Associate Manager, Clinical Health Services (Remote, Illinois License)

CVS Health•Downers Grove, IL

17h•Remote

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Candidates must possess active and unrestricted LCPC OR LCSW OR RN in the state of Illinois

Requirements

3 or more years of experience in a physical or behavioral healthcare setting
1 or more years management experience
3 or more years of experience in managed care
Knowledge of the regulations, standards, and policies which relate to medical management
Active and unrestricted LCPC OR LCSW OR RN in the state of Illinois
Bachelor’s degree in health or human services (e.g. Social Work, Psychology, Nursing, Mental Health, Counseling, Behavioral Sciences, Sociology, Gerontology or related field required.

Nice To Haves

Certified Case Manager (CCM)
Bilingual - English and Spanish
Master’s degree in one of the above noted fields preferred.

Responsibilities

Oversee the implementation of healthcare management services for assigned functional area.
Accountable for maintaining policies & procedures in accordance with applicable regulatory and accreditation standards and implementing them at the employee level (e.g. NCQA, URAC, state and federal standards and mandates as applicable).
Ensure implementation and monitoring of best practice approaches and innovations to better address the member's needs across the continuum of care.
May act as a liaison with other key business areas.
Manage 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 have responsibility for their own case load work.
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.
Assess developmental needs and collaborates with others to identify and implement action plans that support the development of high performing teams.
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 demonstrate the ability to serve as a model change agent and lead change efforts.
Collaborate with licensed staff from other areas that assist with oversight of clinical staff and activities of licensed personnel.
Serve as a content model expert and mentor to the team regarding practice standards, quality of interventions, problem resolution and critical thinking.