Associate Manager, Clinical Health Services (Remote – Must reside in New Jersey) ID-8787

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.

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Position Summary

This Associate Manager opportunity is a fulltime telework position with up to 10% travel to anywhere within the state of New Jersey on as need basis to support the staff. Standard working hours: Monday -Friday, 8am to 5 pm EST.

At Aetna Better Health of New Jersey, we believe that our members should have the opportunity to be leaders in their care. Our healthcare professionals are invested in connecting and servicing the Medicaid population in all 21 counties of New Jersey. This is an opportunity to make an impact on the lives of others by getting to know their stories to improve the quality of their lives. The most rewarding aspect of the MLTSS care management role is evidenced by the positive outcomes of collaborative efforts between the care manager, member, and servicing providers.

Develop, implement, support, and promote health service strategies, tactics, policies, and programs that drive the delivery of quality healthcare to our members. Health service strategies, policies, and programs are comprised of utilization management, quality management, network management, clinical coverage and policies. The position requires leadership, advanced clinical judgment and critical thinking skills in order to facilitate appropriate physical, behavioral health, psychosocial wrap around services. The care management supervisor will be responsible daily program oversight, staff recruitment, staff retention, problem solving, inter and intradepartmental collaboration, direct collaboration with state partners.

The Care Management Supervisor shall be responsible for the management and supervision of the MLTSS Care Management staff. The supervisor is responsible for the daily operations of the MLTSS Program and contractual adherence. The Supervisor will oversee staff who cover CM in concentrated geographic area and surrounding counties. This includes members enrolled in enrolled in Managed Long-Term Services and Supports program (MLTSS) and/or Dual Special Needs Program (D-SNP/ FIDE). Supervisor's Care manager may also be responsible for face to face assessments with non-MLTSS members to evaluate the medical needs of the member to facilitate the member’s overall wellness and help them obtain the services they need to thrive by addressing requests for services such as adult medical daycare, pediatric medical daycare, personal care assistant, nursing facility custodial requests, personal preference program and MLTSS program enrollment. Successful completion of the NJ Choice certification is a contingency of employment. As per NJ Division of Aging Services, Office of Community Choice Options guidance, an exam score of 80% or higher is required, along with successful completion of the State training modules, and field mentoring component.

Required Qualifications

  • Must have one of the following active unrestricted NJ State Licensure RN, LSW, or LCSW
  • Successful completion of the NJ Choice certification is a contingency of employment. As per NJ Division of Aging Services, Office of Community Choice Options guidance, an exam score of 80% or higher is required, along with successful completion of the State training modules, and field mentoring component
  • Must possess reliable transportation and be willing and able to travel up to 10% of the time to meet and support staff as needed anywhere in the state of New Jersey. Mileage is reimbursed per our company expense reimbursement policy
  • 4+ years of experience serving members/patients with special needs
  • 1+ years of previous leadership experience managing teams and personnel
  • 1+ years of excellent assessment, writing, and communication skills
  • 1+ years' experience using a computer, keyboard navigation, navigating multiple systems and applications; and using MS Office Suite applications (Teams, Outlook, Word, Excel, etc.)

Preferred Qualifications

  • MCO experience
  • Experience working with Medicaid and/or Medicare
  • Strongly prefers candidates residing in Central or South parts of New Jersey
  • Working with Healthcare (i.e. nursing homes)
  • Recent leadership experience preferred

Education

  • Minimum of Bachelor’s degree in nursing required for RN license and Master's degree required for BH license

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The Typical Pay Range For This Role Is

$96,408.00 - $207,648.00

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 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.
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