Sr Clinical Strategist

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

Fully remote role with requirement to reside in the state of North Carolina. 

Travel up to 25% possible in support of VBC groups. 

Schedule is Monday - Friday EST standard business hours. No nights, no weekends and no holidays.

The Senior Clinical Strategist works with assigned Aetna Medicare Provider Collaboration groups to drive improved performance by leading clinical performance improvement projects and managing multiple complex deliverables through to implementation. Projects will support population health and will primarily impact Stars and quality but will also focus on improvements in utilization and cost.

The Senior Clinical Strategist works to drive clinical performance of assigned Medicare Provider Collaboration groups by:
- Establishing trusting relationships with provider partners to promote open communication
- Serving as clinical expert on actionable opportunities related to CM, gap closure, workflow discussions, and partnering with case manager supervisor/manager and CMs
- Serving as internal and external liaison and clinical resource, interpreting data and educating regarding how to utilize data for PC performance improvement
-Strategizing with SMEs and clinical teams both internally and externally to drive outcomes and improve efficiencies
-Coordinating and conducting clinically focused meetings to identify opportunities target and prioritize goals and interventions to close gaps in care and achieve optimal stars performance
-Collaboratively working across multiple functions and/or segments to obtain agreement from all impacted parties ( e.g., up and downstream effects often impact multiple functions and/or segments)
- Collaborating with Engagement Managers, Local Market Team, Data Team, Medical Operations and others on initiatives for Stars/quality improvement
 

Required Qualifications

-Registered Nurse with active and unrestricted license in the state the candidate resides
-4+ years of case management experience
-3+ years clinical experience
-1+ year leadership or supervisory experience 
 

Technology Qualifications

- 4+ years of Outlook experience 
- 4+ years of Microsoft Power Point experience
- 4+ years of Microsoft Excel experience
- 1+ years of SharePoint experience

Preferred Qualifications

-Strong communication and interpersonal skills.
-Proven track record in meeting project milestones and -negotiating for resources.
-Proven negotiation skills.
-Proven project management skills.
-Proven success while working in a matrixed environment.
-1+ year managed care experience
- Creating accountability, developing and executing strategy and driving change

Education

Registered Nurse / Associate's Degree required

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$78,331.00 - $168,714.00

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. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 05/11/2025

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