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Senior Clinical Program Consultant (CPC)

CVS Health

CVS Health is a health care innovation company. Together, we are are helping people on their path to better health.

Job Description
This role is work at home. Applicants must reside in the U.S. and in the eastern time zone.

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 (CPCs) who offer clinical insights and solutions to help improve health plan performance for our group commercial plan sponsors.

Highly collaborative, strong individual contributor position in a professional environment working with the account team, multiple Aetna customers, Aetna’s clinical operation teams and our Plan Sponsor Insights team of consultants.

The components of the role include:
• Provide clinical consultation based on analysis and identification of key drivers of results e.g. use data to identify clinical trends. Evaluates performance results, monitors engagement and proactively identifies opportunities for improvement. Collaborates on opportunities for improvement.
• Recommend clinical programs and services that align with the customer’s population health strategy and help drive short- and long-term results e.g. assisting with development of health strategies, tactics, policies and programs (which could include network management, clinical coverage, care management, and compliance policies for data and information) that improve overall population health and encourage efficient and effective delivery of benefits.
• Perform independent development and presentation of clinical content and recommendations in customer facing meetings e.g., present findings and recommended actions to help improve performance and clinical outcomes, and work collaboratively to help track and resolve issues.
• Research and evaluate programs and processes to identify savings and efficiency opportunities that may result in policy and procedure changes that impact the customer and the enterprise.
• Act as a trusted clinical resource providing clinical program guidance.
• Collaborate across the enterprise and with clinical operations to optimize collaboration, efficiency, and impact.
• Provide input to the design of clinical solutions and workflows leveraging knowledge of workflow, policy, and procedures to help ensure teams can work collaboratively.
• Stay current on, and share knowledge of, population health trends.
• Provide coaching, direction, feedback, and support of other matrixed team members including external vendors to drive integrated value for the plan sponsor.

The candidate will work directly with multiple benefits teams, at their location and virtually, using healthcare analytics to identify opportunities for improvement. Solutions from the data and customer experience be developed at an individual level and incorporated into the team strategy. Ideal candidates will be able to leverage advanced industry and clinical knowledge and utilize resources to turn data into actionable and measurable opportunities. There will be opportunity to partner onsite with the customers as well as work virtually. The candidate must be able to work onsite (Florida) at least quarterly and as customer needs require.

Clinical Program Consultants are key members of Aetna’s Plan Sponsor Insights (PSI) business – a business focused on providing insights and solutions based on analytics to customers in the group commercial business. The work environment supports and thrives on out-of-the box thinking, creative talent, and a consultative approach. Our team is highly valued by our internal partners as well as the customers we serve.

Required Qualifications
• Minimum of 7 years’ of clinical experience (may be a combination of different sites of care practice including: hospital, clinic, and/or community health) with a strong understanding of clinical decision support platforms, EMR, and other technologies and data sources used within a healthcare delivery system
• 7+ years of experience in, and knowledge of, the healthcare industry and market.
• 5+ years of Healthcare Consultation Experience working with External Constituents
• 5+ years Leadership experience
• 3+ years of utilizing Microsoft Office Suite and other reporting mechanisms to support analysis

COVID Requirements

COVID-19 Vaccination Requirement
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

Preferred Qualifications
• RN license preferred
• Experience with enterprise-wide and/or cross-functional large-scale initiatives with high degree of complexity.
• Strong clinical analytic skills and demonstrated conceptual thinking
• Experience working with a Health Insurance Carrier
• Strong problem-solving skills and attention to detail
• Excellent consultative, communication and presentation skills (ability to take complex content and facilitate understanding for the audience including preparing and presenting effective and compelling power point slides
• Demonstrated relationship management skills at the senior level; capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously.
• Experience with workflow development/process design
• 3+ years of experience with joint ventures, provider collaboration, or Accountable Care organizations; required
• Comfortable with organizing and responding to multiple deliverables in a timely and professional manner
• Designs, develops interventions, and facilitates work sessions. Develops and delivers all required analysis, reporting and presentation materials

Education
Associate’s Degree minimum required
Bachelor’s degree or MSW preferred

Business Overview
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.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

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Senior Clinical Program Consultant (CPC)

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CVS Health

CVS Health is a health care innovation company. Together, we are are helping people on their path to better health.

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