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Executive Director, Clinical Health Services - Mental Well-being

Executive Director, Clinical Health Services - Mental Well-being

CVS HealthHartford, CT, US
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Executive Director, Clinical Health Services

At Aetna, our health benefits business, we are committed to helping our members achieve their best health in an affordable, convenient, and comprehensive manner. Combining the assets of our health insurance products and services with CVS Health's unrivaled presence in local communities and their pharmacy benefits management capabilities, we're joining members on their path to better health and transforming the health care landscape in new and exciting ways every day.

Aetna is recruiting an Executive Director, Clinical Health Services who is a leader on the Mental Well-being business team informing strategy and operations with mental health clinical expertise, and identifying actions based on data and research to drive optimal cost and outcomes.

Major responsibilities :

  • Drive clinical oversight for our clinical operational areas across our EAP, RFL and On Demand teams ensuring high quality interactions (Clinical oversight, consulting with clinicians and overseeing clinical workflows).
  • Own the cross functional management process with clinical ops and OCPO for Health Affordability and SAI to review medical cost trends and working across lines of business and other constituents such as network and SIU to drive execution on opportunities to improve cost and outcomes.
  • Represent Aetna Mental Well-being externally at events and present to customers on our analytics, clinical story and thought leadership in Mental Health and Well-being.
  • Bring data expertise to guide the analytics design with our performance excellence team to provide clinical design and interpretations, drive modeling and present clinical and outcomes data externally to customers and industry experts.
  • Supports BH Clinical Operations ensuring efficient and effective delivery of healthcare services.
  • Partner with the Chief Psychiatric Officer and our Chief Medical Officer on ensuring clinical discipline in our operations and appropriate clinical policies are in place.
  • Identify and operationalize clinical opportunities to improve access, quality and affordability for members.
  • Represent the Mental Well-being business with centralized Quality function focused on HEDIS and NCQA with mental health clinical guidance and expertise.
  • Provide clinical expertise as part of our mental well-being vendor evaluation process.

Required qualifications :

  • 15+ years of experience in clinical practice and research.
  • 8+ years of experience in the mental healthcare delivery system; significant post-graduate direct patient care experience.
  • 5+ years of leadership or management experience in the healthcare industry with a focus on mental health roles.
  • Depth of clinical knowledge within mental health fields.
  • External speaking experience, including direct engagement with customers, business leaders and industry organizations.
  • Ability to drive change in alignment with the mission, vision and values of the organization.
  • Strong understanding of analytics and ability to translate insights.
  • Demonstrated ability to work effectively and collaboratively in matrixed environment.
  • Strong project management skills (financial, analytical, planning and implementation).
  • Preferred qualifications :

  • Experience with and knowledge of CPT and HCPCS coding guidelines and principles.
  • Understanding of clinical guidelines, best practices and the latest on evidence-based care.
  • Education :

    Bachelor's degree required. BH Clinical Licensure required. Master's degree preferred.

    Pay range :

    The typical pay range for this role is : $184,112.00 - $396,550.00

    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. This position also includes an award target in the company's equity award program.

    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 :

  • Affordable medical plan options, 401(k) plan (including matching company contributions), and 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.
  • Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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