The Care Management Specialist coordinates care for members by conducting health risk assessments and developing individualized care plans. They collaborate with an interdisciplinary team to address social determinants of health and ensure regulatory compliance.
The Nurse Case Manager conducts comprehensive medical and behavioral health assessments to develop and implement individualized care plans for members. They coordinate ongoing care activities, educate members on healthcare decisions, and collaborate with multidisciplinary teams to optimize health outcomes.
Provide psychosocial support and evidence-based mental health counseling to individuals, couples, and families aged 13 and older. Collaborate with clinical care teams to develop treatment plans and ensure continuity of care using virtual platforms.
The Care Management Associate coordinates medical services by handling intake calls, verifying eligibility, and managing pre-certification cases. They also maintain accurate documentation and facilitate communication between healthcare providers and the clinical team.
The clinician will conduct comprehensive in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. They will also perform virtual visits and provide health education to help patients manage their unique health needs.
Conduct comprehensive in-home health evaluations for patients, including medication reviews and physical assessments. Build trusted relationships with patients to bridge gaps in care and improve overall health outcomes.
The Resource Planning Analyst monitors real-time volume and staffing levels to ensure service targets are met across clinical operations. They are responsible for making intraday schedule adjustments and producing workforce data reports for business partners.
The role involves analyzing clinical data and provider performance metrics to identify trends and drive quality improvement initiatives. You will collaborate with cross-functional teams and provider practices to implement strategies that enhance patient outcomes and operational efficiency.
The Senior Manager facilitates the clinical vendor governance lifecycle by managing workflows, vendor inventories, and decision logs. They also support business stakeholders through due diligence and business case development while driving continuous process improvements.
The Nurse Practitioner delivers holistic, evidence-based patient care through a remote technology platform, including assessment, diagnosis, and treatment. They also coordinate care within a multidisciplinary team and document all patient interactions in an electronic health record.
The Quality Management Nurse Consultant develops and implements quality improvement programs to enhance healthcare services and ensure compliance with regulatory and accreditation standards. They analyze organizational performance and drive evidence-based interventions to improve HEDIS and CAHPS goals while collaborating with cross-functional stakeholders.
The role involves supporting the Rebates application by managing incidents, optimizing job streams, and ensuring system stability. You will also collaborate with developers to translate business requirements into technical solutions and mentor junior team members.
Conduct comprehensive in-home health evaluations for health plan members, including medication reviews and physical assessments. Build trusted relationships with patients to help bridge gaps in care and improve overall health outcomes.
The physician will conduct in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. They will also perform virtual visits and provide diagnostic services while maintaining detailed clinical documentation.
Conduct comprehensive in-home health evaluations, including medication reviews, physical assessments, and diagnostic screenings for health plan members. Build trusted relationships with patients to bridge gaps in care and provide health education in a home-based setting.
The Nurse Practitioner provides holistic, evidence-based virtual care, including assessment, diagnosis, and treatment for patients aged 18 months and older. They also manage patient health education, counseling, and coordination within a multidisciplinary team.
The Senior Software Development Engineer will design, code, test, and document complex application solutions while providing technical guidance to the development team. They will lead technical activities for large-scale projects and ensure the integration of API services across the organization.
The Nurse Practitioner will provide holistic, evidence-based virtual care, including assessment, diagnosis, and treatment for patients aged 18 months and older. They will also manage patient health inquiries, document care in an EHR, and collaborate with a multidisciplinary team to ensure high-quality outcomes.
Conduct comprehensive in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. Engage with patients to answer health questions and provide diagnostic services while maintaining accurate clinical documentation via an iPad.
Conduct in-home health evaluations for patients, including medication reviews, physical assessments, and diagnostic screenings. Build trusted relationships with patients to bridge care gaps and provide comprehensive health insights to their care teams.
Conduct comprehensive in-home health evaluations for patients, including medication reviews and physical assessments. Facilitate connections to appropriate care and maintain accurate clinical documentation using provided digital tools.
The Case Manager facilitates healthcare outcomes by collaborating with members, providers, and community organizations to address complex health and social needs. They provide assistance with appointment scheduling, benefit navigation, and patient education using established care management tools.
Provide high-quality clinical care to patients in their homes as a Nurse Practitioner or Physician Assistant. Conduct comprehensive health assessments and manage patient treatment plans effectively.
The Senior Outreach Coordinator manages prevention and wellness activities by analyzing data to improve health outcomes and member education. They also coordinate pilot health interventions and produce community newsletters to support organizational quality objectives.
The Nurse Practitioner will provide holistic, evidence-based virtual care, including assessment, diagnosis, and treatment for patients aged 18 months and older. They will also manage patient education, medication counseling, and coordinate care within a multidisciplinary team.
The Director of Underwriting manages complex PBM contract strategies, overseeing the full contract lifecycle from negotiation to execution. They lead cross-functional teams to ensure financial objectives are met while mitigating operational and legal risks.
Conduct comprehensive in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide patient education and bridge gaps in care to improve overall health outcomes.
The Senior Manager leads a team of project managers to deliver complex technology initiatives while overseeing project portfolios and establishing management standards. They act as a strategic partner to business and technology leaders to drive operational excellence and ensure projects meet quality and budget expectations.
The Senior Manager leads a team of project managers to deliver complex technology initiatives and strategic transformation programs. They are responsible for overseeing project portfolios, establishing governance standards, and managing stakeholder relationships to ensure operational excellence.
The Case Manager will perform comprehensive assessments, planning, and care coordination to meet the health needs of members across various settings. They act as a liaison between patients, families, providers, and insurance carriers to optimize wellness outcomes and facilitate appropriate condition management.
The Executive Director will lead the design, development, and delivery of next-generation Specialty Pharmacy products and platforms. This role involves building and scaling high-performing engineering teams while driving technical strategy and leveraging AI to solve complex healthcare challenges.
The role involves leading the design, development, and implementation of scalable microservices architecture while mentoring a team of Java developers. You will act as a chief technical contributor to translate business requirements into technical specifications and oversee system maintenance and testing.
Care managers act as frontline advocates to assess, plan, and coordinate medical care for members to improve wellness outcomes. They conduct clinical evaluations, develop proactive care plans, and collaborate with interdisciplinary teams to overcome barriers to health.
The Case Manager facilitates healthcare outcomes by collaborating with members, providers, and community organizations to address complex health and social needs. They utilize critical thinking to assist with appointment scheduling, benefit access, and patient education through various care management tools.
The role involves making high-volume outbound calls to Medicare Advantage and Medicaid members to schedule healthcare evaluations. You will be responsible for meeting daily productivity and quality goals while adhering to scripts and privacy regulations.
Conduct in-home and virtual health evaluations, including medication reviews, medical history assessments, and physical examinations. Provide patient education and bridge gaps in care to improve health outcomes for health plan members.
The Nurse Practitioner delivers holistic, evidence-based virtual care, including assessment, diagnosis, and treatment for patients aged 18 months and older. They also provide patient education on health maintenance, STI prevention, and contraceptive care while documenting all interactions in an EHR.
The manager oversees contract performance and develops provider network relationships to meet business strategies and cost-saving targets. They collaborate cross-functionally to manage provider compensation, pricing, and the resolution of escalated contractual or claims issues.
The Utilization Management Nurse Consultant assesses, plans, and coordinates healthcare services to facilitate appropriate member benefits. They apply clinical criteria to render coverage determinations and consult with internal and external parties to ensure quality care.
The Service Advocate manages comprehensive patient care by handling inbound and outbound calls to schedule, reschedule, and cancel appointments. They are also responsible for maintaining accurate patient records and collaborating with medical staff to ensure efficient scheduling operations.
The engineer will design and develop full-stack applications using .NET and Angular while modernizing legacy systems into cloud-ready, API-first platforms. They will collaborate with cross-functional teams to ensure high performance, reliability, and security across all software solutions.
The Case Management Coordinator facilitates healthcare outcomes by evaluating member needs, coordinating care plans, and assisting with appointment scheduling. They also utilize motivational interviewing to engage members and collaborate with multidisciplinary teams to ensure quality of care.
The Nurse Practitioner provides holistic, evidence-based virtual care, including assessment, diagnosis, and treatment for patients aged 18 months and older. They also manage patient health inquiries, coordinate care within a medical home model, and document all services in an electronic health record.
The Health Advocate conducts inbound and outbound calls to Medicare members to educate them on health screenings, medications, and benefits. They are responsible for accurately documenting member interactions and working to resolve barriers to care.
The Case Management Coordinator facilitates healthcare outcomes by evaluating member needs, coordinating care plans, and collaborating with multidisciplinary teams. They utilize critical thinking to identify high-risk factors and provide coaching to empower members in their healthcare decision-making.
The Senior Data Advisor manages complex analytics initiatives, reporting workflows, and data governance activities to support organizational performance goals. They act as a bridge between business stakeholders, IT partners, and data teams to ensure data accuracy, consistent definitions, and actionable insights.
The role involves designing and building analytical models to predict and measure performance for CMS Stars reporting. It also requires developing forecasting models and collaborating with cross-functional teams to drive quality improvement efforts.
The Senior Analyst will prepare and issue financial quotations, manage stop loss policies, and provide pricing strategy guidance to sales and client management teams. They will also interpret operational data to develop fees and present financial deliverables to internal and external stakeholders.
The clinician will conduct in-home health evaluations, including medication reviews, physical assessments, and diagnostic testing for health plan members. They are responsible for building trusted relationships and providing education to help bridge gaps in care.
Lead the design and delivery of enterprise-scale Generative AI solutions using AWS Bedrock and Google Cloud Vertex AI. Define technical strategy, establish architectural standards, and mentor engineering teams to build secure, scalable, and cost-effective AI platforms.
The Clinical Pharmacist evaluates and reviews prior authorization requests to render coverage determinations based on clinical criteria and plan design. They also collaborate with technicians and healthcare providers to facilitate requests and ensure timely communication of decisions.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic testing. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
The Chief of Staff partners with senior leadership to drive strategic priorities, operational initiatives, and organizational objectives. They facilitate cross-functional coordination, manage complex programs, and act as a trusted advisor to ensure effective execution of business goals.
The Case Management Coordinator collaborates with members, providers, and community organizations to address complex health and social determinant needs. They facilitate healthcare outcomes by assisting with appointment scheduling, benefit access, and member education using care management tools.
The Senior Mainframe Capacity & Performance Engineer is responsible for monitoring, analyzing, and optimizing enterprise mainframe resource utilization to ensure platform scalability and reliability. This role involves partnering with cross-functional teams to troubleshoot performance issues, conduct capacity forecasting, and drive infrastructure efficiency initiatives.
The Executive Medical Director will lead the centralized MD Quality function to ensure clinical rigor, consistency, and accountability across all Aetna lines of business. This role involves overseeing multidisciplinary teams, analyzing decision trends, and driving cross-functional quality improvement initiatives.
The manager acts as the primary resource for high-profile providers to maintain positive relationships and resolve complex issues regarding Medicaid policies, claims, and contracts. They also collaborate cross-functionally to manage cost drivers, execute cost initiatives, and ensure provider compliance with plan designs and regulations.
The Distinguished Architect will lead the technical modernization of enterprise claims processing platforms and define the architectural roadmap for a next-generation ecosystem. This role involves guiding large engineering organizations through complex transitions from legacy mainframe systems to cloud-native, API-driven architectures.
The Registered Dietitian will evaluate and customize enteral and parenteral nutrition prescriptions while coordinating care with patients, caregivers, and medical professionals. They will also perform ongoing patient assessments, provide therapy education, and ensure clinical documentation meets payer requirements.
The Authorization Specialist works closely with patient intake coordinators and insurance providers to manage medical authorizations. They are responsible for verifying insurance coverage and ensuring the efficient processing of specialty infusion medication requests.
Conduct in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide health education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
The manager will develop strategies to improve specialty pharmacy operations, patient outcomes, and colleague workflows through data-driven insights. They will partner with cross-functional teams to build business cases, track value realization, and provide executive-ready recommendations.
The Staff Software Development Engineer will design, develop, and implement digital health solutions while leading technical direction and innovation. This role also involves driving operational excellence through automation, reliability improvements, and serving as the technical lead for complex production issues.
The analyst is responsible for post-service claim reviews to determine reimbursement eligibility by compiling claim history and system information. They collaborate with clinicians and medical directors while ensuring compliance with regulatory requirements and internal policies.
Provide psychosocial support and evidence-based mental health therapy to individuals, couples, and families aged 13 and older. Collaborate with clinical care teams to develop treatment plans and ensure continuity of care for patients.
The Pharmacy Services Specialist interacts directly with patients to provide education, resolve medication-related questions, and influence generic utilization. They also conduct adherence outreach to ensure patients remain compliant with their prescribed therapies.
Conduct comprehensive in-home health evaluations, including medication reviews and physical assessments for health plan members. Provide patient education and facilitate connections to appropriate care based on individual health needs.
The manager will lead workforce intelligence and analytics initiatives to support enterprise planning, talent pipeline development, and business decision-making. They are responsible for transforming complex workforce data into actionable insights and managing the data ecosystem across enterprise platforms.
The Senior Manager leads competitive intelligence and capture strategy for Medicaid markets to improve proposal win probability. They are responsible for governing competitive intelligence frameworks and collaborating with cross-functional teams to develop effective pursuit strategies.
The manager directs in-depth market and competitive research to inform capture strategy and proposal development for Medicaid managed care contracts. They collaborate with cross-functional teams to synthesize complex intelligence into actionable insights that drive business growth.
The manager will direct in-depth market and competitive research to inform capture strategy and proposal development for Medicaid managed care contracts. They will collaborate with cross-functional teams to synthesize complex intelligence into actionable insights that drive business growth.
The Director leads a team of account executives to drive strategic and operational excellence, ensuring client satisfaction, retention, and growth. They partner with senior stakeholders to deliver consultative solutions and manage contract negotiations for pharmacy benefit management services.
The Case Management Coordinator collaborates with members, providers, and community organizations to facilitate healthcare outcomes and address social determinants of health. They conduct comprehensive evaluations of member needs, coordinate care plans, and provide coaching to empower members in their healthcare decision-making.
The Registered Dietitian/Health Coach conducts comprehensive health assessments and develops personalized care plans to promote lifestyle behavior changes. They utilize motivational interviewing and active listening to engage members and support them in achieving optimal health goals via virtual appointments.
The Pharmacy Technician will handle incoming calls in a call center environment to support patient health and pharmacy services. They are responsible for maintaining high standards of safety, quality, and compassionate care for all customers.
The Vice President of Corporate Development will lead enterprise-wide merger, acquisition, divestiture, and strategic investment activities for CVS Health. This role involves shaping corporate strategy, advising senior leadership and the Board, and rebuilding the Corporate Development function to ensure operational rigor and effective transaction execution.
The Principal Engineer will lead the AWS cloud engineering team, owning the enterprise AWS platform architecture and standards. They will drive cloud transformation initiatives, implement Infrastructure as Code, and mentor engineers to ensure secure, scalable, and reliable cloud solutions.
The Principal Cloud Infrastructure Engineer will own the enterprise GCP platform, setting architectural direction and establishing engineering standards. They will lead the cloud engineering team, driving Infrastructure as Code (IaC) initiatives and ensuring the platform is secure, scalable, and compliant.
The Executive Assistant will provide comprehensive administrative support to the VP, including complex calendar management, travel arrangements, and expense processing. They will also coordinate meetings, prepare presentations, and manage departmental documentation to ensure smooth executive operations.
The Medical Director will serve as a clinical subject matter expert in Otolaryngology, providing guidance for medical management programs and clinical determinations. They will also collaborate with network physicians and case management teams to ensure quality, evidence-based patient care.
The nurse will perform telephonic counseling for patients with complex conditions, providing education on disease processes, treatment modalities, and medication side effects. They are also responsible for monitoring patient adherence, reporting adverse drug events, and collaborating with clinical staff to resolve patient issues.
The Account Manager is responsible for managing client relationships, ensuring customer satisfaction, and driving customer success. They will act as the primary point of contact for operational matters, analyze client needs, and resolve inquiries to improve the customer experience.
The role involves end-to-end ownership of Preferred Network operations, including defining eligibility criteria and ensuring provider data accuracy. You will lead data-quality initiatives and manage vendor partnerships to ensure the network remains reliable and effective for care teams.
The analyst will assist with month-end close processes, forecast and budget review decks, and the maintenance of gross profit templates. They are also responsible for uploading financial data into Hyperion and performing ad-hoc reporting as required.
The coordinator identifies and triages patient information from various sources to create or update patient accounts. They also coordinate with the operations support team to manage enteral nutrition services and assist patients with backordered items.
The role involves designing, developing, and implementing scalable software solutions while collaborating with cross-functional teams to ensure high-quality code. Additionally, the engineer will provide technical mentorship to junior developers and contribute to the overall technical direction and innovation of engineering projects.
Conduct comprehensive in-home health evaluations for health plan members, including medication reviews and physical assessments. Build trusted relationships with patients to bridge gaps in care and provide personalized health guidance.
Conduct comprehensive in-home health evaluations for health plan members, including medication reviews and physical assessments. Build trusted relationships with patients to bridge care gaps and provide necessary health education.
The Utilization Management Nurse Consultant assesses, plans, and coordinates healthcare services to ensure appropriate benefit utilization for members. They apply clinical criteria to render coverage determinations and communicate with providers to facilitate effective treatment plans.
Conduct comprehensive in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide patient education and facilitate connections to appropriate care based on individual health needs.
Conduct comprehensive in-home health evaluations for patients, including medication reviews and physical assessments. Facilitate connections to appropriate care and document findings using an intuitive clinical workflow on an iPad.
The Scrum Master directs team activities, oversees Scrum events, and removes obstacles to ensure project progress. They also provide coaching to stakeholders, manage agile governance frameworks, and drive continuous improvement initiatives.
The Scrum Master facilitates Scrum events, removes impediments, and supports the Product Owner to drive continuous improvement. They also coach teams on Agile principles, manage budgets, and forecast team capacity to ensure successful project delivery.
Lead the implementation, governance, and optimization of AI and automation solutions to enhance proposal quality and operational efficiency. Partner with cross-functional teams to develop AI-enabled content libraries and deliver training programs that drive organizational AI proficiency.
The engineer will design, develop, and scale AI-powered products by integrating Large Language Models and generative AI into enterprise platforms. They are responsible for defining technical architecture, optimizing inference performance, and ensuring secure, scalable AI deployment.
The Staff Software Developer will drive technical strategy and execution for the Aetna Transactional Cache platform. This role involves collaborating with cross-functional teams to modernize systems and enable innovation across cloud platforms.
The role involves leading the creation of developer tools and services to support enterprise engineering and delivery automation. You will manage and mentor a team of engineers while troubleshooting complex technical issues and supporting CI/CD pipelines.
The Lead Technician supports day-to-day operations of the Clinical Intervention Center by providing workflow guidance, technician training, and operational support. Key tasks include managing Facility Formulary Therapeutic Interchange (FFTI) and Third-Party Therapeutic Interchange (TPTI) projects, reporting, and quality assurance.
Develop and deliver decision support tools and insights to support contracting, financial, and operational strategic decision-making for Retail Health leadership. Act as a subject matter expert for quantitative projects, driving data ingestion, storage, and risk mitigation protocols.
The Senior Product Owner manages product priorities within the Utilization Management value stream to support Commercial, Medicare, and Medicaid lines of business. They act as a bridge between business and technology teams to translate requirements into actionable delivery plans while ensuring alignment with strategic goals.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic testing. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Develop and execute a strategic territory plan to drive growth of Supplemental Health solutions across National Accounts in the Western United States. Build and maintain executive-level relationships with major consulting firms and brokerage organizations while collaborating with internal teams to deliver integrated solutions.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic testing. Build trusted relationships with patients to bridge gaps in care and provide health education.
The Medical Director will develop, implement, and evaluate clinical programs while expanding medical management services to meet member needs. They will also act as a clinical liaison to network providers and support staff in managing prior authorizations and peer-to-peer reviews.
The Medical Director provides clinical oversight and mentorship for CVS Health clinical programs, including utilization management, formulary development, and drug information services. They also act as a clinical partner across the enterprise, performing medication utilization reviews and medical necessity appeals for various client segments.
The Utilization Management Nurse Consultant coordinates and documents benefit management programs to ensure members receive appropriate care at the right time and location. They review clinical records, apply medical necessity criteria, and collaborate with providers to facilitate effective healthcare services.
The manager will lead strategic account management and operational initiatives for a portfolio of complex client relationships to drive satisfaction and growth. They are responsible for overseeing contract implementations, monitoring healthcare industry trends, and serving as a trusted advisor to clients.
The role involves building and scaling predictive forecasting models to optimize pricing and merchandising decisions within a retail environment. You will collaborate with cross-functional teams to translate business requirements into technical solutions while leveraging generative AI and high-performance computing.
The Chief Information and Digital Officer will lead the technology separation and standalone readiness for Omnicare while driving digital transformation and modernization. This executive will oversee cybersecurity, data strategy, and enterprise applications to ensure operational excellence and competitive advantage.
Develop and implement sales strategies to acquire new large group accounts and government programs while managing complex negotiations. Collaborate cross-functionally to integrate client needs with product offerings to drive revenue growth and support renewals.
The Senior Manager will lead strategic initiatives for the Aetna Transactional Cache program, overseeing large-scale data modernization and cloud migration efforts. They are responsible for managing program roadmaps, financials, governance, and cross-functional delivery across engineering and business teams.
Conduct comprehensive in-home health evaluations, including medication reviews, physical assessments, and diagnostic testing for health plan members. Build trusted relationships with patients to bridge care gaps and provide health education in a flexible, clinical setting.
Conduct in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
The Account Manager manages a portfolio of client accounts to drive revenue growth, member retention, and customer satisfaction. They analyze complex client data and collaborate with cross-functional teams to deliver value-added solutions and strategic account plans.
The manager develops and governs enterprise outbound transportation strategies to improve service, cost, and network efficiency. They act as a subject matter expert while leading cross-functional initiatives to optimize routing and transportation technology.
The Staff Software Development Engineer will design, develop, and support scalable, rule-based decision solutions for enterprise business processes. The role involves working with modern IBM automation and AI platforms to drive modernization and intelligent automation initiatives.
The Executive Assistant provides comprehensive administrative support, including managing office operations, financial records, and departmental workflows. They act as a primary point of contact for stakeholders and ensure regulatory compliance across all administrative activities.
The Lead Director will develop market intelligence capabilities by leveraging AI to synthesize competitive signals and inform strategic decision-making across the enterprise. This role involves partnering with cross-functional leaders to translate complex market dynamics into actionable go-to-market and product strategies.
Conduct comprehensive in-home health evaluations for health plan members, including physical assessments and medication reviews. Provide patient education and bridge gaps in care to improve overall health outcomes.
The Care Management Associate supports the coordination of medical and social services by triaging tasks, conducting member outreach, and implementing care plans. They ensure compliance with regulatory standards while maintaining accurate documentation and facilitating effective communication between members and care teams.
The Scrum Master facilitates Scrum events, removes impediments, and coaches teams on Agile principles to drive continuous improvement. They are responsible for budget development, resource planning, and ensuring effective risk management across projects.
The Senior Data Scientist will advance Contact Intelligence as an enterprise capability by identifying high-value use cases and operationalizing insights across the organization. This role involves partnering with cross-functional stakeholders to develop analytical frameworks, measure business impact, and scale AI-driven solutions.
Conduct in-home health evaluations for health plan members, including medication reviews, physical exams, and diagnostic tests. Build trusted relationships with patients to bridge gaps in care and improve overall health outcomes.
Conduct in-home health evaluations for health plan members, including medication reviews, medical history assessments, and physical examinations. Provide patient education and facilitate connections to appropriate care services while maintaining accurate clinical documentation.
Conduct in-home health evaluations for patients, including medication reviews, physical assessments, and diagnostic testing. Build trusted relationships with patients to help bridge gaps in care and improve health outcomes.
Conduct in-home health evaluations for health plan members, including medication reviews, medical history assessments, and physical evaluations. Provide diagnostic and preventive services while building trusted relationships to bridge gaps in patient care.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic screenings. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic testing. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic testing. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct comprehensive in-home health evaluations, including physical exams and medication reviews, to bridge gaps in patient care. Provide patient education and facilitate connections to appropriate care services while maintaining accurate clinical documentation.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic screenings. Build trusted relationships with patients to bridge gaps in care and provide personalized health education.
The Senior Manager develops and delivers analytics, reporting, and business insights to support the Retail Trade organization and manufacturer partnerships. They serve as a subject matter expert on data assets, ensuring data integrity while translating complex datasets into actionable business recommendations.
This role manages business forecasting, capacity planning, and performance projections for specialty operations. The manager will lead a team to ensure accurate staffing requirements and deliver ad-hoc and recurring analytical reports.
Conduct comprehensive in-home health evaluations, including medication reviews and physical assessments for health plan members. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct comprehensive in-home health evaluations for health plan members, including physical assessments and medication reviews. Provide patient education and facilitate connections to appropriate care based on individual health needs.
Conduct comprehensive in-home health evaluations for health plan members, including physical assessments and medication reviews. Provide health education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct comprehensive in-home health evaluations, including medication reviews, physical assessments, and diagnostic screenings for health plan members. Build trusted relationships with patients to bridge gaps in care and provide personalized health education.
The Provider Data Services Senior Coordinator is responsible for loading new and revised Medicaid participating provider data into the QNXT source system. This role involves supporting data integrity and ensuring accurate provider information within CVS Health's healthcare systems.
Conduct comprehensive in-home health evaluations, including physical exams and medication reviews, to bridge gaps in patient care. Provide patient education and diagnostic services while maintaining accurate clinical documentation via an iPad.
Conduct in-home health evaluations including medication reviews, medical history assessments, and physical examinations for health plan members. Provide patient education and diagnostic services while maintaining accurate clinical documentation using an iPad.
The Epic EHR Development Lead oversees the design, configuration, and optimization of Epic solutions across clinical and operational domains. This role provides technical leadership, mentors development teams, and ensures alignment with organizational strategy and regulatory standards.
The Telesales Representative is responsible for acquiring new members through inbound and outbound calls while managing member relationships and inquiries. They must assess customer needs, cross-sell ancillary products, and maintain high levels of member satisfaction and retention.
The Manager, Scrum Master is responsible for leading technology initiatives, managing product teams, and ensuring project delivery aligns with budget, scope, and quality standards. They will oversee Agile processes, facilitate continuous improvement, and coordinate with stakeholders to optimize execution speed and effectiveness.
Conduct comprehensive in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide patient education and facilitate connections to appropriate care services to improve health outcomes.
Supports pharmaceutical design partner innovation by synthesizing insights, developing business cases, and translating feedback into product requirements. Coordinates cross-functional initiatives and prepares executive-ready strategic recommendations to advance product commercialization.
The role involves managing audits of provider information and resolving third-party contracted reimbursement issues. Additionally, the coordinator is responsible for automating and manually loading new and revised provider data transactions.
The Accounts Receivable Collector manages outstanding consumer account balances through professional outreach and effective communication. They are responsible for resolving past-due balances, documenting collection activities, and identifying appropriate payment solutions for customers.
The Senior Associate supports financial operations by preparing performance analysis, reporting, and projections for field leadership. They act as a financial subject matter expert, assisting in strategic initiatives and the development of educational materials for regional teams.
The Telesales Representative is responsible for acquiring new members through inbound and outbound calls using a lead generation platform. They also manage member relationships, address inquiries regarding benefits and services, and ensure retention through high-quality customer service.
The Senior Digital Product Manager defines and drives the product strategy and roadmap for the Medicare Stars Intelligence Platform to improve health outcomes. They lead cross-functional teams, manage product backlogs, and ensure alignment with business objectives and key results.
Define and own the long-term product strategy for AI-driven outreach and rescheduling capabilities within a highly ambiguous healthcare space. Architect intelligent orchestration logic using conversational AI to ensure care continuity and influence cross-functional stakeholders at the department and division level.
Conduct in-home health evaluations for health plan members, including medication reviews, medical history assessments, and physical evaluations. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation using an iPad.
The Senior Analyst will formulate pricing strategies and execute financial modeling for complex PBM client contracts. They will also present financial analyses to executive leadership and collaborate with sales teams to achieve revenue and profitability targets.
Conduct comprehensive in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. Engage with patients one-on-one to answer health questions and provide connections to appropriate care services.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic testing. Build trusted relationships with patients to bridge gaps in care and provide personalized health education.
Conduct comprehensive in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. Utilize clinical workflows to document findings and provide diagnostic services while building trusted relationships with health plan members.
The Senior Manager of Medicaid Compliance oversees the execution and management of compliance program activities for the Ohio Medicaid health plan. This role acts as the primary liaison to state agencies, manages regulatory audits, and ensures all business operations align with Medicaid contractual and regulatory requirements.
The Senior Analyst supports financial planning, forecasting, and variance analysis for non-Medicare commercial pharmacy network costs. They are responsible for building financial models, monitoring network margin performance, and preparing management reporting packages.
The SIU Investigator conducts investigations into suspected healthcare fraud and abuse to prevent financial loss and ensure regulatory compliance. They also collaborate with law enforcement agencies and provide educational programs to promote fraud deterrence.
Conduct in-home and virtual health evaluations, including medication reviews and physical assessments for health plan members. Build trusted relationships with patients to bridge gaps in care and improve overall health outcomes.
The technician is responsible for screening orders, reviewing prescription overrides, and directing questionable prescriptions to the prescriber. They must maintain production and quality standards while working in a team-oriented, closed-door pharmacy environment.
The Principal Software Development Engineer will lead the architecture, design, and delivery of next-generation digital healthcare solutions. This role involves hands-on full-stack engineering, setting technical standards, and mentoring engineering teams across the organization.
The Stop Loss Claims Analyst prepares, tracks, and reconciles stop loss filing packages for self-funded employer groups. They serve as a liaison between internal teams and external carriers to ensure accurate and timely reimbursement.
Conduct comprehensive in-home health evaluations for health plan members, including physical assessments and medical history reviews. Facilitate connections to appropriate care and ensure accurate documentation using clinical workflows.
Lead and develop a team of data engineers and DBAs to deliver reliable, scalable, and efficient data solutions. Oversee the design, support, and continuous improvement of data platforms while ensuring operational excellence and alignment with business needs.
The Principal Engineer will lead the architecture, strategy, and governance of a unified, multi-cloud data ingestion platform and federated data lake. They will drive enterprise-wide technical standards, infrastructure automation, and cost-optimization initiatives to support observability, security, and AI/ML workloads.
The specialist reviews and adjudicates health claims by applying medical necessity guidelines and verifying eligibility. They also manage claim queues and correspondence to ensure accurate and timely processing within established turnaround parameters.
The technician manages inbound calls and requests for prior authorizations while maintaining accurate documentation of all reviews. They also assist with administrative tasks such as monitoring mailboxes and escalating clinical inquiries to the pharmacist team.
The Manager Client Audit will lead and coordinate complex client-requested rebate audits from start to finish. They will serve as the primary point of contact for clients and auditors while resolving audit findings and identifying process improvements.
The technician manages inbound calls and processes prior authorization requests by verifying insurance coverage and clinical documentation. They also assist with appeals, maintain accurate electronic records, and communicate with healthcare providers to ensure regulatory compliance.
The Scrum Master facilitates Scrum events, removes impediments, and promotes collaboration to ensure the effective implementation of the Scrum framework. They also counsel teams on agile principles, track team progress using metrics, and develop actionable insights to drive continuous improvement.
The technician manages inbound calls and faxes to process prior authorization requests while ensuring accurate documentation and regulatory compliance. They also verify insurance coverage, assess medical necessity, and communicate with healthcare providers to resolve documentation issues.
The Senior Manager will support the successful execution and adoption of care management workflows across Oak Street Health centers. They will act as a bridge between centralized strategy and field operations to drive operational consistency and continuous improvement.
The clinician will conduct in-home health evaluations, including medication reviews, physical assessments, and diagnostic testing for health plan members. They are responsible for building trusted relationships and bridging gaps in care while traveling across a defined coverage area.
The Associate Manager oversees healthcare management staff and ensures the implementation of clinical and non-clinical interventions to meet quality and financial objectives. They are responsible for mentoring teams, monitoring care plans, and maintaining compliance with regulatory and accreditation standards.
The Quality Engineering Manager leads teams to ensure the delivery of high-quality technology solutions for Medicare business operations. This role drives quality strategy, test automation, and continuous improvement across multiple applications and platforms.
The Account Executive serves as the primary relationship manager for mid-market and coalition pharmacy benefit manager clients, overseeing renewals, financial performance, and service delivery. They collaborate with internal teams to orchestrate cross-functional delivery while maintaining client satisfaction and retention.
The Senior Manager will oversee the full lifecycle of retail brand contracts, including execution, amendments, and renewals while ensuring compliance with legal and company standards. They will also partner with cross-functional teams to identify cost savings, manage contract data, and drive continuous improvement initiatives.
Conduct comprehensive in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
The Senior Technical Manager will lead the modernization of a legacy SQL Server-based data warehouse into a scalable, cloud-native platform on Google Cloud Platform. This role involves driving migration strategy, enabling governed analytics via Looker, and implementing AI-powered solutions using Vertex AI.
The Patient Care Coordinator processes monthly patient refill requests and ensures accurate documentation for enteral nutrition orders. They also handle incoming calls from patients and providers while verifying insurance and demographic information to facilitate service.
Conduct in-home health evaluations to review medical history, perform physical assessments, and provide diagnostic services. Engage with patients to bridge gaps in care and facilitate connections to appropriate health resources.
The Case Management Coordinator facilitates healthcare outcomes by assisting members with appointment scheduling and accessing benefits. They utilize care management tools to collaborate with teams and provide education to members.
The physician will conduct in-home health evaluations, including medication reviews and physical assessments, to help bridge gaps in patient care. They will also perform virtual visits and provide diagnostic services while building trusted relationships with patients.
Process coverage-related requests such as prior authorizations and appeals via phone and fax for Medicare members. Maintain accurate case documentation while ensuring compliance with CMS-mandated timelines and internal quality standards.
The Principal Engineer will lead the development of offensive tooling and oversee complex red and purple team engagements. They will also provide technical mentorship to operators and collaborate with cross-functional teams to improve enterprise security posture.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic screenings. Build trusted relationships with patients to bridge gaps in care and provide necessary health education.
Conduct in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide connections to appropriate care and document findings using an intuitive clinical workflow on an iPad.
Conduct comprehensive in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. Build trusted relationships with health plan members to provide personalized health education and support.
Conduct approximately 30-minute video visits with health plan members to perform medication and medical history reviews. Educate members on their health journey and ensure all clinical documentation and compliance requirements are met.
Conduct comprehensive in-home health evaluations for health plan members, including physical assessments and medication reviews. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct in-home health evaluations for health plan members, including medication reviews and physical assessments. Facilitate connections to appropriate care and document findings using an intuitive clinical workflow.
Conduct comprehensive in-home health evaluations for patients, including medication reviews and physical assessments. Provide patient education and facilitate connections to appropriate care services to improve health outcomes.
The physician will conduct in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. They will also perform virtual visits and provide diagnostic services while maintaining detailed clinical documentation.
Design and develop engaging training programs and learning materials to support employees through organizational change. Partner with stakeholders to identify learning needs, manage training projects, and utilize data to improve training effectiveness.
The Nurse Practitioner provides virtual primary care to Medicare patients, including sick visits, chronic disease management, and annual wellness assessments. They collaborate with a multidisciplinary team to ensure effective care coordination and accurate clinical documentation.
Conduct in-home health evaluations for health plan members, including medication reviews and physical assessments. Build trusted relationships with patients to bridge gaps in care and provide connections to appropriate health services.
The Senior Director of Engineering Operations is responsible for workforce planning, financial oversight, and operational governance to support a large-scale engineering organization. This role coordinates across multiple departments to drive consistency, transparency, and performance management for over 500 employees and partners.
The physician will conduct in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. They will also perform diagnostic and preventive services while maintaining clinical documentation via an iPad.
Conduct in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide health education and bridge gaps in care while maintaining accurate clinical documentation using an iPad.
Develops and implements sales strategies to acquire new large group accounts and government programs while managing complex negotiations. Collaborates with internal partners to integrate client needs with product offerings and ensures revenue growth objectives are met.
The Accounts Receivable Collector manages a portfolio of business-to-business accounts to drive timely resolution of outstanding balances. They partner with internal teams and clients to maximize cash flow while ensuring compliance with regulatory and corporate requirements.
The Client Support Representative resolves member inquiries regarding pharmacy benefits, claims, and eligibility with empathy and accuracy. They also document interactions, escalate complex cases, and collaborate with leadership to improve service processes.
The Staff Analyst will own the analytical model for the outreach-to-completed-encounter funnel and serve as the technical authority for channel and cadence strategy. They will design experiments, build analytics engineering layers, and mentor analysts to drive member engagement and clinician capacity utilization.
The Strategic Account Executive is responsible for managing the overall account strategy, renewal outcomes, and executive relationships for a portfolio of large, complex pharmacy benefit clients. This role involves leading financial negotiations, providing strategic recommendations, and coordinating across internal teams to ensure client retention and growth.
Conduct comprehensive in-home health evaluations, including medication reviews, physical assessments, and diagnostic screenings. Build trusted relationships with patients to bridge care gaps and provide personalized health education.
The physician will conduct in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in care for health plan members. They will also perform virtual visits and provide diagnostic services while building trusted relationships with patients.
The pharmacist will interpret and evaluate physician medication orders for therapeutic appropriateness and safety while providing leadership to pharmacy support staff. They are responsible for monitoring drug therapy, educating patients, and ensuring compliance with state and federal pharmacy regulations.
The role involves acting as a liaison between health plan members, clinicians, and physician practices to coordinate appointments and facilitate health-related communications. Responsibilities include managing high-volume outbound and inbound calls, tracking data, and ensuring quality service standards are met.
Conduct approximately 30-minute online video visits with health plan members to perform medication and medical history reviews. Educate members on their health needs and ensure high-quality clinical documentation and visit completion rates.
The RPh Operations Advisor supports Medicare Part D members and providers by reviewing clinical information to make accurate pharmacy benefit decisions. This role involves performing provider outreach and ensuring all case documentation complies with Medicare guidelines and timelines.
The Senior Security Engineer investigates potential insider threats and supports digital forensics and incident response activities across the enterprise. This role involves partnering with cross-functional teams to analyze security data, document findings, and recommend corrective actions to mitigate risks.
The Senior Manager will own the strategic roadmap for the diabetes product portfolio, including the design and implementation of new products to reduce care costs. They will lead cross-functional teams to drive product development, prioritize backlogs, and deliver quantitative analyses to support business goals.
You will contribute to the development of mobile applications by writing code and tests while collaborating with product and design teams. Additionally, you will monitor and troubleshoot production applications to ensure stability, performance, and scalability.
The manager will design and maintain technical solutions within the Apptio platform to enable IT financial management and cost optimization. They will also oversee monthly IT chargeback processes and collaborate with business units to ensure accurate financial reporting and allocation.
The Director, Proposal Quality defines and operationalizes the enterprise quality strategy across the Medicaid proposal lifecycle to ensure consistent, compliant, and competitive outcomes. This role leads a high-performing team and builds cross-functional partnerships to drive data-informed improvements and innovation in proposal development.
You will design, build, and maintain data platform automation while troubleshooting complex performance and reliability issues. Additionally, you will mentor junior engineers and contribute to the technical roadmap for data streaming and database services.
The Proposal Quality Analyst will review and edit RFP content for compliance and strategy while collaborating with internal stakeholders to ensure high-quality deliverables. They will also monitor proposal delivery strategies and facilitate capture meetings to influence response positioning.
Conduct approximately 30-minute video visits with health plan members to perform medication and medical history reviews. Provide education to members and ensure high-quality clinical documentation while meeting performance metrics.
The Pharmacy Technician provides clinical support and ensures the smooth delivery of medications to patients' homes. They utilize clinical knowledge and customer service skills to provide personalized one-on-one patient care.
You will design, build, and operate large-scale observability services while leading the enterprise-wide adoption of OpenTelemetry standards. The role involves developing high-performance backend services and collaborating with cross-functional teams to ensure reliable, secure, and cost-efficient telemetry pipelines.
The Data Scientist will design and develop data solutions and predictive models to evaluate health metrics and future outcomes. They will utilize programming skills to analyze large datasets and support the deployment of insights across multiple business channels.
Lead the AI strategy and technical direction for a portfolio of clinical AI capabilities, ensuring they are clinically rigorous, scalable, and ethically grounded. Manage and develop a team of data scientists while partnering with product and engineering to integrate AI solutions into the enterprise clinical intelligence platform.
Lead and mentor a team of product and clinical analysts to define and measure clinical encounter quality, diagnostic accuracy, and coding integrity. Partner with cross-functional teams to translate technical findings into actionable strategies that drive product roadmaps and clinical performance.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic testing. Build trusted relationships with patients to bridge gaps in care and provide personalized health education.
Conduct comprehensive in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
The Care Management Associate coordinates care and treatment needs for members while communicating effectively with healthcare providers. They are responsible for identifying referral opportunities for additional services and delivering exceptional customer support in a fast-paced environment.
You will architect and scale high-throughput telemetry pipelines while leading enterprise-wide adoption of OpenTelemetry. Additionally, you will design and operate core observability services and collaborate with SRE and platform teams to ensure system reliability.
Conduct approximately 30-minute video visits with health plan members to perform medication and medical history reviews. Provide education to members and ensure accurate documentation to close gaps in care.
Conduct approximately 30-minute video visits with health plan members to perform medication and medical history reviews. Educate members on their health needs and ensure accurate documentation to close gaps in care.
Conduct approximately 30-minute video visits with health plan members to perform medication and medical history reviews. Provide education to members regarding their health and ensure high-quality care delivery while meeting operational and clinical performance metrics.
The Nurse Practitioner provides holistic, evidence-based virtual care, including assessment, diagnosis, and treatment for patients aged 18 months and older. They also manage patient health education, coordinate care within a multidisciplinary team, and document all interactions in an electronic health record.
The Staff Software Development Engineer will participate in an Agile product team to design and build high-quality, user-centered software products. Responsibilities include developing frontend and backend code using test-driven development and leading the design process to support business needs.
The Clinical Pharmacist provides comprehensive medication management for patients with chronic conditions and develops individualized care plans within an interdisciplinary team. They also participate in population health initiatives, manage clinical protocols, and monitor patient outcomes to improve chronic disease metrics.
The Account Manager serves as the primary point of contact for clients, overseeing day-to-day operations and ensuring high levels of satisfaction and retention. They analyze performance metrics and market trends to develop strategic plans that drive revenue growth and identify cross-selling opportunities.
The Senior Manager will lead initiatives to standardize controllership operations, improve governance, and drive finance transformation across Medicaid markets. They will partner with cross-functional leadership to optimize operating models, implement scalable solutions, and foster a culture of continuous improvement.
The Senior Manager will lead the Operations Readiness function by ensuring operational changes are effectively designed, prepared, and embedded into day-to-day execution. This role owns the end-to-end readiness lifecycle, partnering with technology and innovation teams to define processes, roles, and performance measures.
Processes prior authorization requests by utilizing clinical guidelines and computer resources to support review decisions. Communicates status updates to providers and pharmacies while maintaining accurate documentation and meeting productivity standards.
The Strategic Account Director leads teams of account executives to manage large, complex PBM client portfolios while driving revenue growth and client retention. They serve as a senior escalation point and partner with cross-functional leadership to deliver data-driven, sustainable value to clients.
The Account Manager serves as the primary point of contact for clients, overseeing day-to-day PBM operations and ensuring timely delivery of requests. They act as a liaison between clients and internal teams to resolve complex issues while maintaining high standards of service and professionalism.
The AVP of Application Security will define and execute the enterprise strategy for securing software across the full development lifecycle. This leader will manage a team of engineers and architects to integrate security into agile development practices while serving as a trusted advisor to executive stakeholders.
Conduct comprehensive in-home health evaluations, including medication reviews, physical assessments, and diagnostic testing for health plan members. Build trusted relationships with patients to bridge care gaps and provide personalized health education.
Conduct comprehensive in-home health evaluations, including medication reviews, physical assessments, and diagnostic screenings for health plan members. Build trusted relationships with patients to bridge care gaps and provide personalized health education.
Lead the development and enforcement of security policies and guardrails for AI-driven systems and agentic frameworks. Architect secure designs for LLMs and autonomous agents while influencing engineering teams to integrate responsible AI practices.
The Executive Director will lead underwriting strategy, risk assessment, and pricing support while serving as a strategic partner to major healthcare clients. They are responsible for managing high-performing teams and driving cross-functional collaboration to achieve organizational growth and profitability objectives.
The manager will define and execute cyber resiliency strategies, ensuring compliance with NIST frameworks across the enterprise. They will also partner with IT and business stakeholders to manage testing, audit requests, and the development of actionable metrics.
You will design and deliver data science solutions to optimize retail pricing and promotions for CVS stores. This involves collaborating with cross-functional teams to build scalable data pipelines and interactive user interfaces within the Palantir Foundry ecosystem.
Provide psychosocial support and evidence-based mental health therapy to individuals, couples, and families aged 13 and older. Collaborate with clinical care teams to develop treatment plans and ensure continuity of care for patients within their communities.
The Senior Decision Scientist will partner with Specialty Operations leaders to solve complex business problems using data, analytics, and quantitative decision-making. This role focuses on translating ambiguous business questions into analytical frameworks and generating actionable insights to influence strategic and operational decisions.
The Patient Care Coordinator serves as the primary point of contact for patients and healthcare providers, managing inquiries and resolving concerns. They are responsible for guiding new infusion patients through the onboarding process while maintaining accurate records across multiple systems.
Conduct face-to-face assessments with members to evaluate medical needs and wellness while helping them access vital care services. Collaborate with interdisciplinary teams to develop proactive care plans that enhance long-term health outcomes.
The Care Manager RN is responsible for assessing, planning, and coordinating case management activities to evaluate and address the medical and social needs of members. They collaborate with interdisciplinary teams and providers to develop proactive care plans that enhance member wellness and health outcomes.
The Care Manager assesses, plans, and coordinates case management activities to evaluate the medical and social needs of members. They collaborate with interdisciplinary teams and stakeholders to develop proactive care plans that enhance member wellness and health outcomes.
The Business Analyst supports regulatory and state reporting requirements by maintaining documentation, updating Salesforce records, and organizing reporting inputs. They collaborate with internal and external teams to ensure report deliverables are accurate, complete, and prepared for review.
Own the end-to-end product roadmap for the clinician payments portfolio, including the variable compensation engine and pay visibility tools. Navigate complex stakeholder requirements across operations, finance, legal, and HR to ensure accurate and compliant compensation delivery.
The auditor participates in quality management work plan activities by conducting medical and clinical audits and developing audit tools. They also facilitate exit interviews with staff and track the completion of corrective action plans.
The Product Manager will lead the intersection of product management and clinical operations for weight management products by translating clinical objectives into scalable solutions. They are responsible for defining product requirements, managing the product backlog, and driving operational performance through data-driven insights.
Conduct approximately 30-minute video visits with health plan members to perform medication and medical history reviews. Provide health education and ensure high-quality care delivery while meeting specific operational and clinical performance metrics.
The Health Coach Consultant acts as a telephonic case manager to support patients and their care teams by applying clinical guidelines and standardized care plans. They are responsible for assessing member needs, reducing health risk factors, and utilizing motivational interviewing to ensure maximum engagement.
The representative will advocate for customers by resolving inquiries regarding benefits and claims while providing guidance on available resources. They are responsible for documenting interactions accurately and collaborating with team members to ensure high-quality service and customer satisfaction.
The analyst supports configuration management activities by implementing and maintaining processes, tools, and controls to ensure system accuracy and compliance. They are responsible for analyzing configuration data and aligning system configurations with organizational standards and regulatory requirements.
Conduct in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide patient education and bridge gaps in care while traveling across a defined coverage area.
The manager develops and maintains strategic relationships with physician partners while leading contract negotiation and provider relations initiatives. They are responsible for reviewing, analyzing, and executing provider contracts to ensure alignment with financial, quality, and compliance objectives.
The Senior Coordinator is responsible for maintaining the accuracy and integrity of provider data across enterprise systems. They perform complex research, resolve data discrepancies, and coordinate with internal stakeholders to ensure compliance with regulatory and business requirements.
The Medical Director will lead utilization review, quality assurance, and case management programs while providing clinical expertise to support medical management. They will also act as a clinical liaison to network providers and perform predetermination and claim reviews.
The manager leads the strategy and operations for out-of-network claims negotiation, including No Surprises Act compliance and elective reimbursement negotiations. They are responsible for coaching the negotiation team, driving financial savings, and fostering strong provider relationships.
The Senior Manager will lead the change management and training strategy for the implementation of a new Warehouse Management System across the CVS Health distribution network. This role involves partnering with senior leadership and cross-functional teams to ensure successful adoption and operational readiness among distribution center colleagues.
The Senior Product Manager will lead the development and innovation of supply chain technology products to enhance omnichannel fulfillment and operational efficiency. This role involves partnering with distribution center leaders, IT, and vendors to drive product roadmaps while balancing business viability and user experience.
The Senior Manager will lead the configuration, deployment, and modernization of a cloud-based Warehouse Management System across the CVS Health distribution network. This role involves partnering with cross-functional teams to align operational processes with system capabilities and driving scalable technology solutions.
Conduct in-home health evaluations, including medication reviews, physical assessments, and diagnostic screenings for health plan members. Build trusted relationships with patients to bridge gaps in care and provide personalized health education.
Conduct comprehensive in-home health evaluations, including medication reviews, physical assessments, and diagnostic screenings. Build trusted relationships with patients to bridge gaps in care and provide personalized health education.
Conduct comprehensive in-home health evaluations, including medication reviews, medical history assessments, and physical examinations. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct comprehensive in-home health evaluations for health plan members, including medication reviews and physical assessments. Build trusted relationships with patients to bridge gaps in care and provide necessary health education.
Conduct in-home health evaluations, including physical exams, medication reviews, and diagnostic screenings for health plan members. Build trusted relationships with patients to bridge gaps in care and provide personalized health education.
The role involves making outbound calls to Medicare Advantage and Medicaid members to schedule in-home or virtual healthcare evaluations. You will be responsible for meeting daily productivity and quality goals while adhering to scripts and maintaining accurate records.
Architect and lead the Conversational AI outreach and rescheduling strategy to optimize member engagement and care continuity. Collaborate with cross-functional teams to define product roadmaps, measure KPIs, and deliver innovative solutions that address complex healthcare challenges.
The Manager of Corporate IT Audit will lead end-to-end SOC 1 and SOC 2 audit engagements while overseeing the audit team. They are responsible for assessing risks, improving internal controls, and ensuring accurate reporting through collaboration with stakeholders.
Review preauthorization requests for behavioral health services using clinical guidelines and evidence-based criteria. Manage crisis calls, assess risk, and coordinate appropriate levels of care while maintaining accurate documentation.
Conduct in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
The AVP leads the national distribution strategy for Medicare and Senior Supplemental Insurance products, managing a team of 32+ and overseeing a $110 million budget. They are responsible for driving profitable growth, managing strategic partnerships, and ensuring operational excellence across all distribution channels.
Provide one-on-one home infusion nursing care and patient education according to the physician's treatment plan. Conduct clinical visits in patient homes and participate in a telephonic on-call rotation for triage support.
Conduct comprehensive in-home health evaluations, including medication reviews, physical assessments, and diagnostic screenings for health plan members. Build trusted relationships with patients to bridge care gaps and provide health education without the need for prescribing medication or altering treatment plans.
Conduct comprehensive in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide patient education and facilitate connections to appropriate care services to improve health outcomes.
Provide one-on-one home infusion nursing care and patient education in accordance with the physician’s plan of treatment. Perform infusion therapies in patient homes and participate in telephonic on-call rotations.
The Contract Negotiation Manager leads end-to-end contract negotiations and manages provider relationships to enhance network access and cost efficiency. They also develop value-based arrangements and analyze financial data to drive measurable business impact.
The Senior Mainframe DB2 Database Administrator will support, optimize, and automate enterprise Db2 for z/OS and IDMS database environments. Responsibilities include performance tuning, backup and recovery, disaster recovery readiness, and participating in a 24x7 on-call rotation.
The AVP of Security Risk Management is responsible for defining and executing the enterprise cybersecurity risk strategy, including governance, control validation, and risk assessment methodologies. This leader collaborates with cross-functional teams to manage third-party, supply chain, and M&A-related cyber risks while providing executive-level reporting on the enterprise risk posture.
The Clinical Case Manager coordinates and communicates all aspects of the utilization and benefit management program using clinical skills and evidence-based care. They conduct comprehensive evaluations of member needs, develop care plans, and provide ongoing support to ensure optimal health outcomes.
The Chief of Staff acts as a strategic partner to the Deputy CISO, driving operational discipline, cross-functional alignment, and execution of cybersecurity initiatives. This role manages executive communications, program governance, budget planning, and performance reporting to ensure organizational objectives are met.
The AVP leads the strategy, design, and execution of enterprise information security governance, risk management, and technology compliance programs. This role manages cybersecurity risk posture, drives modernization through automation, and ensures adherence to regulatory requirements across the organization.
Conduct in-home and virtual health evaluations, including medication reviews, physical assessments, and diagnostic screenings. Build trusted relationships with patients to bridge gaps in care and provide health education.
The Senior Manager leads the strategy, engineering, and operations of the enterprise Observability Data Platform to support various technical teams. They are responsible for platform reliability, telemetry ingestion, and fostering a culture of innovation and operational excellence.
The Manager, Enterprise Pricing supports financial readiness and governance activities for transfer pricing initiatives. This role coordinates across Finance, Legal, and Tax departments to facilitate business arrangements and maintain operational documentation.
The Lead Java Software Engineer will lead and mentor a team of engineers to deliver clinical and interoperability products while collaborating with cross-functional teams. They are responsible for end-to-end application development, production deployment, and ensuring high code quality through testing and performance optimization.
The Senior Network Medical Director serves as the primary clinical leader for provider relationships in the Southeast Region, focusing on cost, quality, and member experience. They are responsible for shaping network strategy, evaluating provider performance, and collaborating with cross-functional teams to ensure high-value care delivery.
The physician will conduct in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. They will also perform virtual visits and provide diagnostic services while maintaining detailed clinical documentation.
Lead the enterprise delivery of complex business process and technology initiatives focused on provider experience and NPS. Collaborate with stakeholders to prioritize work, resolve delivery obstacles, and ensure measurable outcomes through data-driven process improvements.
The Inventory Analytics Manager is responsible for developing and maintaining reporting, dashboards, and automation solutions to improve operational efficiency and data visibility. This role acts as a partner to cross-functional teams by translating complex business questions into scalable, data-driven insights and recommendations.
The manager is responsible for analyzing digital business performance, managing sales and margin forecasting, and delivering actionable insights for assigned categories. They also lead cross-functional collaboration to execute omnichannel growth strategies and improve operational efficiency.
This role defines and drives the strategic analysis portfolio and Utilization Management automation strategy for the Clinical Solutions business unit. The leader partners with cross-functional teams to modernize clinical operations through AI, predictive analytics, and data-driven business transformation.
Lead the design and execution of clinical, population health, and digital member engagement programs in collaboration with cross-functional teams. Drive program performance through data-driven optimization and effective stakeholder management to improve quality and affordability of care.
The Strategic Account Director leads teams of account executives to manage large, complex PBM client portfolios, focusing on revenue growth, retention, and profitability. They serve as a senior escalation point and executive partner, utilizing data and AI-driven insights to guide renewal strategies and cross-functional execution.
The Case Manager conducts face-to-face home visits to assess member medical needs and develops comprehensive care plans to facilitate wellness. They collaborate with interdisciplinary teams and providers to authorize services and ensure safe, cost-effective care delivery.
The Case Manager conducts face-to-face home visits to assess member medical needs and develops comprehensive care plans to facilitate wellness. They collaborate with care teams and providers to authorize services cost-effectively while ensuring safe discharge and quality healthcare delivery.
The Case Manager conducts face-to-face home visits to assess member medical needs and develops comprehensive care plans to facilitate wellness. They collaborate with care teams and providers to authorize services and ensure safe, cost-effective care delivery.
The Case Manager conducts face-to-face home visits to assess member medical needs and develop comprehensive care plans within the MLTSS and D-SNP programs. They collaborate with care teams and providers to ensure cost-effective service delivery and facilitate safe discharge planning.
The Case Manager conducts face-to-face home visits to assess member medical needs and develops comprehensive care plans to facilitate wellness. They collaborate with care teams and providers to authorize services cost-effectively while ensuring safe discharge and program compliance.
The Case Manager conducts face-to-face home visits to assess medical needs and develop comprehensive care plans for members in MLTSS and D-SNP programs. They collaborate with care teams and providers to ensure cost-effective service delivery and advocate for safe, appropriate care transitions.
The Lead Director defines clinical program requirements and workflows to drive technology enablement for complex care coordination programs. This role acts as a bridge between clinical leadership and technical teams to ensure successful program design, implementation, and performance measurement.
The Benefit Verification Specialist verifies insurance coverage and obtains prior authorizations for specialty therapies to ensure timely prescription processing. They coordinate with patient intake teams and communicate with healthcare professionals and insurance carriers to assess patient eligibility.
The Network Relations Manager will advance Value-Based Contracting strategies by managing provider relationships and ensuring network performance. They will analyze network data, resolve provider issues, and collaborate with cross-functional teams to improve health outcomes and cost efficiency.
The Senior Analyst leads the end-to-end development of strategic proposals, including RFP responses, across multiple market segments. They collaborate with cross-functional teams to synthesize data and ensure accurate, high-quality positioning of the company's value proposition.
The Senior Manager leads the quality engineering strategy for the ACAS benefits ecosystem, focusing on defect prevention and shift-left testing practices. They are responsible for driving automation, establishing quality KPIs, and partnering with cross-functional teams to ensure reliable claims adjudication outcomes.
Design, develop, and maintain scalable automation frameworks for web and mobile applications while collaborating with cross-functional teams to ensure high-quality releases. Lead defect triage, root cause analysis, and integrate automated tests into CI/CD pipelines to ensure compliance with healthcare regulations.
The Executive Director, Controller will establish the standalone accounting organization, structure, and governance for Omnicare. They will lead the implementation of new ERP systems and oversee all financial reporting, internal controls, and audit readiness activities.
Provide one-on-one infusion therapy and patient education in the comfort of the patient's home. Manage clinical documentation and participate in an on-call rotation to ensure continuous patient care.
The Medical Director provides clinical expertise to support medical policy, payment policy, and the clinical claim review process. They also participate in work groups to improve healthcare quality and efficiency while collaborating with diverse health delivery professionals.
The pharmacist provides one-on-one medication therapy management consultations via phone or video to identify and resolve medication-related problems. They collaborate with multidisciplinary teams to develop personal care plans and monitor patient outcomes to ensure safety and effectiveness.
The Program Integrity Auditor reviews medical, behavioral, and healthcare provider records to ensure compliance with coding and documentation standards. They also identify aberrant billing patterns, investigate potential fraud, waste, or abuse, and provide education to providers regarding regulatory requirements.
The Capture Director leads strategy and capture planning activities for Medicaid proposals, acting as a liaison between business development and proposal teams. They are responsible for identifying market opportunities, managing competitive intelligence, and leading cross-functional teams to develop winning proposal solutions.
The Senior Cloud Data Security Engineer will design and implement enterprise-wide Data Loss Prevention (DLP) policies across cloud, endpoint, and AI/ML environments. This role involves monitoring data leakage incidents, automating response workflows, and collaborating with cross-functional teams to ensure robust data protection.
The Distinguished Engineer will lead system design and architecture reviews to ensure enterprise applications align with security, compliance, and resiliency standards. They will also mentor engineering teams and drive technical decisions across infrastructure, integration, and cloud domains.
The Senior Analyst is responsible for forecasting and underwriting rebates while serving as a subject-matter expert on rebate economics. They will collaborate with cross-functional teams to develop competitive rebate guarantees and translate complex contract strategies into financial outcomes.
The Case Manager will conduct clinical assessments in various settings to develop and monitor personalized care plans for members. They will collaborate with interdisciplinary teams to ensure safe transitions of care and address both clinical and social determinants of health.
The Registered Nurse Case Manager conducts face-to-face home assessments and develops individualized care plans for members in managed long-term services and support programs. They collaborate with interdisciplinary teams and providers to ensure cost-effective, high-quality care and safe service transitions.
The Case Manager will conduct clinical assessments in various settings to develop and monitor personalized care plans for members. They will collaborate with interdisciplinary teams to ensure safe transitions of care and address both clinical and social determinants of health.
The Territory Sales Executive is responsible for selling CVS Specialty pharmacy services to physicians, clinics, and hospitals within an assigned territory. They must develop sales strategies, educate healthcare professionals, and manage key accounts to meet sales goals for complex medication therapies.
The Clinician Field Mentor performs in-home health evaluations for up to 80% of their time while providing mentorship and guidance to new and active clinicians. They also serve as an early adopter for new clinical workflows and diagnostic services to ensure high standards of care.
The Principal Software Development Engineer will lead the architecture, design, and delivery of scalable, AI-enabled digital healthcare applications. This role involves setting technical strategy, mentoring engineering teams, and ensuring high-performance standards across cloud platforms.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic screenings. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct in-home health evaluations for patients, including medication reviews, physical assessments, and diagnostic testing. Build trusted relationships with patients to bridge gaps in care and provide personalized health insights.
Conduct in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide patient education and bridge gaps in care while traveling across a defined coverage area.
Conduct comprehensive in-home health evaluations, including physical assessments and medication reviews, to bridge gaps in patient care. Provide patient education and facilitate connections to appropriate care services while maintaining accurate clinical documentation.
The Case Manager is responsible for conducting in-home assessments and developing individualized care plans for members in MLTSS and D-SNP programs. They coordinate essential services and collaborate with interdisciplinary teams to ensure cost-effective, high-quality care delivery.
Conduct in-home health evaluations, including physical exams, medication reviews, and diagnostic tests to bridge gaps in patient care. Build trusted relationships with patients and provide comprehensive health assessments while maintaining accurate clinical documentation.
Community Health Workers act as a bridge between members and the healthcare system by conducting home visits to reinforce care plans and improve health outcomes. They also assist members in navigating social services, managing medications, and identifying gaps in community care systems.
The role involves maintaining and enhancing Anaplan models while translating business processes into functional and technical requirements. You will collaborate with IT and stakeholders to drive finance automation, ensure governance standards, and provide user support.
The Senior Manager acts as the Anaplan product owner for P&L forecasting, managing intake, prioritization, and execution of system changes. They collaborate with cross-functional teams to drive financial automation, ensure governance standards, and provide subject matter expertise for enterprise reporting.
The Case Manager RN is responsible for conducting comprehensive in-home assessments and developing person-centered care plans for dual-eligible Medicare and Medicaid members. They coordinate services across interdisciplinary teams to ensure members receive appropriate community-based support while maintaining regulatory compliance.
The Case Management Analyst coordinates care, provides education, and facilitates access to healthcare services for members. They are responsible for assessing member needs, developing care plans, and monitoring progress while ensuring compliance with regulatory standards.
The Case Management Analyst coordinates care and facilitates access to healthcare services by assessing member needs and developing effective care plans. They also monitor progress, document activities, and ensure compliance with regulatory standards and quality management guidelines.
The Senior Analyst manages complex client relationships, ensuring high levels of customer satisfaction and operational excellence. They are responsible for identifying root causes of client issues, leading account-specific initiatives, and acting as a strategic partner to drive retention.
The Senior Manager negotiates complex healthcare provider contracts and manages network adequacy, reimbursement rates, and performance metrics. They also conduct market analysis and collaborate with internal teams to align network performance with organizational strategic goals.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic screenings. Build trusted relationships with patients to bridge gaps in care and provide health education.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic testing. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
The Health Coach provides self-management education, resource referrals, and supportive care to Medicare members with chronic conditions. They are responsible for documenting member interactions, facilitating group coaching classes, and assisting members in navigating their health care decisions.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic screenings. Build trusted relationships with patients to bridge gaps in care and provide health education.
Conduct comprehensive in-home health evaluations, including physical assessments and medication reviews, for health plan members. Provide patient education and facilitate connections to appropriate care while maintaining accurate clinical documentation via an iPad.
Conduct comprehensive in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Lead the development and delivery of enterprise risk adjustment analytics and business intelligence solutions to drive provider performance and executive decision-making. Manage a high-performing team while partnering with cross-functional stakeholders to implement AI, automation, and advanced data storytelling strategies.
The physician will conduct in-home health evaluations, including medication reviews, physical assessments, and diagnostic screenings to bridge gaps in patient care. They will build trusted relationships with patients and provide comprehensive health insights to support their ongoing care needs.
The Telesales Representative is responsible for acquiring new members through inbound and outbound calls while managing member relationships and inquiries. They will also cross-sell ancillary products and ensure high levels of member satisfaction and retention.
The Lead Director drives network strategy and performance improvement for medical drug reimbursement across hospital and provider partners. They design strategic initiatives, manage contract relationships, and ensure alignment with legal and regulatory frameworks.
The Clinician Field Mentor conducts in-home health evaluations for members while providing mentorship and guidance to new and active clinicians. This role also serves as an early adopter for new clinical workflows and diagnostic services to ensure high-quality care standards.
The analyst will design, build, and optimize patient communication strategies across digital, print, and voice channels. They will also collaborate with cross-functional teams to analyze performance metrics and improve operational effectiveness.
Conduct comprehensive in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. Provide patient education and facilitate connections to appropriate care services based on individual health needs.
This role involves leading the design, development, and modernization of mission-critical IBM i applications using RPG and AI-assisted engineering tools. The engineer will mentor team members, reduce technical debt, and collaborate with stakeholders to deliver scalable, high-quality technology solutions.
The Case Management Coordinator collaborates with members, providers, and community organizations to facilitate healthcare outcomes and address social determinants of health. They utilize critical thinking to assist with appointment scheduling, benefit access, and member education through various care management tools.
The Pharmacy Technician acts as a liaison between patients, providers, and pharmacists to manage medication refills and renewals. They are responsible for handling high volumes of inbound and outbound calls while documenting patient requests and coordinating with care teams.
Conduct comprehensive in-home health evaluations, including medication reviews, physical assessments, and diagnostic testing for health plan members. Build trusted relationships with patients to bridge gaps in care and provide health education without the need for prescribing medication or ordering lab tests.
The coordinator facilitates improved healthcare outcomes by providing advocacy, support, and education to members using care management tools. They also evaluate member needs, implement wellness care plans, and monitor progress while collaborating with multidisciplinary teams.
The Senior Data Engineer will design, integrate, and implement modern data solutions while collaborating with engineering, analyst, and data science teams. They are responsible for processing payer files into the data warehouse and supporting the migration of workloads to the cloud.
The Medical Director will perform utilization management, medical necessity reviews, and prior authorization determinations for Medicaid members. They will also collaborate with multidisciplinary teams and participate in a rotating on-call schedule for clinical support.
The Strategic Account Advisor manages day-to-day client relationships and executes strategies to ensure service delivery meets organizational goals. They are responsible for financial oversight, process improvement, and driving client satisfaction within the PBM marketplace.
The Senior Project Manager will lead the planning, execution, and delivery of complex Salesforce initiatives while collaborating with cross-functional teams. They are responsible for defining project scope, managing budgets and risks, and ensuring compliance with data governance and security policies.
The Case Management Coordinator collaborates with members, providers, and community organizations to address complex health and social needs. They facilitate healthcare outcomes by assisting with appointment scheduling, benefit access, and member education.
The representative will educate customers about their benefits and claims while resolving inquiries to ensure high satisfaction. They are responsible for documenting interactions, maintaining confidential records, and collaborating with team members to provide proactive support.
The District Leader, Rx is responsible for overseeing clinical and business operations across approximately 20 retail pharmacies to ensure patient safety and market success. They lead, coach, and develop pharmacy teams while driving business growth through clinical services, talent pipeline management, and operational excellence.
The Account Manager serves as the primary point of contact for clients, overseeing day-to-day PBM operations and ensuring timely delivery of requests. They act as a liaison between clients and internal teams to resolve complex issues and maintain mutually beneficial business relationships.
The Registered Nurse Case Manager will conduct in-home assessments and coordinate physical, behavioral, and psychosocial services for members. They will develop individualized care plans and ensure high-quality, cost-effective care delivery in collaboration with interdisciplinary teams.
Conduct in-home health evaluations including medication reviews, physical assessments, and diagnostic screenings for health plan members. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
The Director leads the development and management of a Medicaid competitive intelligence function to inform capture strategy and executive decision-making. This role oversees a team responsible for competitor profiling, bid analysis, and the maintenance of a comprehensive intelligence library to improve win probability.
The Product Manager will drive key initiatives within the PBM Product Innovation Team by managing financial operations, invoicing, and commercialization support. They will also act as a liaison between business and technical teams to ensure project alignment, process standardization, and successful delivery of solutions.
Conduct comprehensive in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. Engage with patients to answer health questions and provide diagnostic services while maintaining accurate clinical documentation via an iPad.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic screenings. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
The Lead Director will own the strategic vision, architecture, and execution of the Health100 platform roadmap, integrating distributed systems with generative AI. They will lead and mentor engineering teams while ensuring consumer-centric design and operational excellence across all digital health products.
The representative will make over 300 outbound telemarketing calls daily to prospective patients to convert them into new patients. They are responsible for understanding patient needs, explaining the company's value proposition, and scheduling doctor's appointments while meeting performance quotas.
The Pricing Manager supports the development and execution of pricing strategies to drive category performance and revenue growth. This role involves building analytical dashboards, querying large datasets, and conducting market research to inform data-driven pricing decisions.
The Senior Analyst is responsible for researching, analyzing, and correcting rejected pharmacy-generated Medicaid encounters. They will also manage client relationships, provide recurring metric reports, and communicate technical findings to non-technical stakeholders.
The Case Management Coordinator facilitates healthcare outcomes by assisting members with appointment scheduling, benefit access, and care plan implementation. They utilize critical thinking to evaluate member needs, identify high-risk factors, and collaborate with multidisciplinary teams to ensure quality of care.
Lead the architecture, design, and implementation of scalable enterprise software solutions while driving the transition toward AI-driven, cloud-native platforms. You will remain hands-on in coding and design while partnering with cross-functional teams to deploy production-grade Agentic and Generative AI solutions.
The Territory Sales Executive is responsible for selling specialty pharmacy services to physicians, hospitals, and medical clinics within the Central Michigan region. They will independently execute marketing plans and serve as the primary contact for providers to support patients with chronic illnesses.
The Principal Cloud Engineer will lead the design, engineering, and evolution of private cloud storage platforms, focusing on large-scale architecture and data protection. They will drive strategic technology decisions, mentor engineering teams, and ensure the integrity and security of enterprise storage systems.
The Sales Vice President is responsible for developing and executing sales strategies to drive membership growth and new logo wins within the National Accounts South region. This includes managing consultant relationships, leading finalist presentations, and collaborating with cross-functional teams to deliver competitive RFP submissions.
The Lead Director will shape the technology strategy, governance, and operational excellence for the Third-Party Administrator and Payer Solutions organization. They will serve as a trusted advisor to executive leadership, overseeing portfolio governance, financial management, and strategic execution to drive business growth.
You will lead a team of engineers to build and scale an enterprise-grade API platform while collaborating with cross-functional stakeholders to define strategy and roadmaps. You are responsible for mentoring team members, fostering a strong engineering culture, and ensuring the platform meets the needs of thousands of internal developers.
The Case Manager develops proactive care plans to enhance member wellness and coordinates medical needs for dual-eligible populations. They act as frontline advocates by assessing, planning, and implementing case management activities while collaborating with interdisciplinary teams.
The Lead Director will oversee the modernization roadmap for Specialty Pharmacy, driving operational efficiency and technology strategy. They will lead diverse engineering teams across multiple geographies to deliver high-quality software solutions using Agile methodologies.
The Chief of Staff will act as the primary partner to the SVP of Healthcare Analytics, overseeing financial stewardship, operational processes, and executive communications. They will drive strategic planning, talent management, and cross-functional coordination to ensure the organization meets its performance goals.
The clinician will conduct in-home health evaluations, including medication reviews, physical assessments, and diagnostic tests. They are responsible for building trusted relationships with patients to bridge gaps in care and improve health outcomes.
The Market Head of Sales leads a team of Sales Executives to achieve revenue, membership, and profitability objectives within the small-mid size group market. They are responsible for developing sales strategies, cultivating relationships with producers and plan sponsors, and overseeing business development activities.
Pharmacy Technicians manage pharmacy workstations to safely and accurately fill patient prescriptions while maintaining regulatory compliance. They provide compassionate care and support to patients, ensuring all medication needs are met with high ethical standards.
The Manager, CRM Marketing will design and execute data-driven, journey-based marketing campaigns across email and SMS channels to drive patient engagement. They will collaborate with cross-functional teams to optimize campaign performance and ensure all communications comply with healthcare privacy regulations.
The role involves achieving managed care growth targets by identifying and developing relationships with qualified insurance agents and health plan leaders. It also requires training internal teams on value-based care models and coordinating grassroots marketing activities to support center growth.
The Contract Coordinator Analyst supports the Medicaid Network management team by managing the provider contracting lifecycle and ensuring the accuracy of provider documentation. Responsibilities include auditing provider records, maintaining the master contract repository, and ensuring compliance with regulatory and organizational requirements.
The Lead Director oversees provider enrollment, credentialing, and network activation operations to ensure regulatory compliance and revenue integrity. They lead a team of managers to drive operational excellence, scale processes, and resolve complex enrollment-related barriers.
The Lead Director will shape long-term strategy and innovative service offerings by translating vision into actionable growth initiatives. They will lead cross-functional teams to pressure-test new product concepts and provide strategic advisory support to the Executive Leadership Team.
The Staff Product Manager will lead the strategy and execution of internal cloud infrastructure products, focusing on automated and self-service platform experiences. They will own complex, cross-functional roadmaps and partner with engineering and architecture teams to drive product outcomes.
The Territory Sales Executive is responsible for selling specialty pharmacy services to physicians, clinics, hospitals, and academic institutions. They must independently formulate and execute marketing plans while serving as the primary contact for providers within their assigned territory.
The Case Manager will conduct face-to-face assessments to evaluate member medical needs and wellness while developing proactive care plans. They will collaborate with interdisciplinary teams to help members access vital services and achieve improved health outcomes.
The Senior Manager directs provider network management and negotiates value-based contracts to improve health outcomes and cost efficiency in the Louisiana Medicaid market. They also conduct market analysis and collaborate with internal teams to ensure network adequacy and alignment with strategic organizational goals.
The Lead Director is responsible for establishing and managing value-based relationships with network providers to meet total cost and quality goals. They oversee the complete contracting cycle, including planning, negotiation, and performance management across complex provider systems.
The Lead Director will define the strategic vision and roadmap for enterprise Pharmacy Benefit Management reporting products while managing cross-functional teams. They will act as a strategic advisor to business leaders, ensuring product value delivery and alignment with organizational financial goals.
The Lead Director manages the development and negotiation of complex provider contracts to meet network adequacy, financial, and quality goals. They also collaborate cross-functionally to implement strategic network configurations and drive cost-saving initiatives.
The Care Manager facilitates the delivery of healthcare benefits and coordinates case management activities for chronically ill members across the continuum of care. They act as a liaison between members, providers, and insurance carriers to optimize wellness outcomes and ensure appropriate condition management.
The Principal Architect will define and implement strategic technology roadmaps with a focus on applied AI, cloud infrastructure, and microservices to drive business value. They will also provide technical leadership, mentorship, and architectural governance to ensure high-quality, scalable, and secure software delivery across the enterprise.
Architect and build full-stack AI application capabilities, including agent backend services, APIs, and front-end interfaces. Lead technical design for agent-powered features and mentor engineering teams on agentic systems and reliability standards.
The manager will lead digital innovation initiatives for specialty pharmacy patient experiences, including defining project visions and requirements. They will collaborate with cross-functional teams to build business cases and monitor data to drive continuous improvement in digital products.
The Account Manager acts as a liaison between clients and the enterprise to manage relationships, identify growth opportunities, and ensure customer satisfaction. They are responsible for conducting quarterly executive reviews, managing contract renewals, and developing action plans for at-risk accounts.
Conduct in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Lead the strategy and execution of regulatory implementation, technology modernization, and capital investment planning for Pharmacy Network Services. Act as a bridge between business operations, technology, and compliance to ensure scalable operational capabilities and regulatory adherence.
Provide technical and analytical leadership to shape Aetna's Finance Data Governance function and modernize the finance data ecosystem. Manage claims data domain ownership, data quality initiatives, and strategic partnerships across the Health Care Business.
Lead back-end engineering teams to create exceptional member experiences through digital services and cloud migration. Provide strategic guidance, coaching, and technical vision while integrating emerging AI technologies to enhance operational efficiency.
The Claims Reviewer reviews pharmacy claims to identify and rectify inaccuracies that would lead to client over-payment. This involves contacting pharmacies for proper documentation and following policies to correct inaccurate submissions.
This hybrid role drives technical execution and organizational effectiveness by leading the design of scalable web applications and cloud solutions. The lead also manages strategic planning, operational governance, and executive reporting to align technology investments with business outcomes.
Conduct comprehensive in-home health evaluations, including physical exams and medical history reviews, to bridge gaps in care. Provide diagnostic and preventive services while building trusted relationships with patients in their homes.
The role involves reviewing behavioral healthcare assessments and care plans for children with complex needs within the OhioRISE program. It requires providing clinical consultation to care coordinators and utilizing clinical judgment to ensure medical appropriateness and quality of care.
Own the end-to-end roadmap for clinician performance tools, including the MySignify Scorecard and the Clinician Management Module. Drive the strategy for AI-powered features and use A/B testing to improve clinician quality metrics and operational efficiency.
Lead a team of analysts to drive growth and operational efficiency within the sales call center through data-backed solutions. Collaborate with cross-functional leaders to develop reporting and implement initiatives that improve acquisition ROI and growth velocity.
Lead Medicare Advantage and ACA risk adjustment analytics, predictive modeling, and financial valuations to drive risk score accuracy. Manage a high-performing informatics team and partner with executive leadership to influence organizational strategy and operational outcomes.
Participants will learn the fundamentals of insurance underwriting, risk analysis, and pricing strategies through virtual training and case studies. The program focuses on professional development and networking with industry experts to prepare students for future internship opportunities.
Lead the technical direction and architecture for an enterprise API platform, including the developer portal and API catalog. Drive the integration of AI-powered capabilities and MCP servers to enhance the developer experience across the organization.
Lead the design, development, and deployment of AI-powered products and agentic systems across the enterprise. Coach other architects and engineers on applied-AI coding techniques and AI-augmented workflows to accelerate production cycles.
Lead and manage a team of software engineers by providing technical direction, architecture guidance, and mentorship. Drive the technical strategy and execution of software initiatives while ensuring production stability and high availability.
Supports end-to-end Medicare Part B claims processing and ensures compliance with CMS requirements through prescriber outreach and documentation review. Manages a centralized repository of documentation to reduce bad debt and mitigate legal risks for the Revenue Cycle Team.
Perform comprehensive medical claim and record reviews for the Special Investigations Unit to ensure coding compliance and identify fraud, waste, or abuse. Provide detailed written findings and collaborate with Medical Directors and legal counsel to validate decisions.
Lead the strategy and execution of FinOps products and digital capabilities across multi-cloud and enterprise platforms. Partner with engineering, finance, and architecture to manage complex roadmaps and optimize cloud financial management.
Provide psychosocial support, education, and evidence-based mental health care to individuals, couples, and families aged 13+. Manage patient care through assessment and treatment planning tools within a virtual clinic environment.
Provide psychosocial support, education, and evidence-based mental health care to individuals, couples, and families aged 13 and older. Manage a clinical practice focusing on assessment and treatment planning within a remote environment.
This role focuses on accelerating product growth by providing dedicated enablement and client-facing support for priority products. The manager will partner with cross-functional teams to translate product strategy into market execution and ensure operational readiness for launches.
The Medical Director oversees oncology-specific utilization reviews, quality assurance, and medical policy implementation. They serve as a clinical liaison to network providers and support the development of medical management programs.
Reviews and adjudicates complex medical claims while serving as a subject matter expert for escalated issues. Supports customer service operations and mentors team members to ensure accurate claim processing and a positive member experience.
The Strategic Account Executive manages overall account strategy, renewal outcomes, and executive relationships for large employer pharmacy benefit manager clients. The role focuses on leading renewal negotiations, guiding financial decisions, and serving as a trusted partner to client stakeholders.
Lead a team of colleagues and contractors in managing pharmacy reimbursement appeals while ensuring high accuracy and adherence to tight turnaround times. Develop and automate processes to increase productivity and ensure operational compliance with state regulatory changes.
Lead a team in managing pharmacy reimbursement appeals and service warranty processes while ensuring compliance with state regulations. Collaborate cross-functionally to automate processes, improve productivity, and resolve complex inquiries from regulators and pharmacies.
Lead the strategy and implementation of enterprise data protection and privacy engineering capabilities across structured and unstructured data environments. Partner with cross-functional teams to embed privacy-by-design principles and deploy Privacy Enhancing Technologies (PETs).
Provide psychosocial support, education, and evidence-based mental health care to individuals, couples, and families aged 13 and older. Manage patient care through assessment and treatment planning tools within a virtual clinic environment.
Lead the design and development of scalable, secure cloud-native microservices and event-driven architectures using Java and Kafka. Manage complex data migration efforts and ETL pipelines specifically for healthcare EHR integration and interoperability.
The Strategic Account Executive manages overall account strategy, renewal outcomes, and executive relationships for large employer pharmacy benefit manager clients. The role focuses on leading renewal negotiations, guiding financial decisions, and serving as a trusted partner to client and consultant stakeholders.
Directly supervise pharmacy service representatives to ensure compliance and efficient medication ordering. Manage daily workflows, staff performance reviews, and operational audits to maintain service quality.
Define and drive the technical direction for mobile enterprise solutions while remaining hands-on with critical-path systems. Lead architectural reviews, develop strategic roadmaps, and mentor senior engineers to elevate engineering quality and delivery.
The Pharmacy Network Manager is responsible for aggregating data and producing analytical reports to ensure the efficient operation of Aetna's pharmacy network. The role focuses on developing performance measures, managing stakeholder relationships, and identifying fraud, waste, and abuse.
Drive growth in Specialty pharmacy by building innovative products and holistic solutions for oncology and rare disease therapies. Develop a robust product roadmap and lead clinical governance to optimize health outcomes and reduce costs for clients.
Lead end-to-end contract negotiations and implementation of fee-for-service and value-based agreements with healthcare providers. Manage provider networks to ensure accessibility, quality, and financial goals are met while optimizing cost arrangements.
Contact Medicare Advantage and Medicaid members via an automatic dialer to schedule in-home or virtual healthcare evaluations. Meet daily productivity targets for outbound dials and appointments while adhering to approved scripts and privacy guidelines.
Drive growth in Specialty pharmacy by building innovative products and holistic solutions for oncology and rare disease therapies. Develop a robust product roadmap and collaborate across the organization to optimize health outcomes and reduce costs for clients.
Lead the strategy, roadmap, and delivery of ServiceNow Human Resources Service Delivery (HRSD) capabilities to enhance colleague experiences and operational efficiency. Act as the primary liaison between HR stakeholders and technical teams to translate business needs into actionable product requirements and managed backlogs.
Provide compassionate in-home health services to individuals and families within the Durango and La Plata County area. Collaborate with colleagues to simplify the healthcare experience and prioritize patient safety and quality.
Lead the end-to-end delivery of enterprise AI and ML products from design through production deployment and value realization. Establish engineering standards and reusable implementation patterns while partnering with cross-functional teams to accelerate AI adoption.
Lead the strategy and delivery of enterprise AI platform capabilities and reusable data products to enable scalable AI/ML adoption. Oversee high-performing engineering teams to establish operational standards for agentic systems and data modernization.
The Strategic Account Executive manages overall account strategy, renewal outcomes, and executive relationships for large employer pharmacy benefit manager clients. The role focuses on leading renewal negotiations, guiding financial decisions, and serving as a trusted partner to client stakeholders.
Own the product roadmap for backend systems, APIs, and the third-party integration layer of a SaaS product suite. Drive the development of scalable, interoperable systems and manage integrations with EHR/EMR platforms and health data networks.
Lead the end-to-end management of encounter and claims data submissions to state agencies, ensuring accuracy and regulatory compliance. Partner with technical teams and vendors to monitor 837 file transmissions and resolve data quality errors.
Conduct comprehensive in-home health evaluations, including physical exams and medical history reviews, to bridge gaps in care. Build trusted relationships with patients and provide diagnostic and preventive services using a digital clinical workflow.
Conduct comprehensive in-home health evaluations, including physical exams and medical history reviews, to bridge gaps in care. Build trusted relationships with patients and provide connections to appropriate healthcare services based on unique needs.
Conduct comprehensive in-home health evaluations, including physical exams and medical history reviews, to bridge gaps in care. Provide diagnostic and preventive services while building trusted relationships with patients in their homes.
Conduct comprehensive in-home health evaluations, including physical exams and medical history reviews, to bridge gaps in care. Provide diagnostic and preventive services while building trusted relationships with patients in their homes.
Conduct comprehensive in-home health evaluations, including physical exams and medical history reviews, to bridge gaps in care. Provide diagnostic and preventive services while building trusted relationships with patients in their homes.
Lead the enterprise architecture for observability and hybrid multi-cloud infrastructure across Azure, AWS, GCP, and on-prem environments. Establish telemetry standards, instrumentation patterns, and FinOps maturity while mentoring other architects.
Lead the design and deployment of production-grade ML and Generative AI solutions to enhance the digital workplace experience. Collaborate cross-functionally to implement intelligent assistants, predictive analytics, and workflow automation at scale.
Recruits healthcare providers and negotiates contracts using internal guidelines and competitive market intelligence to ensure network adequacy. Manages ongoing provider relationships and resolves escalated issues regarding claims payment and contract interpretation.
The Case Management Coordinator evaluates members' needs and coordinates care plans to achieve optimal healthcare outcomes. They also consult with various stakeholders to overcome barriers and ensure quality of care.
The Case Management Coordinator evaluates members' needs and coordinates care plans to achieve optimal healthcare outcomes. They collaborate with various stakeholders to address barriers and enhance the quality of care.
Handle inbound and outbound calls to manage complex specialty medication orders, insurance verification, and new patient enrollment. Coordinate refill shipments and escalate clinical issues to staff pharmacists for resolution.
Handle inbound and outbound calls to manage complex specialty medication orders, insurance verification, and new patient enrollment. Coordinate medication shipments and escalate clinical issues to staff pharmacists for resolution.
Handle inbound and outbound calls to manage complex specialty medication orders, insurance verification, and new patient enrollment. Coordinate medication shipments and escalate clinical issues to staff pharmacists for resolution.
Handle inbound and outbound calls to assist patients with complex specialty medication orders and insurance verification. Coordinate new patient enrollments and process medication refill requests while escalating clinical issues to pharmacists.
Handle inbound and outbound calls to assist patients with complex specialty medication orders and insurance verification. Coordinate new patient enrollments and process medication refill requests while escalating clinical issues to pharmacists.
Handle inbound and outbound calls to assist patients with complex specialty medication orders, insurance verification, and enrollment. Coordinate medication shipments and escalate clinical issues to staff pharmacists.
Handle inbound and outbound calls to assist patients with complex specialty medication orders and insurance verification. Coordinate new patient enrollments and process medication refill requests while escalating clinical issues to pharmacists.
Handle inbound and outbound calls to assist patients with complex specialty medication orders, insurance verification, and enrollment. Coordinate medication shipments and escalate clinical issues to staff pharmacists.
Responsible for providing accurate coverage determinations for inpatient and outpatient services using UM criteria and clinical judgment. Coordinates with care teams and providers to ensure patients receive medically appropriate care in the right setting.
Design and operationalize scalable Generative AI solutions and agentic frameworks within a HIPAA-regulated healthcare environment. Lead the development of production-grade LLM applications, RAG systems, and cloud-native AI infrastructure across AWS and GCP.
Lead the design, development, and deployment of enterprise-wide AI-powered products and agentic systems. Coach other architects and engineers on AI-augmented workflows and maintain high production quality through disciplined engineering judgment.
Investigate allegations of Medicaid healthcare fraud, waste, and abuse while collaborating with compliance and legal teams. Manage a caseload of investigations, conduct interviews, and prepare comprehensive reports for corrective action.
Lead the design, operation, and scaling of CVS Health's on-premises AI compute platform and Enterprise AI Factory. Establish the SRE practice and operational baselines for GPU clusters, network fabrics, and orchestration layers to ensure high availability and performance.
Provide psychosocial support, education, and evidence-based mental health care to individuals, couples, and families aged 13 and older. Manage a virtual practice including assessment and treatment planning to ensure continuity of care.
Drive the architecture and delivery of scalable, cloud-native platforms utilizing microservices and AI capabilities. Lead the development of intelligent search systems, RAG frameworks, and AI-powered decision-support tools.
Provide psychosocial support, education, and evidence-based mental health care to individuals, couples, and families aged 13 and older. Manage a clinical practice including assessment and treatment planning within a virtual environment.
Provide psychosocial support, education, and evidence-based mental health care to individuals, couples, and families aged 13 and older. Manage a clinical practice including assessment and treatment planning without the burden of billing or credentialing.
Provide psychosocial support, education, and evidence-based mental health care to individuals, couples, and families aged 13 and older. Manage patient care through assessment and treatment planning tools within a virtual clinic environment.
Lead cross-functional efforts to accelerate product growth by providing enablement and client-facing support for priority healthcare products. Translate product strategy into market execution by partnering with sales, marketing, and operations to drive adoption and revenue.
Accelerate product growth by providing dedicated enablement and client-facing support for priority products. Partner across sales, marketing, and operations to translate product strategy into effective market execution and scalable launches.
Lead enterprise-wide architecture strategy and drive modernization of high-volume healthcare ecosystems, specifically focusing on claims and payment processing. Translate strategic business initiatives into scalable, cloud-native solutions while managing mainframe migration and AI integration.
Act as a Technical Lead and Individual Contributor to build a next-generation digital health platform. Responsibilities include designing scalable solutions, creating Proof of Concepts, and mentoring junior developers to ensure delivery excellence.
Accurately enter and interpret prescriptions while managing insurance payments and benefit investigations. Handle inbound calls to provide patient education and resolve issues in coordination with pharmacists.
The role involves providing in-home health evaluations and building trusted relationships with patients to improve their health outcomes. Clinicians will engage with patients, review their medical history, and conduct physical evaluations.
The physician will conduct in-home health evaluations, engaging with patients to answer health questions and review their medical history. They will build trusted relationships and help bridge gaps in care while providing personalized health evaluations.
The clinician will provide in-home health evaluations, engaging with patients to bridge gaps in care. They will conduct assessments, answer health questions, and build trusted relationships to improve health outcomes.
Accurately enter and interpret prescriptions, calculate doses, and process insurance payments. Handle inbound calls to provide patient education, resolve problems, and perform benefit investigations.
The role involves providing in-home health evaluations, engaging with patients to bridge gaps in care, and building trusted relationships to improve health outcomes. Clinicians will conduct assessments, answer health questions, and utilize technology for evaluations.
The clinician will provide in-home health evaluations, engaging with patients to bridge gaps in care. This role involves building trusted relationships and conducting comprehensive health assessments in patients' homes.
The role involves conducting in-home health evaluations, building trusted relationships with patients, and providing personalized health assessments. Clinicians will engage with patients to answer health questions and bridge gaps in care.
The physician will conduct comprehensive in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. They will also perform virtual visits and provide diagnostic services while maintaining accurate clinical documentation via an iPad.
The Lead Director will define and evolve the architecture strategy for member-facing digital platforms, ensuring they are scalable, secure, and intelligent. This role involves leading a team of architects while partnering with product, engineering, and data teams to drive AI-driven innovation and platform modernization.
Conduct in-home health evaluations for patients, including medication reviews, physical assessments, and diagnostic testing. Build trusted relationships with patients to bridge care gaps and provide personalized health insights.
Conduct in-home health evaluations including medication reviews, physical assessments, and diagnostic tests for health plan members. Build trusted relationships with patients to bridge gaps in care and provide health education.
Conduct in-home health evaluations, including physical assessments, medication reviews, and diagnostic tests for health plan members. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct comprehensive in-home health evaluations, including medication reviews, physical assessments, and diagnostic testing for health plan members. Provide patient education and bridge gaps in care to improve health outcomes while maintaining detailed clinical documentation.
Conduct comprehensive in-home health evaluations, including medication reviews, physical assessments, and diagnostic screenings for health plan members. Build trusted relationships with patients to bridge care gaps and provide health education in a compassionate, flexible manner.
Conduct in-home health evaluations for patients, including physical assessments, medication reviews, and diagnostic testing. Provide patient education and bridge gaps in care to improve overall health outcomes.
The Lead Architect defines and drives enterprise-scale digital solutions by designing end-to-end architectures and guiding engineering teams through implementation. They are responsible for establishing technical standards, maintaining architectural documentation, and leading production incident response.
The Client Relations Executive is responsible for selling specialty pharmacy services within the bleeding disorders segment and managing relationships with healthcare providers and support groups. Success is measured by the retention of existing business and the acquisition of new referral business within the assigned multi-state territory.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic testing. Provide health education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
The physician will conduct in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. They will travel extensively to provide these services and document findings using an intuitive clinical workflow on an iPad.
Conduct comprehensive in-home health evaluations for health plan members, including medication reviews and physical assessments. Build trusted relationships with patients to bridge gaps in care and provide personalized health education.
Conduct comprehensive in-home health evaluations for health plan members, including physical assessments and medical history reviews. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic testing. Build trusted relationships with patients to bridge gaps in care and provide personalized health education.
Provide in-home health evaluations for health plan members, including medication reviews and physical assessments. Conduct virtual visits as needed and provide health education to improve patient outcomes.
Provide in-home health evaluations for health plan members, including medication reviews and physical assessments. Conduct virtual visits as needed and provide patient education to bridge gaps in care.
Conduct in-home health evaluations, including medication reviews, physical assessments, and diagnostic tests for health plan members. Build trusted relationships with patients to bridge gaps in care and provide personalized health education.
Conduct comprehensive in-home health evaluations for health plan members, including physical assessments and medication reviews. Build trusted relationships with patients to bridge care gaps and provide necessary health education.
Conduct in-home health evaluations for patients, including medication reviews, medical history assessments, and physical examinations. Provide patient education and facilitate connections to appropriate care based on individual health needs.
Conduct comprehensive in-home health evaluations, including medication reviews, physical assessments, and diagnostic screenings. Build trusted relationships with patients to bridge care gaps and provide health education in their home environments.
Conduct in-home health evaluations for health plan members, including physical assessments, medication reviews, and diagnostic testing. Build trusted relationships with patients to bridge gaps in care and provide personalized health education.
Conduct in-home health evaluations for health plan members, including medication reviews, medical history assessments, and physical evaluations. Provide health education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct in-home health evaluations for health plan members, including medication reviews, medical history assessments, and physical evaluations. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct comprehensive in-home health evaluations, including medication reviews and physical assessments for health plan members. Provide patient education and facilitate connections to appropriate care services to improve health outcomes.
The Principal Architect will own the technical architecture and engineering leadership for the Vulnerability Services Engine platform. This role involves hands-on design, implementation, and performance optimization of large-scale distributed systems and data products.
Conduct comprehensive in-home health evaluations for patients, including medication reviews and physical assessments. Provide patient education and facilitate connections to appropriate care services to improve health outcomes.
Conduct in-home health evaluations for health plan members, including medication reviews, medical history assessments, and physical examinations. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
The Senior Data Scientist will activate clinical data repositories to improve healthcare outcomes by designing data models and building clinical data feature stores. They will also serve as a subject matter expert, collaborating with stakeholders to ensure data integrity, documentation, and alignment with clinical standards.
Conduct in-home health evaluations, including medication reviews, medical history assessments, and physical examinations for health plan members. Provide patient education and facilitate connections to appropriate care services while maintaining accurate clinical documentation.
Provide psychosocial support and evidence-based mental health counseling to individuals, couples, and families aged 13 and older. Collaborate with clinical care teams to develop treatment plans and ensure continuity of care for patients.
Conduct comprehensive in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. Engage with patients to build trusted relationships and provide connections to appropriate care services.
Conduct comprehensive in-home health evaluations for patients, including medication reviews and physical assessments. Build trusted relationships with patients to bridge gaps in care and provide connections to appropriate health resources.
The physician will conduct in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. They will also perform virtual visits and provide diagnostic services as required by health plans.
Conduct in-home health evaluations for patients, including physical assessments, medication reviews, and medical history documentation. Provide comprehensive health education and bridge care gaps while maintaining accurate clinical records using an iPad.
Conduct in-home health evaluations to bridge gaps in care and build trusted relationships with patients. Perform medication reviews, physical evaluations, and diagnostic tests while documenting findings through an intuitive clinical workflow.
The physician will conduct in-home health evaluations, including medication reviews, physical assessments, and diagnostic tests for health plan members. They will also perform virtual visits as needed and facilitate connections to appropriate care based on patient needs.
Conduct comprehensive in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. Engage with patients to build trusted relationships and provide connections to appropriate care based on their unique health needs.
Conduct in-home health evaluations for patients, including medication reviews, medical history assessments, and physical examinations. Facilitate connections to appropriate care and document findings using an intuitive clinical workflow on an iPad.
Conduct in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide comprehensive health insights and bridge gaps in care through one-on-one patient engagement.
Conduct in-home health evaluations for patients, including medication reviews, medical history assessments, and physical examinations. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct in-home health evaluations for health plan members, including medication reviews and physical assessments. Facilitate connections to appropriate care and document findings using an intuitive clinical workflow on an iPad.
Conduct in-home health evaluations, including medication reviews, medical history assessments, and physical evaluations for health plan members. Provide patient education and facilitate connections to appropriate care to improve overall health outcomes.
Conduct comprehensive in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. Provide health education and facilitate connections to appropriate care services based on individual patient needs.
Conduct in-home health evaluations for health plan members, including medication reviews, medical history assessments, and physical examinations. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation using an iPad.
Conduct in-home health evaluations for health plan members, including medication reviews, medical history assessments, and physical examinations. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation using provided digital tools.
Conduct in-home health evaluations for patients, including physical exams, medication reviews, and medical history assessments. Provide health education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct comprehensive in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct in-home health evaluations, including medication reviews, physical assessments, and diagnostic testing for health plan members. Build trusted relationships with patients to bridge gaps in care and provide personalized health education.
Conduct comprehensive in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. Provide patient education and facilitate connections to appropriate care services based on individual health needs.
Conduct in-home health evaluations to bridge gaps in care and build trusted relationships with patients. Perform medication reviews, physical assessments, and diagnostic tests while documenting findings through an intuitive clinical workflow.
Conduct in-home health evaluations to review medical history, perform physical assessments, and identify gaps in care for health plan members. Provide diagnostic and preventive services while maintaining accurate clinical documentation using an iPad-based workflow.
Conduct in-home health evaluations to review medical history, perform physical assessments, and provide diagnostic services. Engage with patients to bridge gaps in care and ensure their health needs are communicated to their primary care teams.
Conduct in-home health evaluations to bridge gaps in care and build trusted relationships with patients. Perform medication reviews, physical evaluations, and diagnostic tests while documenting findings via an intuitive clinical workflow.
Conduct in-home health evaluations to bridge gaps in care and build trusted relationships with patients. Perform medication reviews, physical evaluations, and diagnostic tests while documenting findings through an intuitive clinical workflow.
Conduct in-home health evaluations for health plan members to review medical history, medications, and perform physical assessments. Facilitate connections to appropriate care and document findings using an intuitive clinical workflow on an iPad.
Conduct in-home health evaluations for health plan members, including medication reviews and physical assessments. Facilitate connections to appropriate care and document findings using an intuitive clinical workflow on an iPad.
Provide psychosocial support and evidence-based mental health therapy to individuals, couples, and families aged 13 and older. Collaborate with clinical care teams to develop treatment plans and ensure continuity of care for patients.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic testing. Build trusted relationships with patients to bridge gaps in care and provide connections to appropriate health resources.
Conduct comprehensive in-home health evaluations for health plan members, including medication reviews and physical assessments. Build trusted relationships with patients to bridge care gaps and provide personalized health education.
Conduct in-home health evaluations for members, including medication reviews, medical history assessments, and physical evaluations. Provide diagnostic and preventive services while building trusted relationships to help bridge gaps in patient care.
The role involves conducting in-home health evaluations, engaging with patients to answer health questions and bridge gaps in care. Clinicians will build trusted relationships and provide personalized health evaluations.
The clinician will provide in-home health evaluations, engaging with patients to bridge gaps in care and improve health outcomes. Responsibilities include conducting assessments, answering health questions, and utilizing technology for evaluations.
The physician will conduct in-home health evaluations, engaging with patients to bridge gaps in care. They will build trusted relationships and provide personalized health evaluations in patients' homes.
This role involves providing in-home health services as a Nurse Practitioner or Physician Assistant in the field within Washington state. The position is designated as part-time employment.
The Physician will conduct in-home health evaluations lasting about 45 minutes, which includes reviewing medical history, performing a physical evaluation, and potentially conducting ordered diagnostic tests. This role involves joining a national network of clinicians dedicated to improving health outcomes by connecting people to the right care for their unique needs.
The clinician will provide in-home health evaluations, which include medication and medical history reviews, physical evaluations, and diagnostic tests, engaging with people in their homes to bridge gaps in care. This role involves joining a national network of clinicians dedicated to improving health outcomes by conducting visits and fulfilling specified Signify Health services.
This role involves acting as both a Technical Lead and Individual Contributor to build a next-generation platform, focusing on architecting, designing, and implementing highly scalable, fault-tolerant, cloud-native services using modern engineering practices. The engineer will also troubleshoot complex distributed system issues, define technical roadmaps, and enforce microservice resiliency patterns.
The Physician will conduct in-home health evaluations lasting about 45 minutes, which include medication and medical history review, a physical evaluation, and diagnostic tests if ordered. They will engage with people one-on-one to answer health questions and help bridge gaps in care within a national network of clinicians.
The Physician will conduct in-home health evaluations lasting about 45 minutes, which includes reviewing medical history, performing a physical evaluation, and conducting diagnostic tests if ordered. This role involves engaging with patients to build trusted relationships and help bridge gaps in care within a national network of clinicians.
The Physician will conduct in-home health evaluations lasting about 45 minutes, which includes reviewing medical history and medications, performing a physical evaluation, and conducting diagnostic tests if ordered. This role involves joining a national network of clinicians dedicated to improving health outcomes by connecting people to the right care for their unique needs.
The Physician will conduct comprehensive in-home health evaluations lasting about 45 minutes, which include medication and medical history review, physical evaluation, and diagnostic tests when ordered. This role focuses on engaging with patients one-on-one to build trusted relationships and bridge gaps in care without prescribing medicine or altering current treatment regimens.
The specialist provides care management services and evidence-based short-term psychotherapy to patients with behavioral health needs, acting as a key resource for Care Teams across primary clinics. Responsibilities include screening patients, developing care plans, coordinating referrals, and documenting encounters in the electronic medical record.
The physician will provide comprehensive in-home health evaluations, which include medication and medical history review, a physical evaluation, and diagnostic tests, while engaging with patients one-on-one to answer health questions. This role requires extensive travel, up to 100% of the time, across defined coverage areas, potentially necessitating overnight stays.
The physician will provide in-home health evaluations, which include medication and medical history reviews, physical evaluations, and potentially diagnostic tests, connecting with people in their homes to bridge gaps in care. This role requires up to 100% travel across defined coverage areas, potentially necessitating overnight stays, and involves conducting virtual visits as needed.
The clinician will conduct in-home health evaluations lasting about 45 minutes, which include medication and medical history review, a physical evaluation, and diagnostic tests if ordered. They will engage with people to bridge gaps in care and build trusted relationships to improve health outcomes.
The clinician will provide in-home health evaluations, connecting one-on-one with individuals to review health history, medications, and perform physical evaluations, while also conducting virtual visits as needed. This role involves joining a national network of clinicians dedicated to improving health outcomes by bringing personalized health evaluations directly to members' homes.
The Physician will conduct in-home health evaluations lasting about 45 minutes, which includes reviewing medical history and medications, performing a physical evaluation, and conducting diagnostic tests if ordered. This role involves engaging with patients one-on-one to build trusted relationships and help bridge gaps in care.
The clinician will conduct comprehensive, personalized in-home health evaluations lasting about 45 minutes, which includes reviewing medical history, medications, and performing physical evaluations. They will also be responsible for fulfilling requirements for specified Signify Health services, including diagnostic and preventive services, while connecting patients to the right care.
The clinician will conduct in-home health evaluations lasting about 45 minutes, which includes reviewing medical history, performing a physical evaluation, and potentially conducting diagnostic tests. They will join a national network of clinicians dedicated to improving health outcomes by connecting millions of people nationwide to the right care for their unique needs.
This role involves providing in-home care as a Nurse Practitioner or Physician Assistant, contributing to building a connected, convenient, and compassionate health experience for individuals. The position is full-time, anticipating 40 weekly hours, and is part of a team dedicated to simplifying healthcare one person, one family, and one community at a time.
The clinician will provide in-home health evaluations, engaging with people to bridge gaps in care, which includes medication and medical history review, and physical evaluations. This role requires extensive travel, up to 100% of the time, within a defined coverage area, potentially necessitating overnight stays.
Therapists will provide psychosocial support and education to address the mental well-being of individuals, couples, and families aged 13 and older, utilizing evidence-based care and assessment tools to ensure continuity of treatment. They will practice at the top of their license with clinical team support while reaching patients within their communities.
The Physician will provide in-home health evaluations, engaging with individuals to bridge gaps in care by conducting comprehensive assessments including medication review and physical evaluations. This role involves joining a national network of clinicians dedicated to improving health outcomes by visiting millions of people nationwide.
The clinician will provide comprehensive in-home health evaluations, which include medication and medical history reviews, physical assessments, and diagnostic tests, lasting about 45 minutes per visit. They will join a national network of clinicians dedicated to improving health outcomes by connecting millions of people nationwide to the right care for their unique needs.
The role involves providing in-home health care to patients, ensuring a compassionate and connected health experience. The Nurse Practitioner or Physician Assistant will work closely with patients and their families to simplify health care.
The clinician will provide in-home health evaluations, engaging with patients to bridge gaps in care. Responsibilities include conducting health assessments and connecting patients to appropriate care.
The clinician will conduct comprehensive in-home health evaluations lasting about 45 minutes, which includes reviewing medical history, performing a physical evaluation, and potentially administering diagnostic tests. This role involves engaging with patients locally and virtually to bridge gaps in care and build trusted relationships.
The Physician will provide In-Home Health Evaluations, engaging with people in their homes to bridge gaps in care through comprehensive, personalized health assessments including medication review and physical evaluation. This role involves joining a national network of clinicians dedicated to improving health outcomes by conducting visits and fulfilling Signify Health service requirements.
The clinician will conduct in-home health evaluations lasting about 45 minutes, which includes reviewing medical history, performing a physical evaluation, and conducting diagnostic tests as ordered. They will engage with individuals to answer health questions and bridge gaps in care while using an iPad for clinical workflow.
The physician will provide in-home health evaluations lasting about 45 minutes, which includes medication and medical history review, a physical evaluation, and potentially diagnostic tests. This role involves joining a national network of clinicians dedicated to improving health outcomes by visiting millions of people nationwide.
The clinician will conduct comprehensive in-home health evaluations lasting about 45 minutes, which includes reviewing medical history, medications, and performing physical evaluations. This role focuses on connecting with patients to bridge gaps in care and providing necessary diagnostic and preventive services as ordered.
This role involves acting as both a Technical Lead and Individual Contributor to architect, design, and implement highly scalable, fault-tolerant, cloud-native services using container orchestration and automated CI/CD pipelines. The engineer will also troubleshoot complex distributed system issues, define technical roadmaps with stakeholders, and enforce microservice resiliency patterns.
The clinician will provide comprehensive in-home health evaluations lasting about 45 minutes, which includes reviewing medical history, medications, and performing physical evaluations. This role focuses on building trusted relationships and connecting people to the right care by conducting visits locally and virtually as required.
The clinician will conduct in-home health evaluations lasting about 45 minutes, which includes reviewing medical history, performing physical evaluations, and potentially administering diagnostic tests. They will join a national network of clinicians dedicated to improving health outcomes by connecting people to the right care for their unique needs.
The physician will conduct in-home health evaluations, engaging with patients to answer health questions and review their medical history. They will also provide connections to appropriate care based on individual needs.
The clinician will provide in-home health evaluations, engaging with patients to bridge gaps in care. They will conduct assessments, answer health questions, and build trusted relationships to improve health outcomes.
The Physician will provide In-Home Health Evaluations, which include medication and medical history review, a physical evaluation, and potentially diagnostic tests, lasting about 45 minutes per visit. They will join a national network of clinicians dedicated to improving health outcomes by connecting millions of people nationwide to the right care for their unique needs.
The physician will conduct in-home health evaluations, engaging with patients to bridge gaps in care. They will build trusted relationships and provide personalized health evaluations.
The physician will conduct in-home health evaluations, engaging with patients to answer health questions and review their medical history. They will also help bridge gaps in care and connect patients to the right services.
The role involves conducting in-home health evaluations and engaging with patients to bridge gaps in care. Clinicians will connect with patients, review their medical history, and perform physical evaluations.
The clinician will conduct in-home health evaluations, engaging with patients to assess their health needs and provide personalized care. This role requires extensive travel within a defined coverage area to meet patients in their homes.
The physician will conduct in-home health evaluations, engaging with patients to bridge gaps in care. This role involves building trusted relationships and providing personalized health evaluations.
The physician will conduct in-home health evaluations, engaging with patients to bridge gaps in care. They will build trusted relationships and provide personalized health evaluations.
The physician will conduct in-home health evaluations, connecting with patients to answer health questions and review their medical history. They will also provide diagnostic and preventive services as needed.
The physician will conduct in-home health evaluations, engaging with patients to assess their health needs and bridge gaps in care. This role involves building trusted relationships and providing personalized health evaluations.
The physician will conduct in-home health evaluations, engaging with patients to review their medical history and perform physical evaluations. They will also help bridge gaps in care and connect patients to the appropriate health services.
The clinician will conduct in-home health evaluations, engaging with patients to answer health questions and review their medical history. They will also provide connections to appropriate care based on individual needs.
The clinician will conduct in-home health evaluations, engaging with patients to answer health questions and review medical histories. They will also provide diagnostic and preventive services as needed.
The Care Management Associate manages enrollment for the Children’s Specialty program and supports comprehensive coordination of medical services. This includes developing wellness plans, engaging community resources, and ensuring effective utilization of healthcare services.
Responsible for all population health management components and oversee the strategic design, implementation, and evaluation of population health initiatives. Develop and implement operational plans that align with established population health goals and coordinate with various stakeholders on population health activities.
The Care Management Coordinator collaborates and informs the case management process to facilitate appropriate healthcare outcomes for members. This includes conducting comprehensive evaluations, coordinating care plans, and monitoring progress to ensure quality of care.
The Senior Manager of Clinical Innovation manages and drives use cases within the clinical innovation portfolio to solve key business problems. This role involves collaborating with cross-functional teams to develop, test, and implement innovative solutions.
As a Staff Software Development Engineer, you'll lead efforts to create end-to-end CI/CD pipelines and build applications and tools that enhance the deployment experience across CVS Enterprise. You'll focus on delivering scalable solutions that improve customer experience and align with enterprise initiatives.
The Medical Director (Spine) will expand Aetna's medical management programs to address member needs across the continuum of care and support the Medical Management staff. They will lead utilization review and quality assurance, providing clinical expertise and business direction in support of medical management programs.
The UM Medical Director will ensure timely and consistent responses to members and providers related to precertification, concurrent review, and appeal requests. This position is primarily responsible for Utilization Management, including prior authorization as well as concurrent review.
The Care Management Associate manages enrollment for the Children’s Specialty program and supports comprehensive coordination of medical services. This role involves developing wellness plans, engaging community resources, and ensuring effective utilization of healthcare services.
The Medical Director will ensure timely and consistent responses to members and providers related to precertification, concurrent review, and appeal requests. This position is primarily responsible for Utilization Management, including prior authorization and pre-certification as well as concurrent review.
The UM Medical Director will ensure timely and consistent responses to members and providers related to precertification, concurrent review, and appeal requests. This position is primarily responsible for Utilization Management, including prior authorization as well as concurrent review.
The Medical Director will ensure timely and consistent responses to members and providers related to precertification, concurrent review, and appeal requests. This position is primarily responsible for Utilization Management, including prior authorization and pre-certification as well as concurrent review.
The Medical Director will ensure timely and consistent responses to members and providers related to precertification, concurrent review, and appeal requests. This position is primarily responsible for Utilization Management, including prior authorization and concurrent review.
The Medical Director will oversee medical policy implementation and participate in the development and evaluation of clinical programs. They will focus on utilization review and quality assurance, ensuring effective execution of medical services programs.
The Medical Director will ensure timely and consistent responses to members and providers related to precertification, concurrent review, and appeal requests. This position is primarily responsible for Utilization Management, including prior authorization and precertification as well as concurrent review.
The Medical Director will direct daily work on Part C appeals and provide support to appeal nurses. They will also monitor IRE and collaborate with Medicare Quality and Compliance.
The Case Manager is responsible for assessing, planning, implementing, and coordinating case management activities to evaluate the medical needs of members. They develop proactive care plans and collaborate with various stakeholders to enhance member wellness and address health and social challenges.
Lead the design and development of solutions for complex technical projects while acting as a subject matter expert. Collaborate with various stakeholders to solve technical problems and ensure timely progress of system design and development tasks.
The Manager will support key financial initiatives through financial modeling, capital planning, and business case development. This role involves collaboration across teams to drive data-informed decisions and operational efficiency.
The Staff Software Development Engineer will design, build, and deploy infrastructure capabilities for database technologies in various cloud environments. They will collaborate with multiple teams to create automation and improve customer experiences.
The Case Manager RN is responsible for assessing, planning, implementing, and coordinating case management activities with members to evaluate their medical needs. This role involves developing proactive strategies to enhance members' overall wellness and facilitate smooth transitions to Aetna programs and plans.
The Care Management Associate will interface with various groups providing care coordination services for eligible children and young adults receiving Medicaid services in Ohio. They will handle administrative tasks, including managing inbound care management inquiries and processing referrals.
The Care Management Associate manages enrollment for the Children’s Specialty program and supports comprehensive coordination of medical services. This includes developing wellness plans, engaging community resources, and ensuring effective utilization of healthcare services.
The Lead Director of UM Innovation Delivery manages and drives initiatives to solve key business problems and create new value for Utilization Management. This role involves leading strategic projects, collaborating with senior leadership, and overseeing the execution of complex initiatives aligned with corporate goals.
The Care Management Coordinator collaborates with various stakeholders to facilitate healthcare outcomes for members by providing care coordination, support, and education. They conduct comprehensive evaluations of members' needs and implement care plans while monitoring progress.
As a Medical Economics Analyst, you will provide consultative support and medical cost-based analysis of markets and network initiatives. You will analyze utilization and unit cost medical cost drivers and manage multiple projects to improve patient care.
This role ensures clinical programs and workflows are delivered accurately and on time, focusing on evaluating population health programs within Value Based Contracting. The Clinical Consultant provides consultative solutions to improve quality, increase efficiency, and drive cost savings within client organizations.
As a Product Manager, you will provide technical, analytical, and business support for Medicare, Medicaid, and Commercial products. You will develop business requirements, analyze program reporting, and ensure compliance with client and regulatory requirements.
