Health Services Team Lead

Job Summary

At CVS Health, we are building a world of health around every consumer and are surrounded by dedicated colleagues who are passionate about transforming health care. 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.

Work Schedule: Monday-Friday, 8am-6pm, may change due to business needs. The Team Lead is accountable to leadership to support the day-to-day operations of the team. This position has no supervisory oversight of staff, but requires a solid understanding of the workflows, policies, and procedures to ensure the team is producing at a successful level. Additional responsibilities include but are not limited to the following:

• The Team Lead supports the onboarding of new staff as well as quality monitoring and assignment triage.
• The Team Lead is a single point and first line of contact for staff for clinical issues. They may lead projects as assigned.
• The Team Lead provides ongoing communication and updates to leadership and contributes and participates in team meetings.
• The role requires promoting cooperation and team-building between all department members. Serve as a resource to team members as well as a content model expert and mentor to the team regarding practice standard, quality of interventions, problem resolution, and critical thinking.
• Develop, implement, and support program policies and procedures.
• Provide mentoring that also includes monitoring and providing feedback regarding performance relative to best practices. Act as a role model for the company values, particularly regarding company policies on confidentiality and respect.
• Communicate effectively with a variety of audiences both within CCR as well as external departments. Organization and prioritization of tasks is critical in our fast-paced and changing environment in CCR.
• Support a positive work environment that promotes the concept of teamwork.
• Respond to issues and inquiries including assistance with escalated issues. Assist analysts with resolution of problems involving research into policy, data, or claims. Identifies, researches, develops, and recommends solutions to problems/issues.
• Provide support to supervisors as needed. Maintain proficiency with CCR policies, procedures, and reviews by routinely completing cases and carrying a case load as able.

This role is a Hybrid role which means a hybrid colleague works some of their scheduled workdays each week in an assigned company office location, and some workdays from a designated virtual work location, usually located in the colleague’s home.

Required Qualifications

6 months minimum experience with clinical review - Proficiency in Aetna Systems utilized in CCR - Rumba, ASD, ATV/MC

Preferred Job Qualifications

2 plus years clinical review experience preferred - Proven track record of subject matter expertise. - Ability to mentor and support staff to meet business needs Exceptional communication skills Time efficient and highly organized Requires proficiency with computer skills which includes navigating multiple systems and keyboarding. - HRP System experience a plus

Education

High School Diploma or Equivalent GED

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is: $18.50 - $42.35

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: 08/19/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.