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

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. 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. Required Qualifications 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, Power BI (nice‑to‑have), Visio (nice‑to‑have) Preferred Qualifications 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. Education Master's degree or equivalent experience in clinical area of expertise (e.g. bachelor's degree plus 7 years' experience; associate's degree or RN diploma plus 9 years' experience). Hours and Compensation Anticipated Weekly Hours: 40. Time Type: Full time. Pay Range: $87,035.00 - $187,460.00. This pay range represents the base hourly rate or base annual full‑time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short‑term incentive program in addition to the base pay range listed above. Benefits This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. We anticipate the application window for this opening will close on: 06/20/2026. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. #J-18808-Ljbffr Council of State and Territorial Epidemiologists