Position Summary
The Supervisor, Clinical Health Services is responsible for oversight of healthcare management staff, including the organization and development of high performing teams.
In this role, you will
- Oversee a non-clinical DE staff
- Work closely with functional area managers to ensure consistency in clinical interventions supporting our members.
- Be accountable for meeting the financial, operational and quality objectives of the unit.
- Oversee the implementation of healthcare management services for assigned functional area.
- Implement clinical policies & procedures in accordance with applicable regulatory and accreditation standards (e.g. NCQA [National Committee for Quality Assurance], URAC [Utilization Review Accreditation Commission], state and federal standards, and mandates as applicable).
- Serve as a content model expert and mentor to the team regarding practice standards, quality of interventions, problem resolution and critical thinking.
- Ensure implementation and monitoring of best practice approaches and innovations to better address the member's needs across the continuum of care.
- May act as a liaison with other key business areas.
- May develop/assist in development and/review new training content.
- May collaborate/deliver inter and intra-departmental training sessions.
- Protect the confidentiality of member information and adhere to company policies regarding confidentiality.
- Manage resources responsible for identification of members, development, and implementation of care plans, enhancement of medical appropriateness, quality of care, and monitoring, and evaluating and documenting of care.
- Develop, initiate, monitor and communicate performance expectations.
- Ensure the team's understanding and use of information system capability and functionality.
- May have responsibility for their own case load work.
- May act as a single point of contact for the customer and the account team including: participation in customer meetings, implementation and oversight of customer cultural requirements, and support implementation of new customers.
- Participate in the recruitment and hiring process for staff, using clearly defined requirements in terms of education, experience, technical, and performance skills.
- Assess developmental needs and collaborate with others to identify and implement action plans that support the development of high-performing teams.
- Establish an environment and work style that promotes the concept of teamwork, cross-product integration, and continuum of care-thinking that results in strong performance.
- Consistently demonstrate the ability to serve as a model change agent and lead change efforts.
- Create a positive work environment by acknowledging team contributions, soliciting input,
- and offering personal assistance when needed.
- Be accountable for maintaining compliance with policies and procedures, and implement them at the employee level.
Required Qualifications
- 3-5 years of clinical experience.
- 1+ year of direct people leadership, supervisory, team lead, or management experience in a healthcare setting.
- Candidate must hold an active Arizona (AZ) RN license and be authorized to practice in the state of Arizona.
- May be required to travel to health fairs on an occasional weekend basis.
- Working knowledge of Microsoft Office products (Word, Excel, PowerPoint, Outlook).
Preferred Qualifications
- 1+ Previous experience in managed care.
- Ability to work with a team, build high morale, and encourage group commitment to goals and objectives.
- 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, both in oral and written formats (e.g., may provide support to the sales staff & network staff via onsite customer visits and/or presentations).
- BSN preferred.
Education
- Registered Nurse Diploma or Associates Nursing Degree required.
Anticipated Weekly Hours
40
Time Type
Full time
The typical pay range for this role is
$80,340.00 - $173,040.00
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.
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.