Clinical Program Consultant (CPC, dedicated TX)
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Excellent opportunity for a solution-oriented, experienced clinician with a passion for consulting to leverage their clinical, analytic and consultative skills to join our team of Clinical Program Consultants (CPCs). Our talented CPCs offer clinical insights based on analytics and develop 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, the Plan Sponsor Insights organization and key enterprise partners to support our customer. This will be a dedicated position for a large school district within Texas.
Clinical Program Consultants are key members of the Plan Sponsor Insights (PSI) business – a business focused on providing insights based on analytics to customers. The work environment supports and thrives on out-of-the box thinking, creative talent and a consultative approach. Our team consists of physician, clinical, well-being and analytic consultants and is highly valued by our internal partners as well as the customers we serve.
Fundamental Components/Job Description:
• 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 our customers’ strategies and help drive short- and long-term results
• Develop and present clinical content and recommendations collaborating with the account team for review and discussion with customers
• 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 customers’ population health strategy across the clinical spectrum
Opportunity to work from home versus in an Aetna office location. Candidates should be within driving distance of an Aetna office. Required recruiting geography – Texas (Houston, Sugarland, Tomball, San Antonio, Dallas, Austin)
This is a customer-facing role with travel throughout the year (~4x annually and as requested). Adjustments to be made to account for COVID. Currently all work is performed virtually.
• Minimum of 5 years clinical experience (may be a combination of different sites of care practice including: hospital, clinic, and/or community health)
• 3+ years of Healthcare Consultation Experience working with External Constituents; Required
• 1+ years Proactive consultation experience in consulting for solutions; collaborating for results
• 3 + years Proficient with MS Office programs
• 3+ years Leadership experience
CVS Health requires its 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, or religious belief that prevents them from being vaccinated.
If you are 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 within the first 10 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 45 days of your employment. In some states and roles, you may be required to provide proof of full vaccination before you can begin to actively work. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.
If you are unable to be fully vaccinated due to disability, medical condition, or religious belief, you will be required to apply for a reasonable accommodation within the first 10 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. In some states and roles, you may be required to have an approved reasonable accommodation before you can begin to actively work. If your request for an accommodation is not approved, then your employment may be terminated.
• If candidate is not currently WELCOA certified they will need to complete this certification once in the role
• 1+ years Strong problem-solving and clinical analytic skills turning data into information
• Attention to detail
• Experience working with a Health Insurance Carrier, benefit plan design
• Experience communicating for impact; driving change. 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
• Ability to establish highly collaborative relationships within and outside the organization including at the executive level
• Willing and able to travel. Adjustments to be made to account for COVID. Currently all work is performed virtually.
Bachelor’s degree or equivalent experience
Registered Nurse (RN) License Required
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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