
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.
🔥 17 hours ago
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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 services for the assigned functional area • Manage and develop high-performing healthcare management teams • Ensure consistency in health-related and psycho-social interventions supporting members • Meet financial, operational, and quality objectives of the unit • Maintain policies and procedures in accordance with NCQA, URAC, state, and federal standards • Implement and monitor best-practice approaches and innovations across the continuum of care • Manage resources responsible for member identification, care-plan development, medical appropriateness, quality-of-care monitoring, evaluation, and documentation • Potentially manage an individual caseload • Liaise with key business areas and serve as a customer and Account Team point of contact • Participate in customer meetings and support implementation of new customers • Assess developmental needs and implement team development action plans • Promote teamwork, cross-product integration, and continuum-of-care thinking • Lead change efforts and serve as a model change agent • Collaborate with licensed staff overseeing clinical staff and licensed personnel activities • Mentor the team on practice standards, intervention quality, problem resolution, and critical thinking
• 3+ years of experience in a physical or behavioral healthcare setting • 1+ year(s) management experience • 3+ years of experience in managed care • Knowledge of regulations, standards, and policies related to medical management • Bachelor’s Degree in health or human services or a related field (REQUIRED) • Certified Case Manager (CCM) preferred • Direct/hardwired internet connection to a modem/router within 7 feet of the computer • Minimum internet speed of 25 Mbps download and 3 Mbps upload • WiFi and satellite internet are not permitted • Quiet, secure, private designated home work location compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently living • Microsoft Office 365 or similar Google Workspace experience • Ability to use multiple monitors and navigate multiple applications • Ability to use email, calendar invites, Teams messaging, and virtual meetings • Ability to access secure systems such as VPN and EHR portals • Ability to manage strong passwords and recognize suspicious emails or links • Ability to troubleshoot common technical issues • Must obtain required internet speeds and adhere to Work From Home requirements if hired
• 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 physical, emotional, and financial well-being • Company-provided equipment (keyboard, monitor, computer, headset, etc.) • Remote work from home
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