficiency (may cross multiple business functions).
  • Implements and monitors business plan and oversees any implementations or business transitions impacting service operations.
  • Collaborates and partners with other business areas across/within regions or segments and within other centralized corporate areas to ensure all workflow processes and interdependencies are identified and addressed on an on-going basis.
  • Promotes a clear vision aligned with company values and direction; sets specific challenging and achievable objectives and action plans; motivates others to balance customer needs and business success; challenges self and others to look to the future to create quality products, services, and solutions.
Required Qualifications
  • Ohio resident
  • Active unrestricted OH Licensure in one of the following clinical areas: LISW, LPCC, LMFT or RN
  • 5+ years' experience in clinical areas of expertise
  • 2 years' experience managing programs and multiple direct reports including other managers
  • 3+ years' MCO experience to include management and oversight of behavioral health related teams and projects
  • 3+ years' experience in children's mental health, developmental disabilities, juvenile justice or a public sector human services or behavioral healthcare field, providing community-based services to children and youth, and their family/caregiver
  • Must have knowledge of OhioRISE Program and contractual requirements
  • Experience in one or more of the following areas of expertise: family systems, community systems and resources, case management, child and family counseling/therapy, child protection or child development
  • Demonstrated willingness to be hands-on with action-oriented problem solving in a role that is demanding and requires a high level of energy and professionalism
  • Demonstrated ability to promote a positive work culture and collaborate within and across departments to accomplish goals
  • Demonstrated business skills including business development, business planning, and operations.
  • Communicates effectively both verbally and in writing such that messages are understood; that is, understanding the essence and subtleties of the communication and the intended audience.
  • High level proficiency with Microsoft Office tools, including MS Teams, Excel, Word, Power Point; as well as SharePoint and QuickBase experience.
  • Must be able to obtain CCM within 6 months of start date
  • Ability to travel in-state up to 15% of the time
Preferred Qualifications
  • Medicaid Experience
  • Experience with Health Plan Start-Up
Education
  • Master's degree required for BH license
  • BSN required for RN license
Anticipated Weekly Hours
40Time Type
Full timePay Range

The typical pay range for this role is:$90,382.00 - $194,670.00This 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.
For more information, visit https://jobs.cvshealth.com/us/en/benefitsWe anticipate the application window for this opening will close on: 04/04/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Client-provided location(s): Columbus, OH, USA
Job ID: CVS-R0535168
Employment Type: Other

Perks and Benefits

  • Health and Wellness

    • Health Insurance
    • Dental Insurance
    • Vision Insurance
    • Life Insurance
    • HSA
    • HSA With Employer Contribution
    • Pet Insurance
    • Mental Health Benefits
  • Parental Benefits

    • Fertility Benefits
    • Adoption Assistance Program
    • Family Support Resources
  • Work Flexibility

    • Flexible Work Hours
    • Remote Work Opportunities
    • Hybrid Work Opportunities
  • Vacation and Time Off

    • Paid Vacation
    • Paid Holidays
    • Personal/Sick Days
  • Financial and Retirement

    • 401(K) With Company Matching
  • Professional Development

    • Tuition Reimbursement
  • Diversity and Inclusion

    • Employee Resource Groups (ERG)
    • Diversity, Equity, and Inclusion Program