Associate Manager, Health Services

CVS Health•Work At Home-Illinois, IL

1d•$46,988 - $112,200•Remote

About The Position

Responsible for overseeing healthcare management staff, organizing and developing high-performing teams, and working with functional area managers to ensure consistent health-related and psychosocial interventions for members. The role is accountable for the unit’s financial, operational, and quality objectives. The Associate Manager oversees healthcare management services for an assigned functional area and maintains policies and procedures in accordance with applicable regulatory and accreditation standards, including NCQA, URAC, and relevant state and federal requirements. The role implements and monitors best-practice approaches and innovations that address member needs across the continuum of care. Responsibilities may include liaising with other business areas; managing resources involved in member identification, care-plan development and implementation, medical appropriateness, quality-of-care monitoring, evaluation, and documentation; and carrying an individual caseload. The role may serve as the customer and Account Team’s primary contact, participating in customer meetings, overseeing customer cultural requirements, and supporting new-customer implementation. It assesses team development needs and works with others to implement development plans. The Associate Manager promotes teamwork, cross-product integration, and continuum-of-care thinking; leads change efforts; collaborates with licensed staff overseeing clinical work and licensed personnel; and serves as a subject-matter expert and mentor on practice standards, intervention quality, problem resolution, and critical thinking. This is a full-time, work-from-home position. Colleagues must work from the state and city where they reside and maintain a private, secure, distraction-free home workspace that complies with CVS Health and HIPAA guidelines. A hardwired internet connection to a modem or router within seven feet of the computer is required, with minimum speeds of 25 Mbps download and 3 Mbps upload; Wi-Fi and satellite internet are not permitted. CVS Health provides equipment such as a computer, monitor, keyboard, and headset, while the colleague supplies workspace furniture. The position requires use of multiple monitors and applications, digital communication and collaboration tools, secure systems, and basic independent troubleshooting of common technical issues.

Requirements

At least 3 years of experience in a physical or behavioral healthcare setting.
At least 1 year of management experience.
At least 3 years of experience in managed care.
Knowledge of regulations, standards, and policies related to medical management.
Bachelor’s degree in health or human services, such as Social Work, Psychology, Nursing, Mental Health, Counseling, Behavioral Sciences, Sociology, Gerontology, or a related field.
Ability to obtain and use a direct, hardwired internet connection within seven feet of the computer, with minimum speeds of 25 Mbps download and 3 Mbps upload; Wi-Fi and satellite internet are not permitted.
Ability to maintain a quiet, secure, private, tidy, and organized designated home work location compliant with CVS Health and HIPAA guidelines, and to work uninterrupted during work hours.
Must work within the state and city where currently residing.
Ability to use multiple monitors and applications simultaneously and communicate using email, calendar invites, Teams messaging, and virtual meetings.
Experience with Microsoft Office 365 applications or similar tools such as Google Workspace.
Ability to access secure systems such as VPN and EHR portals, follow basic security practices, troubleshoot common technical issues, and contact IT when needed.
Openness to learning new skills as the workplace environment evolves.

Nice To Haves

Certified Case Manager (CCM).
Master’s degree in health or human services, such as Social Work, Psychology, Nursing, Mental Health, Counseling, Behavioral Sciences, Sociology, Gerontology, or a related field.

Responsibilities

Oversee healthcare management staff and organize and develop high-performing teams.
Oversee healthcare management services for an assigned functional area.
Maintain and implement policies and procedures in accordance with applicable regulatory and accreditation standards, including NCQA, URAC, and relevant state and federal requirements.
Implement and monitor best-practice approaches and innovations to address member needs across the continuum of care.
Manage resources responsible for identifying members, developing and implementing care plans, enhancing medical appropriateness and quality of care, and monitoring, evaluating, and documenting care.
May manage an individual caseload.
May serve as a liaison with other key business areas and as a single point of contact for the customer and Account Team.
Participate in customer meetings, oversee implementation of customer cultural requirements, and support implementation of new customers.
Assess team development needs and collaborate with others to implement action plans supporting high-performing teams.
Promote teamwork, cross-product integration, and continuum-of-care thinking to achieve strong performance.
Model change leadership and lead change efforts.
Collaborate with licensed staff from other areas who oversee clinical staff and activities of licensed personnel.
Serve as a content expert and mentor on practice standards, quality of interventions, problem resolution, and critical thinking.
Work from a secure and private designated home workspace and meet the stated hardwired internet requirements.
Use multiple monitors and applications, digital communication and collaboration tools, secure systems, and basic technical troubleshooting.