Associate Manager, Clinical Health Services

4004 Aetna Medicaid Administrators; Illinois; Hybrid; USD 88,000 - 190,000; Full time

Job summary

CVS Health is seeking a senior clinical health services leader to oversee ICM and LTSS case management staff. You will guide clinical interventions for members, collaborate with Health Services managers, and help drive financial and quality outcomes while ensuring compliance with applicable health regulations.

The role requires 5+ years of clinical experience and an active RN/LCSW/LCPC license in the resident state.

Qualifications

• 5+ years clinical work experience.
• Active and unrestricted license/certification (RN, LCSW or LCPC) in their state of residence.

Responsibilities

• Oversees Integrated Care Management (ICM) and LTSS healthcare case management staff.
• Collaborates with Health Services managers to ensure consistent and accurate clinical interventions for members.
• Executes tasks to meet financial, operational, and quality objectives of the unit.
• Serves as a resource on government and regulatory acts (COBRA, EMTALA, Medicare) as applicable.
• Helps implement and sustain action plans and policies for Clinical Health Services.

Skills

Clinical experience

Education

Associate's Degree (REQUIRED)

Bachelor's Degree (PREFERRED)

RN/LCSW/LCPC license

Job description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Job Overview

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.

Responsibilities

• Owns responsibility for the oversight of Integrated Care Management (ICM) and Long-Term Services and Supports (LTSS) 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 Medicare 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.

Required Qualifications

• 5+ years clinical work experience
• Candidate must have active and unrestricted applicable license/certification and - specialized knowledge and expertise from entry to experienced level – Registered Nurse License (RN), Licensed Clinical Social Worker (LCSW) or Licensed Clinical Professional Counselor (LCPC) in their state of residence

Preferred Qualifications

• Advanced 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

• Associate's Degree (REQUIRED)
• Bachelor's Degree or Master’s Degree (PREFERRED)

License

• Active and unrestricted Registered Nurse (RN) License, Licensed Clinical Social Worker (LCSW) or Licensed Clinical Professional Counselor (LCPC) in their state of residence

Work from Home Requirements

You must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of your computer and a minimum download speed of 25 mbs download and 3 mbs upload. WiFi and satellite internet are not permitted. A quiet, secure and private designated home virtual work location, free from distractions, tidy and organized, compliant with CVS Health and HIPAA guidelines, and allowing for uninterrupted work during work hours. Work-from-Home colleagues are required to work within the state and city where they have confirmed they currently live. The company will provide equipment (keyboard, monitor, computer, headset, etc.). All new hires should provide their own workspace furniture (desk or standing desk, as this position would require you to be at your desk for extended periods of time). If hired, you will commit to obtaining required internet speeds and adhere to all Work From Home requirements.

Technical and Logistical Requirements

• Device & System Navigation: Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously to streamline tasks and improve efficiency.
• Communication Tools: Ability to communicate on digital channels such as via email, calendar invites, Teams messaging, and virtual meetings.
• Collaboration & Scheduling: Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) applications or similar (Google Workspace).
• Systems Access & Security: Ability to Log in to secure systems (e.g., VPN, EHR portal), lock a computer screen when unattended, manage strong passwords, and recognize suspicious emails or links.
• Troubleshooting & Support: Ability to resolve common technical issues independently, such as: restarting an application when frozen, resolving internet connection issues, and contacting IT for unresolved technical issues.
• Future Growth: Openness to learning new skills in the future as the workplace environment evolves

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is: $88,374.00 - $190,344.00 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.

Benefits

Great benefits for great people 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.

Application Deadline

We anticipate the application window for this opening will close on: 10/30/2026

Legal and Compliance

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

Culture

Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.