Health Services Care Management Lead

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 Associate Manager is responsible for oversight of healthcare management staff including the organization and development of high performing teams. Works closely with functional area managers to ensure consistency in clinical and non-clinical interventions supporting our members. Accountable for meeting the financial, operational and quality objectives of the unit Oversees the implementation of healthcare management services for assigned functional area Implements clinical and non-clinical policies & procedures in accordance with applicable regulatory and accreditation standards (e.g. NCQA, state and federal standards and mandates as applicable) Serve as a content model expert and mentor to the team regarding practice standards, quality of interventions, problem resolution and critical thinking 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 May develop/assist in development and/review new training content May collaborate/deliver inter and intra-departmental training sessions Protects the confidentiality of member information and adheres to company policies regarding confidentiality Manages 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 Develop, initiate, monitor, and communicate performance expectations Ensures the team's understanding and use of information system capability and functionality May have responsibility for their own case load work May act as a single point of contact for the member and the Care Management Team including participation in care team meetings, implementation and oversight of member cultural requirements, and support implementation of new members Participate in the recruitment and hiring process for staff using clearly defined requirements in terms of education, experience, technical and performance skills Assesses 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 demonstrates the ability to serve as an model change agent and lead change efforts Create a positive work environment by acknowledging team contributions, soliciting input, and offering personal assistance, when needed Accountable for maintaining compliance with policies and procedures and implements them at the employee level Required Qualifications Must reside in the state of Florida, preferably in Miami FL, and be willing to travel up to 25% of the time 3+ years of managed care experience 2+ years of experience with LTSS 2+ years of Management experience, with the ability to mentor and support staff to meet business needs 2+ years experience in effective communication with Providers, Members, Staff and other Leaders both in oral and written format Ability to evaluate and interpret data, identify areas of improvement, and focus on interventions to improve outcomes Knowledge of the regulations, standards, and policies which relate to medical management Proficiency with computer skills which includes navigating multiple systems and keyboarding, and familiarity with Microsoft Excel, Word, and web-based applications desired Time efficient and highly organized Preferred Qualifications 3-5 years of experience in a physical or behavioral healthcare setting Ability to work with people in such a manner as to build high morale and group commitment to goals and objectives Ability to evaluate and interpret data, identify areas of improvement, and focus on interventions to improve outcomes Previous remote work-from-home experience preferred, with demonstrated ability to stay organized, communicate effectively, and work independently in a virtual environment Education Bachelor's degree in business or health or human services (e.g. Social Work, Psychology, Nursing, Mental Health, Counseling, Behavioral Sciences, Sociology, Gerontology or related field required. Experience may replace education. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $46,988.00 - $102,000.00 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 We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. 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. Additional details about available benefits are provided during the application process and on Benefits Moments. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. #J-18808-Ljbffr Hispanic Alliance for Career Enhancement