Utilization Management Clinical Team Lead, CVS Health

CVS Health

Location:
United States, Remote

Category:
-

Contract Type:
Employment contract

Salary:

54095.00 - 116760.00 USD / Year

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Job Description:

The Team Lead plays a key role in supporting the daily operations of the team and serves as a vital resource for both staff and leadership. While this role does not include direct supervisory responsibilities, it requires a strong understanding of workflows, policies, and procedures to help ensure team success. The Team Lead is instrumental in onboarding new team members, monitoring quality, triaging assignments, and leading designated projects.

Job Responsibility:

Actively contributes to team meetings and fosters a collaborative work environment
Promoting teamwork and collaboration across the department
Serving as a knowledgeable resource and mentor to team members
Modeling best practices in clinical standards, quality, and critical thinking
Supporting adherence to plan sponsor performance goals
Assisting in the development and implementation of policies and procedures
Encouraging continuous improvement through critical thinking and feedback
Providing performance insights and coaching to enhance team effectiveness
Upholding company values, especially regarding confidentiality
Communicating clearly and effectively with diverse audiences
Managing tasks with strong organizational and prioritization skills
Supporting a positive, team-oriented work culture
Assisting supervisors as needed
Maintaining responsibility for individual caseloads, as applicable
Responding to inquiries and resolving issues promptly
Participate in occasional on-call rotations, including some weekends and holidays

Requirements:

Active, unrestricted RN license in your state of residence with multistate/compact licensure privileges
Ability to obtain licensure in non-compact states as needed
5+ years of clinical practice experience in medical healthcare
2+ years managed care experience
2+ years of experience with personal computer, keyboard navigation, and MS Office Suite applications
2+ years of healthcare management experience required (preferably in a managed care setting)
Ability to provide on-call UM coverage for nights and weekends on a rotational schedule

Nice to have:

2+ years of experience in a managed care organization (MCO)
Experience in a high-volume clinical call center or prior remote work environment
BSN degree

What we offer:

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
No-cost wellness screenings
Tobacco cessation and weight management programs
Confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access

Additional Information:

Job Posted:
September 12, 2025

Expiration:
September 14, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Utilization Management Clinical Team Lead