At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Job Description Summary

Designs and implements Clinical Health medical services, leveraging industry-proven procedures and best practices. Assists with clinical Health Service programs, procedures, and services.

A Brief Overview
Designs and implements Clinical Health medical services, leveraging industry-proven procedures and best practices. Assists with clinical Health Service programs, procedures, and services.

What you will do

Owns responsibility for the oversight of ICM and /or Long-Term Services and Supports (LTSS) and Waiver
healthcare case management staff, including progressing initiatives for high-performing health service teams.Works closely with functional Health Services managers in order to ensure ongoing consistency and accuracy in clinical interventions supporting current members.Takes accountability for completing tasks aimed to successfully achieve the financial, operational, and quality objectives of the work area.Functions as a key resource to healthcare members for governmental, state, local, and legal initiatives including the Consolidated Omnibus Budget Reconciliation Act (COBRA), Emergency Medical Treatment & Labor Act (EMTALA), and Medicaid acts and regulations.Assists in implementing and sustaining action plans, initiatives, and strategies for Clinical Health Services policies and procedures.Provides application expertise to Health Services account managers as needed, to aid in the retention of existing clients by improving team member use of healthcare resources and tools.Partners with patient resources and divisional management, Clinical Education, and other key departments to assist in the evaluation of performance initiatives, subsequently recommending appropriate training to positively impact outcomes.Works to implement effective Clinical Health Services change management plans when new initiatives are rolled out or enhanced by upper management.Facilitates regular staff meetings to ensure all team members are fully versed on ongoing as well as new work area policies, procedures, and expectations.

For this role you will need Minimum Requirements

3-5 years work experienceRequires applicable license/certification and - specialized knowledge and expertise from entry to experienced levelAdvanced problem solving and decision making skills.Advanced knowledge of medical terminology.Advanced collaboration and teamwork skills.Advanced growth mindset skills (agility and developing yourself and others).Advanced skills in execution and delivery (planning, delivering, and supporting).Ability to consider the relative costs and benefits of potential actions to choose the most appropriate option.Advanced digital literacy skills.

Education
 

Master's DegreeMust have a LISW, LISW-S, LPCC, LPCC-S, RN Master level

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$72,306.00 - $155,736.00

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. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 08/03/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.