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.

 

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Position Summary

 

This is a work from home position; Must be willing to work the following schedule: Monday through Friday, 8am to 5pm in time zone of residence with occasional rotating weekend and holiday coverage required per business needs.

 

The Team Lead is accountable to leadership to support the day to day operations of the team. This position has no supervisory oversight of staff, but requires a solid understanding of the workflows, policies and procedures to ensure the team is producing at a successful level. The Team Lead supports the on-boarding of new staff as well as quality monitoring and assignment triage.

 

The Team Lead is a single point and first line of contact for staff for clinical issues. They may lead projects as assigned. The Team Lead provides ongoing communication and updates to leadership and contributes and participates in team meetings. The role requires promoting cooperation and team-building between all department members.

• Serve as expert in contractual regulations.

• Serve as a content model expert and mentor to the team regarding practice standard, quality of interventions, problem resolution and critical thinking.

• Ensure adherence to plan sponsor performance targets.

• Implement and support program policies and procedures.

• Utilize critical thinking skills to raise the level of team performance.

• Training

• Mentor the team, monitoring and providing feedback regarding performance relative to best practices;

• New-hires: Request access, plan orientation, schedule CORE training, train new-hires, perform quality audits on work completed, orient to UM, state contract requirements, Desktops/Job Aids, TAT, productivity goals, and serve as mentor after training completed

 

• Act as a role model for the Aetna values, particularly regarding company policies on confidentiality.

• Communicate effectively with a variety of audiences.

• Well organized and able to prioritize tasks.

• Support a positive work environment that promotes the concept of teamorrk.

• Support to Supervisors as directed.

• May have responsibility for their own caseload work.

• Respond to issues and inquiries as needed.

• Collaborate with other market Team Leads on shared projects

• Complete quality audits on new hires per policy and quarterly as assigned

• Assist manager with other tasks as assigned including PTO calendar and holiday schedule

• Be on leadership on-call schedule for weekends

• Assists with High Dollar Case reporting and presentation

• Attend meetings when the manager is unable to attend

• Coordinates assistance with other states and departments as needed

Required Qualifications

• Must be able to work Monday through Friday, 8am to 5pm in time zone of residence with rotating weekend and holiday coverage required per business needs

• 3+ years of clinical practice experience in an inpatient setting

• 2+ years of managed care experience

• Must have active, current and unrestricted RN licensure in state of residence. Willingness to obtain additional state licenses or compact license as needed (paid for by company)

• 1+ years MS office products experience including Teams, Outlook, Excel, and Word

Preferred Qualifications

• 2+ years' experience with performance improvement projects

• Clinical leadership experience

• Ability to mentor and support staff to meet business needs

• Exceptional communication skills

• Time efficient and highly organized

Education

Associate's degree in Nursing required

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