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Manager, OhioRISE Clinical Health Services

Job in Bowling Green, Warren County, Kentucky, 42103, USA
Listing for: Socket.dev
Full Time position
Listed on 2026-09-22
Job specializations:
  • Management
    Healthcare Management, Change Management
  • Healthcare
    Healthcare Management
Salary/Wage Range or Industry Benchmark: 87000 - 187000 USD Yearly USD 87000.00 187000.00 YEAR
Job Description & How to Apply Below

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position

Summary

Full-time remote teleworker position in Ohio. Travel is required up to 10%% of the time to surrounding regions in Ohio, corporate office in New Albany, Ohio, or support to areas in Ohio to assist with member, stakeholder, or direct report needs. Develop, implement, support, and promote Health Services strategies,tactics, policies, and programs that drive the delivery of quality healthcaretoestablishcompetitive businessadvantagefor Aetna OhioRISE.

Health Servicesstrategies, policies, and programs which arecomprisedofquality management and clinical coverage to support current and emerging policies.

The Manager,Clinical Health Service sis responsible for oversight and management of clinical team processes including the organization and development of high performing teams. The Manager, Clinical Health Services is responsible for the oversight and management of clinical team processes, and the organization and development of high performing teams. Core business hours are Monday-Friday, 8AM-5PM

Position Responsibilities
  • Reinforces clinical philosophy, programs,policies,and procedures.
  • Communicates strategicplanand specific tactics to meet plan.
  • Ensures implementation of tactics to meet strategicdirectionfor cost and quality outcomes.
  • Creates direction and communicates a business case for change by focusing on and addressing key priorities to achieve business results.
  • Identifies opportunities to implement best practice approaches and introduce innovations to better improve outcomes.
  • Accountable for meeting the financial,operational,and qualityobjectivesof the unit.
  • Accountable for the day-to-day management of assigned team for appropriate implementation and adherence with established practices,policies,and procedures.
  • Works closely with functional area managers to ensure consistency in clinical interventions supporting our plan sponsors.
  • Develop, initiate,monitor and communicate performance expectations.
  • May act as a single point of contact for the customer and the Account Team which includes participation in customer meetings, implementation and oversight of customer cultural requirements, and support implementation of new customers.
  • Participate in the recruitment and hiring process for staff using clearly defined requirements in terms of education, experience, technical and performance skills.
  • Assesses developmental needs and collaborates with others toidentifyand implement action plans that support the development of high performing teams.
  • Consistentlydemonstratesthe ability to serve as a model change agent and leadchangeefforts.
  • Accountable formaintainingcompliance with policies and procedures andimplementsthem at the employee level.
  • Ability to evaluate and interpret data,identify areas of improvement, andfocuseson interventions to improve outcomes.
  • Ability to proactive address any performance management needs for direct reports
  • Ability to met or exceed KPI and business metrics for the direct team that is being managed
  • Working with internal, external, and state regulatory personnel with professionalism and provide prompt remediation processes
  • Some travelrequiredper organizational needs as applicable toroleand responsibilities not limited to home baseofficein New Albany, OH.
Required Qualifications
  • Resides in Ohio
  • Active Ohio unrestricted state independent licensure…
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