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Position Summary
This position is eligible for telework anywhere in the US; Must work CST or EST hours.
Help us elevate our patient care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our Dual Eligible Special Needs Plan (DSNP) members, who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand DSNP to change lives in new markets across the country.
- The Nurse Educator will support the training and compliance monitoring of the DSNP/MMP Management team. They are responsible for conducting audits of current processes, reports, and procedures to identify process improvements and issue resolutions.
- Develops and conducts ongoing staff training based on workflow needs and outcomes of clinical audits.
- Develops and implements comprehensive training program for department new hires.
- Implements training programs to increase role specific consistencies and efficiencies related to process workflows.
- Measures outcomes of clinical staff training and identifies key findings to ensure effective alignment of training content and method of delivery with business objectives and staff performance requirements.
- Provides ongoing and random qualitative and quantitative analysis using organizational performance measurements to ensure compliance with government regulations and corporate policy.
- Assists with onboarding and training of new hired staff.
Required Qualifications
- 3+ years of experience in a managed care clinical operation environment (utilization management, case management, and/or behavioral health case management) required.
- Must have active, current and unrestricted RN licensure in state of residence.
- 1+ year of Dual Special Need Program/Medicaid Medicare plan experience required.
- Must be able to work Monday through Friday, 8:00am to 4:30pm CST or EST.
Preferred Qualifications
- Previous Managed Care experience.
- Excellent verbal and written communication skills.
- Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually.
- Ability to use standard corporate software packages and corporate applications.
Education
- Associates degree required.
- BSN preferred.
Pay Range
The typical pay range for this role is: $60,522.80 - $129,600.00. 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.
We anticipate the application window for this opening will close on: 03/15/2024.
CVS Health requires certain 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, religious belief, or other legally recognized reasons that prevents them from being 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 or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com. If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.
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