Associate Manager, Clinical Health Services - Fully Remote at CVS Health

Illinois, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Health Insurance, Medical ManagementIndustries

Requirements

5+ years’ experience as a Registered Nurse with hospital experience; preferably in the specialty
A Registered Nurse that holds an unrestricted license in their state of residence, with multi-state/compact privileges or can be licensed in all non-compact states
1+ years’ of case management experience
Certified Case Manager (CCM) or obtains CCM within 3 years of becoming a supervisor
Registered Nurse Diploma or Associates required (Bachelors preferred)

Responsibilities

Supervision of Case Managers who assess patient needs, evaluate plan of care, monitor effectiveness of care, communicate case objectives and act as patient advocate
Act as a resource for the Case Managers and support staff
Maintain a focus on timely customer service for internal and external clients
Establish professional working relationships with all members of the interdisciplinary team and communicate case objectives to the appropriate involved parties
Coach and utilize creative strategies that will allow all staff to become better case managers
Willingness to volunteer and lead committees, share insights, offer innovative solutions and evaluate outcomes
Resolve staff issues and communicate information appropriately to the Manager of Case Management
Refer all cases that do not meet applicable criteria or have a potential quality of care issue to a physician reviewer
Identify and address quality issues and participates in quality management activities
Assist in the preparation of reports that analyze and track quality of service and utilization statistics
Comply with policies and procedures and conforms to URAC standards while performing the job functions

Skills

Key technologies and capabilities for this role

Case ManagementTelephonic Case ManagementUtilization ManagementDisease ManagementPatient AdvocacyStaff SupervisionCare PlanningCustomer ServiceInterdisciplinary Team CollaborationCoaching

Questions & Answers

Common questions about this position

Is this position remote?

Yes, this is a fully remote work from home role anywhere in the US, with virtual training.

What are the required qualifications for this role?

Candidates need 5+ years’ experience as a Registered Nurse with hospital experience, preferably in the specialty; an unrestricted RN license in their state of residence with multi-state/compact privileges or ability to be licensed in all non-compact states; 1+ years of case management experience; and Certified Case Manager (CCM) or obtain CCM within 3 years of becoming a supervisor.

What is the salary for this position?

This information is not specified in the job description.

What does the role involve in terms of team supervision and culture?

The role involves supervision of Case Managers, acting as a resource for staff, coaching staff to improve, resolving staff issues, establishing professional relationships with the interdisciplinary team, and willingness to volunteer, lead committees, and share innovative solutions.

What makes a strong candidate for this Associate Manager role?

Strong candidates will have supervisor/management experience, experience with MCG, NCCN and/or Lexicomp, and proficiency with MS Office products, in addition to meeting the required RN and case management qualifications.

CVS Health

Comprehensive pharmacy and healthcare services

About CVS Health

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.

Woonsocket, Rhode IslandHeadquarters

1963Year Founded

DEBTCompany Stage

Healthcare, Consumer GoodsIndustries

10,001+Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

Risks

Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.

The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.

The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.

Differentiation

CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.

The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.

CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.

Upsides

Expansion of telehealth services allows CVS to reach more patients remotely.

Increased consumer interest in wellness boosts demand for CVS's health-related products.

The trend towards value-based care aligns with CVS's integrated healthcare approach.

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