National Accounts Clinical Program Consultant

at  CVS Health

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 SUMMARY

* This can be a fully remote or hybrid opportunity*
Excellent opportunity for an experienced clinician with a passion for consulting and improving overall population health to leverage clinical, analytic, and consultative skills to join our team of Clinical Program Consultants (CPC) who offer clinical insights and solutions to help improve health plan performance for our group commercial plan sponsors. The CPC role is a highly collaborative position working proactively with the Aetna account team, Aetna’s Care management teams, and key National Account partners to support our customers.

In this role, the consultant is empowered to:

• Provide progressive consultative clinical insights based on analysis of clinical plan utilization and impact of member behavior on medical plan costs.
• Recommend clinical programs and services that align with the customer’s strategy and help drive short- and long-term results.
• Analyze, synthesize, and present clinical content with recommended actions to drive member behavior change and help improve plan performance in customer facing meetings.
• Act as a trusted clinical resource educating constituents about population health, industry trends, and impact of health disparities.
• Collaborate across the enterprise to drive goal alignment with customer and health plan.
• Provide input to customer’s population health strategy across the clinical spectrum.
• Create and propose solutions to improve member health including leveraging community opportunities and resources.

This is a customer-facing role with some travel to meet with customers and review plan performance, discuss recommendations, etc.

In this role, the consultant will:

• Provide consultative clinical insights based on analysis and identification of key drivers of results; includes analysis of high-cost claimants, transplants, etc.
• Recommend clinical programs and services that align with the customer’s strategy and help drive short- and long-term results.
• Develop and present clinical content and recommendations in customer facing meetings e.g. present findings and recommended actions to help improve plan performance and clinical outcomes, and work collaboratively to help track and resolve issues
• Act as a trusted clinical resource; share current information about population health trends.
• Collaborate across the enterprise and with care management to understand gaps and identify opportunities.
• Provide input to customer’s population health strategy across the clinical spectrum.

REQUIRED QUALIFICATIONS

• Must be willing to travel to office and customer locations.
• Comfortable presenting in front of executive level audience
• Experience communicating for impact with large groups.
• Minimum of 3 years clinical experience (2 years in acute care, the other 1 year may be a combination of different sites of care including: hospital, clinic, and/or community health)
• Strong clinical analytic skills and demonstrated conceptual thinking. This includes utilizing Excel and other reporting mechanisms to support analysis.
• Strong problem-solving skills and attention to detail.
• Adept at communicating chronic conditions and impact on population health.
• Proficient consultative, communication and presentation skills (especially PowerPoint).
• Skilled at organizing and responding to multiple deliverables in a timely and professional manner.
• Ability to establish highly collaborative relationships within and outside the organization including at the executive level.
• Proficient with MS Office programs (Excel, PowerPoint, Word, and Outlook).

PREFERRED QUALIFICATIONS

• Unrestricted active registered nurse license.
• 1+ years progressive leadership experience.
• Experience working with a Health Insurance Carrier.
• Experience with benefit plan design.

EDUCATION

BSN MSW/LCSW degree preferred/specialized training/relevant professional qualification, or equivalent work experience.

In this role, the consultant is empowered to:

• Provide progressive consultative clinical insights based on analysis of clinical plan utilization and impact of member behavior on medical plan costs.
• Recommend clinical programs and services that align with the customer’s strategy and help drive short- and long-term results.
• Analyze, synthesize, and present clinical content with recommended actions to drive member behavior change and help improve plan performance in customer facing meetings.
• Act as a trusted clinical resource educating constituents about population health, industry trends, and impact of health disparities.
• Collaborate across the enterprise to drive goal alignment with customer and health plan.
• Provide input to customer’s population health strategy across the clinical spectrum.
• Create and propose solutions to improve member health including leveraging community opportunities and resources

In this role, the consultant will:

• Provide consultative clinical insights based on analysis and identification of key drivers of results; includes analysis of high-cost claimants, transplants, etc.
• Recommend clinical programs and services that align with the customer’s strategy and help drive short- and long-term results.
• Develop and present clinical content and recommendations in customer facing meetings e.g. present findings and recommended actions to help improve plan performance and clinical outcomes, and work collaboratively to help track and resolve issues
• Act as a trusted clinical resource; share current information about population health trends.
• Collaborate across the enterprise and with care management to understand gaps and identify opportunities.
• Provide input to customer’s population health strategy across the clinical spectrum