[Remote] Utilization Management Clinical Team Lead (Remote)

Note: The job is a remote job and is open to candidates in USA. CVS Health is the nation’s leading health solutions company, dedicated to transforming health care. The Utilization Management Clinical Team Lead plays a key role in supporting team operations, onboarding new members, and providing guidance while maintaining communication with leadership. Responsibilities • 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 • Performing sedentary work, including extended periods of sitting, computer use, and document review • Participate in occasional on-call rotations, including some weekends and holidays, per URAC and client requirements Skills • 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+ year's managed care experience is required • 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 • 2+ year of experience in a managed care organization (MCO) • Experience in a high-volume clinical call center or prior remote work environment Benefits • 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. Company Overview • CVS Health is a health solutions company that provides an integrated healthcare services to its members. It was founded in 1963, and is headquartered in Woonsocket, Rhode Island, USA, with a workforce of 10001+ employees. Its website is Apply tot his job