[Hiring] Manager, Clinical Health Services @CVS Health

Role Description

Aetna is starting a new Oncology Care Model providing specialized care pathways to our members throughout their oncology treatment. We are seeking an RN to be the Manager, Clinical Health Services, to lead a variety of direct reports on the Oncology Care Model team including a Nurse Practitioner, Nurse, Pharmacist, Behavioral Health Specialist, and Oncology Companion. The team will partner with an Oncology Medical Director. This is a fully remote position. Eligible candidates may live anywhere in the contiguous United States.

• Accountable for the day-to-day management of assigned clinical teams, ensuring adherence to established practices, policies, procedures, and contractual requirements.
• Experience leading clinical operations and building a new multidisciplinary oncology team from the ground up, including onboarding and training staff.
• Lead, develop, and support high-performing clinical teams through effective coaching, performance management, and professional development.
• Participate in the recruitment and hiring process using clearly defined requirements related to education, experience, technical skills, and performance competencies.
• Develop, initiate, monitor, and communicate performance expectations and productivity standards.
• Assess developmental needs and implement action plans that support employee growth and team effectiveness.
• Ensure the successful execution of care management and care coordination activities across the continuum of care.
• Support the management of complex physical and behavioral health cases through clinical guidance, consultation, and collaboration.
• Utilize critical thinking and sound clinical judgment to support appropriate healthcare outcomes and remove barriers to care.
• Provide clinical leadership and support care management staff in delivering culturally competent, member-centered interventions.
• Conduct regular individual and team meetings focused on service delivery, quality outcomes, professional development, and operational performance.
• Collaborate with care managers, medical directors, social support teams, provider partners, and market leadership to achieve business and clinical goals.
• Communicate strategic plans and ensure implementation of tactics that support quality, operational, and financial objectives.
• Evaluate and interpret clinical, operational, and quality performance data to identify opportunities for improvement and implement targeted interventions.
• Identify and escalate quality of care concerns through established channels and drive corrective action when appropriate.
• Champion best practices, innovation, and continuous improvement initiatives that enhance member outcomes and operational effectiveness.
• Serve as a change leader by effectively communicating the business case for change and guiding teams through organizational and operational transformations.
• Maintain compliance with all applicable policies, procedures, regulatory requirements, and contractual obligations.
• May serve as a key point of contact for health plan partners, customers, and internal stakeholders, including participation in customer meetings and implementation initiatives.
• Accountable for achieving clinical, operational, quality, and financial objectives for the assigned team.

Qualifications

• Active and unrestricted RN license in their state of residence and have the ability to obtain multi-state licensure upon hire.
• 5+ years of oncology experience.
• Minimum of 2 years of utilization management experience - may include oversight or management of UM activities or teams.
• Demonstrated leadership experience, managing direct reports preferred.
• Knowledge of oncology treatment modalities, supportive care, and symptom management.
• Strong understanding of medical necessity principles and evidence-based clinical guidelines.
• Experience working with multidisciplinary healthcare teams.
• Experience leveraging digital health tools, predictive analytics, AI-enabled workflows.

Preferred Qualifications

• Oncology RN certification through ONCC. Any of the following: OCN, CPHON, CBCN, TCTCN, AOCNP, ROCNTM, AOCNS, AOCN.
• Mastery of problem solving and decision-making skills.
• Mastery of collaboration and teamwork.
• Mastery of growth mindset (agility and developing yourself and others) skills.
• Mastery of execution and delivery (planning, delivering, and supporting) skills.
• Ability to consider the relative costs and benefits of potential actions to choose the most appropriate option.
• Ability to function in clinical settings with diverse cultural dynamics of clinical staff and patients.
• Mastery knowledge of phases of care transitions and resources available for patients.
• Mastery of digital literacy skills.

Education

• Master’s degree or equivalent experience – BSN preferred.
• Equivalent years of experience defined by CVS Policy: If candidate has associate’s degree, additional 4 years of experience is needed. If candidate has bachelor’s degree, an additional 2 years of experience is required.

Anticipated Weekly Hours

• 40

Time Type

• Full time

Pay Range

The typical pay range for this role is: $87,035.00 - $187,460.00. 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.

Benefits

• Comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families.
• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs and other resources, based on eligibility.

Application Information

We anticipate the application window for this opening will close on: 11/07/2026. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws.