Bring your heart to CVS Health. Every one of us at CVS Health shares 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.
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
Position Summary
Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours .
The supervisor is responsible for oversight of healthcare management staff including the organization and development of high performing teams. Works closely with functional area management to ensure consistency in clinical interventions supporting our members. Accountable for meeting the financial, operational and quality objectives of the unit.
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Oversees the implementation of healthcare management services for assigned functional area.
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Effective communication skills, both verbal and written
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Implements clinical policies and procedures
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Serves as content model expert and mentor to team
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Problem resolution and critical thinking
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Monitor best practice approaches
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Act as liaison with other key business areas
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Assist in development of training content as applicable
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Protect confidentiality
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Manage resources
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Develop, initiate, monitor and communication performance expectations
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Participate in recruitment and hiring process
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Establish environment that promotes teamwork, cross product integration and continuum of care thinking that results in strong performance
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Change agent
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Create a positive work environment
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Accountable for maintaining compliance
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Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding.
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Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment.
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Work requires sitting for extended periods, talking on the telephone and typing on the computer.
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Work from home position:During work hours, Colleagues who are working from home must be available by phone, video-conference, and email in a manner and frequency that is required by the Colleague's Leader. Colleagues must be available from time to time to come into the office or client location on a given day for work-related meetings, training sessions or other events, as directed by their Leader.
Required Qualifications
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Must have active current and unrestricted RN licensure in state of residence.
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3+ years of acute experience as a Registered Nurse
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1+ years of Utilization Management experience
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Experience using Microsoft Office products, including Teams, Outlook, and Excel
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Occasional travel less than 5% to complete audits/meetings
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Must be willing and able to work four 10-hour shifts including every Saturday and Sunday with two additional weekdays to be determined. Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours.
Preferred Qualifications
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EST / CST candidates preferred
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Managed Care experience preferred.
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Prior supervisory experience
Education
Associate degree required
BSN preferred.
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$96,408.00 - $207,648.00
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.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit Benefits | CVS Health (https://jobs.cvshealth.com/us/en/benefits)
We anticipate the application window for this opening will close on: 03/09/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
