Clinical Team Lead

CVS Health

1d•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. This is a work from home position. Applicant must reside in the state of Florida and be willing to work the following schedule: Monday through Friday, 8am to 5pm EST with occasional rotating weekend and holiday coverage required per business needs. The Team Lead is accountable to leadership to support the day to day operations of the team. This position has no supervisory oversight of staff, but requires a solid understanding of the workflows, policies and procedures to ensure the team is producing at a successful level. The Team Lead supports the onboarding of new staff as well as quality monitoring and assignment triage. The Team Lead is a single point and first line of contact for staff for clinical issues. They may lead projects as assigned. The Team Lead provides ongoing communication and updates to leadership and contributes and participates in team meetings. The role requires promoting cooperation and team-building between all department members.

Requirements

Must reside in Florida
Must be able to work Monday through Friday, 8am to 5pm EST with occasional rotating weekend and holiday coverage required per business needs
3+ years of clinical practice experience in an inpatient setting
2+ years of managed care experience
Must have active current and unrestricted RN licensure in state of Florida.
Willingness to obtain additional state licenses or compact license as needed (paid for by company)
Requires proficiency with computer skills which includes navigating multiple systems, keyboarding and using MS office products including Teams, Outlook, Excel, and Word

Nice To Haves

2+ years' experience with performance improvement projects
Clinical leadership experience
Ability to mentor and support staff to meet business needs
Exceptional communication skills
Time efficient and highly organized

Responsibilities

Serve as expert in contractual regulations.
Serve as a content model expert and mentor to the team regarding practice standard, quality of interventions, problem resolution and critical thinking.
Ensure adherence to plan sponsor performance targets.
Implement and support program policies and procedures.
Utilize critical thinking skills to raise the level of team performance.
Train the team, monitoring and providing feedback regarding performance relative to best practices.
Onboard new-hires: Request access, plan orientation, schedule CORE training, train new-hires, perform quality audits on work completed, orient to UM, state contract requirements, Desktops/Job Aids, TAT, productivity goals, and serve as mentor after training completed.
Act as a role model for the Aetna values, particularly regarding company policies on confidentiality.
Communicate effectively with a variety of audiences.
Be well organized and able to prioritize tasks.
Support a positive work environment that promotes the concept of teamwork.
Support to Supervisors as directed.
May have responsibility for their own caseload work.
Respond to issues and inquiries as needed.
Collaborate with other market Team Leads on shared projects.
Complete quality audits on new hires per policy and quarterly as assigned.
Assist manager with other tasks as assigned including PTO calendar and holiday schedule.
Be on leadership on-call schedule for weekends.
Assist with High Dollar Case reporting and presentation.
Attend meetings when the manager is unable to attend.
Coordinate assistance with other states and departments as needed.