Full Job Description
*Candidates must possess active and unrestricted LCPC OR LCSW OR RN in the state of Illinois *
Position Summary/Mission
Responsible for the oversight of healthcare management staff including the organization and development of high performing teams. Works closely with functional area managers to ensure consistency in health related and psycho-social interventions supporting our members and is accountable for meeting the financial, operational and quality objectives of the unit.
Fundamental Components & Physical Requirements
Oversee the implementation of healthcare management services for assigned functional area. Accountable for maintaining policies & procedures in accordance with applicable regulatory and accreditation standards and implementing them at the employee level (e.g. NCQA, URAC, state and federal standards and mandates as applicable). 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. Manage resources responsible for identification of members, development and implementation of care plans, enhancement of medical appropriateness and quality of care and monitoring, evaluating and documenting of care. 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. Assess developmental needs and collaborates 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. Collaborate with licensed staff from other areas that assist with oversight of clinical staff and activities of licensed personnel. Serve as a content model expert and mentor to the team regarding practice standards, quality of interventions, problem resolution and critical thinking.
Requirements:
3 or more years of experience in a physical or behavioral healthcare setting
1 or more years management experience
3 or more years of experience in managed care
Knowledge of the regulations, standards, and policies which relate to medical management
Preferred:
Certified Case Manager (CCM)
Bilingual - English and Spanish
Education:
Bachelor's degree in health or human services (e.g. Social Work,
Psychology, Nursing, Mental Health, Counseling, Behavioral Sciences, Sociology, Gerontology or related field required.
Master's degree in one of the above noted fields preferred.
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.
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.
We anticipate the application window for this opening will close on: 10/08/2026
