Senior Manager, Clinical Health Services - Aetna Better Health VA - RN or BH

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.

The Senior Manager, Clinical Health Services plays a vital leadership role at Aetna Better Health of Virginia, overseeing the Maternal Health Team. This position is responsible for managing clinical team operations, fostering the development of high-performing teams, and ensuring the effective delivery of care management and coordination across the continuum of care—including assessment, planning, implementation, coordination, monitoring, and evaluation. The Senior Manager reports directly to the Senior Principal Clinical Leader. In this role, the Senior Manager helps establish and implement processes that support the efficient and effective delivery of healthcare services. They assist in coordinating patient care, optimizing care manager workflows, driving quality improvement initiatives, and maintaining compliance with regulatory standards. The Senior Manager collaborates closely with interdisciplinary teams to enhance member outcomes and contribute to overall operational excellence in clinical settings. This is a fully remote position with up to 35% in state travel. Eligible candidates must reside in Virginia.

Oversees managers of multiple teams, ensuring alignment with strategic goals. Mentors managers and assists in succession planning. Oversees operational efficiency across teams, identifies process improvements, and ensures compliance with state and federal guidelines. Acts as a subject matter expert for clinical knowledge to key internal and external constituents in the coordination and administration of benefits management initiatives and objectives. Develops and enforces policies to maintain regulatory compliance. Leads audit preparation and corrective action plans. Implements quality improvement initiatives to enhance the member experience and drive key performance metrics. Collaborates with executive leadership, state agencies, and external partners to align care management strategies with organizational goals. Analyzes performance trends, identifies gaps, and develops strategies for improvement. Develops training programs to enhance clinical and operational competencies across teams. Leads organization-wide initiatives to improve service delivery, regulatory adherence, and cost-effectiveness.