Manager, Clinical Health Services (IC) - Aetna Commericial Operations

CVS Health•Work At Home-Ohio, OH

6d•$87,035 - $187,460•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. Position Summary The Manager of Clinical Health Services (IC) is an independent contributor role with no direct reports and will support Aetna’s Commercial division. The Manager Clinical Health Services supports a telephonic care management team by standardizing workflows, improving performance outcomes, and building staff capability through structured training and continuous improvement. This role partners with clinical leaders, quality, analytics, and operational SMEs to identify gaps, reduce variation, enhance member experience, ensure reliable adoption of care management processes, documentation standards, and engagement best practices. This position is ideal for a process-minded, people-focused professional who can translate complex workflows into clear job aids and training, coach staff toward consistent execution, and measurably improve results. This is a fully remote role. Eligible candidates may live anywhere in the contiguous US. The applicant will exhibit the following skills Process discipline: sees variation, simplifies workflows, builds standard work. Training craft: adult learning principles, clear facilitation, practical application. Coaching mindset: supportive, direct, constructive, consistent follow-up. Data fluency: uses metrics to diagnose issues and measure impact. Change leadership: helps teams adopt new behaviors with minimal friction. Telephonic excellence: understands call flow, empathy, scripting, and pacing. Operational credibility: balances quality/compliance with productivity realities.

Requirements

Active and unrestricted license in state of residence
5 years relevant experience
2+ years in a healthcare operations environment, preferably telephonic care management, utilization management, population health, or call center clinical operations.
Demonstrated experience delivering training, facilitation, coaching, or performance improvement support.
Strong documentation and process design skills (SOPs, job aids, workflow mapping).
Excellent communication skills—able to teach, coach, and influence clinical and non-clinical audiences.
Working knowledge of HIPAA and basic healthcare compliance expectations
Ability to work a schedule aligned with core business hours in the Eastern or Central time zones.
Ability to travel up to 10% as needed
Proficiency with Microsoft 365 tools: Teams, SharePoint, PowerPoint, Word, Excel

Nice To Haves

Power BI (nice-to-have)
Visio (nice-to-have)
Clinical background (RN, LPN/LVN, SW, CCM, CHES, or similar) strongly preferred in many CM environments.
Experience with quality programs and standards relevant to health plans (e.g., NCQA, HEDIS-related workflows, internal audits).
Familiarity with Lean/Six Sigma tools (Yellow Belt/Green Belt a plus).
Experience with call monitoring/call quality programs, documentation audits, or clinical coaching.
Experience building training curricula, e-learning, or assessments in an LMS.

Responsibilities

Standardizing workflows
Improving performance outcomes
Building staff capability through structured training and continuous improvement
Partnering with clinical leaders, quality, analytics, and operational SMEs to identify gaps, reduce variation, enhance member experience, ensure reliable adoption of care management processes, documentation standards, and engagement best practices.