Associate Manager, Clinical Health Services

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. This is a remote work from home role anywhere in the US with virtual training. Shift schedule is 8:30am - 5pm within time zone of residence. American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support cost-effective quality care for members.

• This position consists of working intensely as a telephonic Associate Manager, Case Management with staff and clients for fully and/or self-insured clients.
• Supervision of Case Managers who assess patient needs, evaluate plan of care, monitor effectiveness of care, communicate case objectives and act as patient advocate.
• Act as a resource for the Case Managers and support staff.
• Maintain a focus on timely customer service for internal and external clients.
• Establish professional working relationships with all members of the interdisciplinary team and communicate case objectives to the appropriate involved parties.
• Coach and utilize creative strategies that will allow all staff to become better case managers
• Willingness to volunteer and lead committees, share insights, offer innovative solutions and evaluate outcomes.
• Resolve staff issues and communicate information appropriately to the Manager of Case Management.
• Refer all cases that do not meet applicable criteria or have a potential quality of care issue to a physician reviewer.
• Identify and address quality issues and participates in quality management activities.
• Assist in the preparation of reports that analyze and track quality of service and utilization statistics.
• Comply with policies and procedures and conforms to URAC standards while performing the job functions.

Required Qualifications

• 5+ years’ experience as a Registered Nurse with hospital experience; preferably in the specialty.
• The AHH RN Case manager position requires the nurse to support members across multiple states. A RN who resides in a compact state is required to have an active multistate license through the Nurse Licensure Compact (NLC), allowing practice across participating states with one license. Nurses residing in non‑compact states must hold an individual, state‑specific RN license for each state they support.
• 1+ years’ of case management experience.
• Certified Case Manager (CCM) or obtains CCM within 3 years of becoming a supervisor.

Preferred Qualifications

• Supervisor/Management experience.
• Experience with MCG, NCCN and/or Lexicomp.
• Experience with MS Office products.

Education

• Registered Nurse Diploma or Associates required.
• Bachelors 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. 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 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. We anticipate the application window for this opening will close on: 05/29/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Apply tot his job Apply To this Job