
10,000+ employees
Founded 1963
🏥 Healthcare
⚕️ Healthcare Insurance
🛒 Retail
Healthcare • Healthcare Insurance • Retail
CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.
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10,000+ employees
Founded 1963
🏥 Healthcare
⚕️ Healthcare Insurance
🛒 Retail
Healthcare • Healthcare Insurance • Retail
CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.
• Oversee healthcare management staff and organize and develop high-performing teams • Work with functional area managers to ensure consistency in clinical and non-clinical member interventions • Meet financial, operational, and quality objectives of the unit • Oversee implementation of healthcare management services for the assigned functional area • Implement clinical and non-clinical policies and procedures in accordance with regulatory and accreditation standards • Serve as a content model expert and mentor regarding practice standards, intervention quality, problem resolution, and critical thinking • Implement and monitor best-practice approaches and innovations across the continuum of care • Liaise with key business areas • Develop, assist with development, and review training content • Collaborate on and deliver inter- and intra-departmental training sessions • Protect member information confidentiality and follow company confidentiality policies • Manage resources responsible for member identification, care-plan development and implementation, medical appropriateness, quality-of-care monitoring, evaluation, and documentation • Develop, initiate, monitor, and communicate performance expectations • Ensure team understanding and use of information-system capabilities and functionality • Potentially manage an individual caseload • Serve as a single point of contact for members and the Care Management Team, including care-team meetings and member cultural requirements • Participate in staff recruitment and hiring • Assess developmental needs and implement action plans supporting high-performing teams • Promote teamwork, cross-product integration, and continuum-of-care thinking • Lead change efforts as a model change agent • Create a positive work environment by acknowledging contributions, soliciting input, and offering assistance • Maintain compliance with policies and procedures at the employee level
• Must reside in Miami-Dade County, Florida • Must possess reliable transportation • Willingness and ability to travel up to 50% of the time • 3+ years of managed care experience • 3-5+ years of experience in a physical or behavioral healthcare setting • Knowledge of regulations, standards, and policies related to medical management • Proficiency with computer skills, including navigating multiple systems and keyboarding • Time efficient and highly organized • Exceptional communication skills • Ability to mentor and support staff to meet business needs • Bachelor's degree in business or health or human services, such as Social Work, Psychology, Nursing, Mental Health, Counseling, Behavioral Sciences, Sociology, Gerontology, or a related field • Bilingual in Spanish preferred • 1-3 years management experience preferred • Computer literacy and familiarity with Microsoft Excel, Word, and web-based applications desired • Ability to evaluate and interpret data, identify areas of improvement, and focus on interventions to improve outcomes • Ability to communicate effectively with Providers, Members, Staff, and other Leaders in oral and written formats
• CVS Health bonus, commission or short-term incentive program in addition to base pay • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting the physical, emotional, and financial well-being of colleagues and their families, based on eligibility • Mileage reimbursement per company expense reimbursement policy
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