At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the development and monitoring of high performing teams. Works closely with functional area leadership team (department Associate Managers, Manager, and other key stakeholders such as program design/product, Medical Directors, account teams/plan sponsor liaisons, etc.) to ensure consistency in clinical interventions supporting our members.

The Associate Manager role includes (but is not limited to):

Accountable for meeting the financial, operational, and quality objectives of the unit.Oversees the implementation of healthcare management services for assigned functional areaImplements clinical policies & procedures in accordance with applicable regulatory and accreditation standards (e.g., NCQA, URAC, 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 thinkingEnsure implementation and monitoring of best practice approaches and innovations to better address the member's needs across the continuum of careDrive operational excellence by streamlining processes and workflows to drive efficiencies, leveraging technology to streamline and simplifyMay act as a liaison with other key business areas.May develop/assist in development and/review new training contentMay collaborate/deliver inter and intra-departmental training sessionsProtects the confidentiality of member information and adheres to company policies regarding confidentialityMay collaborate with leadership for the development of, monitoring and communicating performance expectationsEnsures the team's understanding and use of information system capability and functionality 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 skillsAssesses developmental needs and collaborates with others to identify and implement action plans that support the development of high performing teamsEstablish an environment and work style that promotes the concept of teamwork, cross product integration, and continuum of care thinking that results in strong performanceConsistently demonstrates the ability to serve as a model change agent and lead change effortsCreate a positive work environment by acknowledging team contributions, soliciting input, and offering personal assistance, when neededAccountable for maintaining compliance with policies and procedures and implements them at the employee level

Required Qualifications

Candidate must have active, current and unrestricted Registered Nurse (RN) Licensure in state of residenceMust be able to work Monday - Friday 8:00 to 5:00pm ESTMust be able to work occasional late week day and/or weekend coverageMust be able to work holiday coverage rotation per the needs of the department3+ years clinical experience as a Registered Nurse3+ years of managed care experience1+ years of utilization management experienceAbility to travel up to 5% for meetings/auditsMust have Microsoft Office suites experience

Preferred Qualifications

Experience with MedCompass1+ year leadership experience (formal or informal roles)Ability to communicate effectively with providers, members, staff, and other leaders both in oral and written formats (exceptional communication skills)Ability to evaluate and interpret data, identifies areas of improvementTime efficient and highly organizedAbility to mentor and support staff to meet business needs

Education

Associate's Degree in Nursing (REQUIRED)Bachelor's Degree in Nursing (PREFERRED)

License

Candidate must have active, current and unrestricted Registered Nurse (RN) Licensure in state of residence

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

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.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 07/18/2025

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