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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.

Pay Range

The typical pay range for this role is:

$66,330.00 - $145,860.00

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. 
 
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: 01/30/2025

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