Experienced Associate Manager - Duals Utilization Management and Inpatient/Post-Acute Care Leadership

Introduction to CVS Health and Our Mission

At CVS Health, we are driven by a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. As a leader in the healthcare industry, we are dedicated to making a positive impact on the lives of our members, patients, and communities. Our Heart At Work Behaviors support this purpose, empowering everyone who works at CVS Health to feel valued and play a vital role in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient, and affordable.

Job Overview: Associate Manager - Duals Utilization Management

We are seeking an experienced and compassionate Associate Manager to lead our Duals Utilization Management team, focusing on inpatient and post-acute care. As an Associate Manager, you will be responsible for overseeing a high-performing team of utilization management professionals, ensuring that our members receive the best possible care while meeting the financial, operational, and quality objectives of the unit. This is an exceptional opportunity to join a dynamic team and make a meaningful difference in the lives of our members.

Key Responsibilities:

• Accountable for meeting the financial, operational, and quality objectives of the unit, ensuring that our members receive high-quality, cost-effective care.
• Oversee the implementation of healthcare management services for assigned functional areas, collaborating with cross-functional teams to ensure consistency in clinical interventions.
• Implement clinical policies and procedures in accordance with applicable regulatory and accreditation standards, such as NCQA, URAC, state, and federal standards and mandates.
• Serve as a content model expert and mentor to the team, providing guidance on practice standards, quality of interventions, problem resolution, and critical thinking.
• Ensure the implementation and monitoring of best practice approaches and innovations to better address the member's needs across the continuum of care, driving operational excellence and streamlining processes.
• Act as a liaison with other key business areas, developing and maintaining strong relationships with stakeholders, including program design/product, Medical Directors, account teams, and plan sponsor liaisons.
• Develop and assist in the development and review of new training content, collaborating with the training team to ensure that staff have the necessary skills and knowledge to excel in their roles.
• Collaborate with leadership to develop, monitor, and communicate performance expectations, ensuring that the team is aligned with organizational goals and objectives.
• Protect the confidentiality of member information and adhere to company policies regarding confidentiality, maintaining the highest level of integrity and professionalism.

Essential Qualifications:

• Active, current, and unrestricted RN licensure in the state of residence, with a minimum of 3+ years of inpatient clinical experience as a Registered Nurse.
• 3+ years of Managed Care experience, with 1+ year of Utilization Management experience and 1+ year of leadership experience (formal or informal roles) with direct reports.
• Ability to work Monday through Friday, 8:00 am to 5:00 pm CST, with occasional late week day and/or weekend coverage, as well as holiday coverage rotation per the needs of the department.
• Travel required up to 5% for meetings and audits, with MS Office suites experience and excellent communication and interpersonal skills.
• Associates Degree in Nursing required, with a BSN preferred.

Preferred Qualifications:

• Experience with MedCompass, Medicaid, Medicare, and Duals, with the ability to communicate effectively with providers, members, staff, and other leaders both in oral and written formats.
• Ability to evaluate and interpret data, identifying areas of improvement and driving operational excellence.
• Time-efficient and highly organized, with exceptional communication skills and the ability to mentor and support staff to meet business needs.

Career Growth Opportunities and Learning Benefits

At CVS Health, we are committed to the growth and development of our colleagues. As an Associate Manager, you will have access to a range of learning and development opportunities, including training programs, mentorship, and career advancement opportunities. Our organization is dedicated to creating a culture of innovation, collaboration, and continuous learning, where you can grow professionally and personally.

Work Environment and Company Culture

Our company culture is built on the principles of heart, integrity, and excellence. We strive to create a work environment that is inclusive, supportive, and empowering, where everyone feels valued and respected. As an Associate Manager, you will be part of a dynamic team that is passionate about making a positive impact on the lives of our members and communities.

Compensation, Perks, and Benefits

We offer a competitive salary range of $80,340.00 - $173,040.00, depending on experience and qualifications. In addition to your compensation, you will enjoy a range of benefits, including medical, dental, and vision benefits, a 401(k) retirement savings plan, and an Employee Stock Purchase Plan. We also offer numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, you will enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year.

Conclusion

If you are a compassionate and experienced healthcare professional looking for a challenging and rewarding leadership role, we encourage you to apply for the Associate Manager - Duals Utilization Management position. As a member of our team, you will have the opportunity to make a meaningful difference in the lives of our members, while growing professionally and personally in a dynamic and supportive environment. Don't hesitate to apply today and join our team of dedicated healthcare professionals who are passionate about delivering exceptional care and service to our members and communities.