Clinical Health Services Associate Manager

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, Monday-Friday 8am - 5pm EST position (shifts may vary based on business needs) Weekend/evening/holiday coverage will occasionally be required.Must have the ability to work on-call rotational coverage on weekends and some rotational on-call holiday coverage as needed.The Associate Manager is accountable to support the day to day clinical and business operations of the team. This position has supervisory oversight of staff, and requires a solid understanding of the workflows, policies and procedures to ensure the team is producing at a successful level. The Associate Manager is also responsible for oversight of utilization management nurses including the organization and development of high performing teams.

• Accountable for meeting the financial, operational and quality objectives of the unit.
• Ensures team maintains compliance and privacy practices.
• Oversees the implementation of utilization management services for assigned area
• Implements clinical policies & procedures in accordance with applicable regulatory and accreditation standards (e.g., NCQA, URAC, state and federal standards and mandates as applicable)
• Serve as a content model expert and mentor to the team regarding practice standards, quality of interventions, problem resolution and critical thinking
• Ensure implementation and monitoring of best practice approaches and innovations to better address the member's and provider's needs across the continuum of care
• May act as a liaison with other key business areas.
• May develop/assist in development and/review new training content.
• May collaborate/deliver inter and intra-departmental training sessions
• Protects the confidentiality of member information and adheres to company policies regarding confidentiality
• Manages resources responsible for identification of members, development and implementation of care plans, enhancement of medical appropriateness and quality of care and monitoring, evaluating, and documenting of care
• May collaborate with leadership for the development of, monitoring and communicating performance expectations
• Ensures the team's understanding and use of information system capability and functionality
• May act as a single point of contact for the customer and the Account Team including 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 to identify and implement action plans that support the development of high performing teams and on-purpose culture.
• Establish an environment and work style that promotes the concept of teamwork, cross product integration, and continuum of care thinking that results in strong performance
• Consistently demonstrates the ability to serve as a model change agent and lead change efforts
• Create a positive work environment by acknowledging team contributions, soliciting input, and offering personal assistance, when needed
• Accountable for maintaining compliance with policies and procedures and implements them at the employee level

• Must have active current and unrestricted RN licensure in state of residence
• 5+ years of acute experience as a Registered Nurse
• 3+ years of Utilization Management experience
• Must have experience using MS Office
• Must be willing to work holiday rotation annually, up to 2 per year
• Utilization Management work schedules will include weekends, holidays, and evening hours rotation.

• Prior leadership experience
• Ability to evaluate and interpret data, identifies areas of improvement

• Associates degree required
• BSN preferred

• 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.