Medical and health services manager Jobs in Hartford, CT

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

At Aetna, our health benefits business, we are committed to helping our members achieve their best health in an affordable, convenient, and comprehensive manner. Combining the assets of our health insurance products and services with CVS Health's unrivaled presence in local communities and their pharmacy benefits management capabilities, we're joining members on their path to better health and transforming the health care landscape in new and exciting ways every day.

Aetna is recruiting for an Executive Director, Clinical Health Services who will be a critical leader in the care management organization responsible for leading and overseeing clinical strategy and operations that support clinical operations across the enterprise. This role will have strategic direction and oversight for the day-to-day operations across multi-disciplinary teams that support our members in government programs. Teams will primarily be clinical, organized by territory and consist of Care Management Consultants (RN) reporting into appropriate levels of clinical leadership.

You will make an impact by :

• Executing the strategic agenda for clinical management supporting populations in our government programs.
• Analyzing and supporting utilization management performance of all relevant models and business lines, meeting all clinical business and performance goals.
• Identifying gap needs and implements strategies to improve outcomes and member / provider experience.
• Leading health strategies, tactics, policies, and programs that ensure appropriate utilization and cost savings.
• Partnering and collaborating with business leaders, internal / external customers, regulators, and consultants to improve outcomes.
• Overseeing and ensuring compliance with all applicable Federal and State regulations relevant to the plan's function.
• Working in close alignment with executive leaders, as well as with matrixed quality, care management, program design and external and internal business partners / vendors / consultants.
• Managing budget and staffing with membership movement and staffing ratio movement across lines of business.
• Developing and overseeing the implementation of staffing models that are consistent, cost effective and meet all compliance obligations.
• Leading, developing, motivating, recognizing, and managing high-performing teams to meet organizational goals and objectives while effectively managing change.
• Building an environment that supports professional development, mobility, and operational excellence.
• Fostering a culture that accelerates our strategy through our Heart-At-Work Behaviors by keeping the customer and colleague as the central focus.
• Supporting CVS Health in attracting, retaining, and engaging a diverse and inclusive consumer-centric workforce that delivers on our purpose and reflects the communities in which we work, live, and serve.

Required Qualifications

The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment. This position offers broad exposure to all aspects of the company's business, as well as significant interaction with all the business leaders. The candidate will be expected to have the following key attributes :

Education

Bachelor's degree required.

Pay Range

The typical pay range for this role is :

184,112.00 - $396,550.00

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. This position also includes an award target in the company's equity award program.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit Benefits | CVS Health

We anticipate the application window for this opening will close on : 03 / 05 / 2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.