The Senior Manager will lead the product strategy and operations for cardiometabolic and obesity solutions, overseeing the product portfolio and driving new product development. They will collaborate cross-functionally to set pricing, monitor performance, and ensure regulatory compliance to achieve business growth.
The Senior Manager negotiates complex healthcare provider contracts and establishes reimbursement rates, service agreements, and performance metrics. They also conduct market analysis and consult with internal teams to align provider network performance with organizational strategic goals.
The AVP of Platform Security will define and execute the enterprise strategy for securing cloud, container, and AI platforms across the organization. This leader will manage a high-performing team to implement security standards, controls, and operating models that support secure and scalable technology adoption.
The Lead Director will drive the technology strategy and modernization roadmap for Specialty Pharmacy value streams while leading diverse engineering teams. This role involves fostering innovation, ensuring operational efficiency, and partnering with business leaders to deliver scalable software solutions.
The Care Manager coordinates care for members with chronic medical and behavioral health conditions by developing individualized care plans and connecting them with community resources. They conduct comprehensive assessments, provide disease management education, and collaborate with an interdisciplinary team to ensure optimal health outcomes.
The specialist is responsible for the real-time tracking, inventory control, and maintenance scheduling of medical device fleets such as infusion and enteral pumps. They also collaborate with pharmacy and sales teams to ensure safety standards are met and coordinate the return or exchange of equipment with patients.
The Claim Benefit Specialist reviews and adjudicates medical claims to ensure accuracy, policy compliance, and timely reimbursement. They also communicate with healthcare providers and patients to resolve discrepancies and analyze claims data to identify trends.
The Account Executive serves as the senior liaison for PBM clients, leading strategic account teams to ensure client satisfaction and service delivery. They are responsible for growing business through renewals, retention, and up-selling CVS Health solutions while managing client relationships and financial performance reporting.
The Case Manager will perform telephonic case management by assessing member needs, applying clinical guidelines, and collaborating with care teams to ensure quality care. They will also conduct medical necessity reviews and use motivational interviewing to engage members in their health planning.
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.
The Director leads a team to leverage analytics, technology, and investigative strategies to mitigate risk and shrink across the organization. This role oversees vendor management, system performance, and the development of data-driven investigative methodologies to support field and corporate operations.
The Case Manager facilitates comprehensive care coordination, assessment, and planning for members to optimize health outcomes and wellness. They act as a liaison between members, families, providers, and insurance carriers while ensuring compliance with regulatory and company policies.
The Associate Manager oversees healthcare management staff to ensure high-quality clinical and non-clinical interventions for members. They are responsible for meeting financial, operational, and quality objectives while mentoring teams and ensuring compliance with regulatory standards.
Lead the end-to-end implementation and operational execution of Medicare Advantage programs while coordinating with internal and external stakeholders. Monitor program performance, ensure regulatory compliance, and drive continuous improvement to support business objectives and member experience.
The IT Audit Analyst will document and evaluate SOX IT general controls while developing an understanding of risk assessment objectives and financial frameworks. They will also collaborate with business management and external auditors to communicate findings and monitor testing status.
The Vice President & Chief Operating Officer for Medical Affairs will oversee core operational functions including utilization management, care model design, and clinical pathways. This leader will drive enterprise-wide alignment, operational excellence, and technology-enabled transformation across Aetna's clinical and business units.
The Executive Medical Director will lead the centralized MD Quality function to ensure clinical rigor, consistency, and transparency in medical decision-making. This role involves overseeing multidisciplinary teams, analyzing decision trends, and driving quality improvement initiatives across all lines of business.
The Case Manager RN will conduct telephonic and face-to-face assessments to develop individualized care plans for members with complex medical needs. They will coordinate services and resources while partnering with multidisciplinary teams to optimize health outcomes and facilitate care transitions.
The Medical Claim Analyst is responsible for the initial review, triage, and verification of medical claims to ensure regulatory compliance and accurate documentation. They also facilitate communication between internal and external teams to resolve payment issues and support medical management services.
This role serves as a strategic partner for Enterprise Workforce Management, focusing on maintaining and innovating business practices to optimize labor budgets. The analyst will leverage technical tools to develop reporting, modeling, and data visualization to support informed workforce decision-making.
The representative will educate customers about their benefits and claims while resolving inquiries to improve their health and well-being. They are responsible for documenting interactions, maintaining confidential records, and utilizing AI-enabled tools to provide efficient support.
The Account Manager manages a portfolio of client accounts to ensure high levels of satisfaction, retention, and revenue growth. They analyze market trends and client data to develop strategic plans and conduct routine business reviews to optimize account outcomes.
The Billing Consultant is responsible for finalizing dues, collecting payments, and allocating funds across benefits and structures. They must also prepare accurate invoices, reconcile payments, and resolve financial discrepancies while reporting on a monthly basis.
The Senior Analyst will optimize pharmacy and MAC pricing while implementing pricing commitments to meet business requirements. They will also perform quality control processes and develop reports to support internal business partners and clients.
The Senior Product Manager will lead the development and expansion of Fraud, Waste, and Abuse (FWA) products to drive significant annual business impact. They will oversee product strategy, manage cross-functional squads, and integrate AI/ML capabilities to enhance performance and scalability.
The Team Lead oversees the execution of renewal processes, reporting programs, and Salesforce case workflows to ensure operational efficiency. They provide leadership, mentorship, and guidance to team members while maintaining strong relationships with internal and external stakeholders.
The Lead Director oversees the strategy for analytical validation, forecasting accuracy, and financial integrity across the underwriting ecosystem. They lead a team of analysts to conduct root cause analysis, develop reporting solutions, and ensure data-driven decisions align with business outcomes.
Lead and develop high-performing engineering teams to design and modernize mission-critical systems for pharmacy benefit management. Manage the full people-leadership lifecycle, operational budgets, and delivery execution while championing modern engineering practices and AI adoption.
The Lead Director will drive strategic growth initiatives by developing value propositions, sales enablement frameworks, and compelling content for the Commercial & Specialty Markets division. This role involves leading cross-functional teams to execute high-impact projects while serving as a trusted advisor to senior leadership.
The Mental Wellbeing Director is responsible for developing account management strategies, driving client retention, and overseeing operational performance for a portfolio of large, complex clients. They will lead cross-functional teams, analyze market trends, and build strong relationships with key stakeholders to ensure the success of Aetna’s Resources for Living program.
The Certified Professional Coder will perform comprehensive medical record reviews to ensure billing compliance and identify potential fraud, abuse, or billing errors. They will also articulate findings to various stakeholders, including investigators, law enforcement, and medical directors.
The role involves designing, developing, and implementing digital solutions by architecting and coding software applications. You will also collaborate with cross-functional teams to conduct system testing, debugging, and contribute to technical innovation.
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.
The Senior AI Solutions Strategist acts as a bridge between business stakeholders and engineering teams to define and deliver AI-powered solutions. Responsibilities include managing domain relationships, facilitating discovery sessions, conducting ROI analysis, and overseeing the governance of AI initiatives.
The Senior QA Automation Engineer will work with QA leads to provide testing support for digital products, including web, Windows, and database applications. They are responsible for developing efficient automated and manual test cases to validate that solutions meet business requirements.
The Executive Director will lead a new Strategy, Finance & Value Creation capability to improve strategic decision-making and investment discipline within the Medicare business. This role involves providing rigorous analysis and objective recommendations to senior leadership to drive measurable business outcomes and long-term strategic growth.
The Associate Vice President, Medicare Advantage CFO serves as the senior finance leader responsible for financial strategy, performance management, and bid governance across the Medicare Advantage portfolio. This role partners with business leaders to drive growth and profitability while providing integrated financial leadership and strategic decision support.
The Clinical Pharmacist conducts reviews of medical data to perform prior authorizations for specialty medications. This role involves applying clinical criteria to prospective and concurrent reviews while handling inbound calls from healthcare professionals and members.
The Senior Investigator conducts complex investigations into healthcare fraud, waste, and abuse by analyzing claims data and identifying aberrant billing patterns. They also collaborate with law enforcement, medical directors, and internal stakeholders to facilitate case outcomes and ensure regulatory compliance.
The Manager of Network Relations serves as the primary point of contact for high-profile providers, managing complex issues related to Medicaid policies, claims, and contract interpretation. They also collaborate cross-functionally to optimize provider interactions, ensure compliance, and execute cost-management initiatives.
The Quality Assurance Manager leads test design activities, develops quality programs, and manages testing strategies to ensure high-quality product delivery. They also oversee compliance audits, analyze performance metrics, and collaborate with cross-functional teams to drive continuous improvement.
The role involves maintaining and enhancing Anaplan models while translating business processes into functional and technical requirements. You will collaborate with IT and finance stakeholders to drive automation, ensure governance standards, and track measurable results using KPIs.
The Medicaid Specialist manages incoming and outgoing calls to assist patients with Medicaid redetermination, eligibility, and application processes. They also serve as an internal resource for Medicaid-related questions and advocate for patient access to healthcare resources.
Conduct in-home health evaluations, including medication reviews, medical history assessments, and physical examinations for health plan members. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
The CIC Technician supports clinical operations by providing responsive customer service to facilities and prescribers while collaborating with pharmacists on cost-savings initiatives. Responsibilities include processing medication-related claim rejections, managing therapeutic interchanges, and handling documentation through various pharmacy software systems.
The pharmacist will provide exceptional customer service to patients and healthcare professionals while ensuring accurate delivery of pharmaceutical care services. Responsibilities include drug therapy monitoring, patient education, and chronic disease state management for clinical programs.
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.
The manager will oversee financial reporting processes and conduct detailed financial analysis to support business decision-making. They are responsible for ensuring the accuracy of financial statements and maintaining compliance with accounting standards.
The Manager of Provider Services leads provider recruiting efforts for a division, including managing direct reports and developing regional recruiting strategies. They collaborate with leadership to forecast hiring needs and execute multi-channel marketing and conference strategies.
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.
The Case Manager conducts comprehensive clinical assessments and develops care plans to meet the complex health and social needs of dual-eligible members. They facilitate care coordination, perform crisis intervention, and collaborate with providers to ensure quality, cost-effective outcomes.
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 utilizing care management tools.
The fellow will participate in shared service functions for both clinical and operational administration of pharmacy benefit services. They will focus on utilization management to deliver optimized medication utilization and high-quality outcomes.
The Senior Analyst will evaluate the financial impact of plan design changes and maintain business rules to ensure proper financial controls. They will coordinate across internal departments to review client benefit designs and provide consultative support on financial performance.
The Senior Manager leads the strategy, architecture, and operations of enterprise messaging and integration platforms, including IBM MQ and ACE. They are responsible for managing engineering teams, driving platform modernization, and ensuring high availability and security across mission-critical environments.
The Informatics Manager will design and maintain health information systems while ensuring regulatory compliance for HEDIS and state reporting. They will also lead the informatics team in data management, analytics, and the integration of AI-enabled technologies to improve healthcare outcomes.
The Medicaid Proposal Writer develops strategic, compliant, and compelling responses to RFPs by collaborating with subject matter experts and proposal teams. They also manage content libraries, analyze data to highlight company differentiation, and ensure all proposal narratives align with internal quality standards.
The Field Social Worker conducts in-person assessments and develops member-centered care plans for dual eligible populations. They collaborate with healthcare providers and community resources to address social determinants of health and ensure effective care coordination.
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 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 while maintaining accurate clinical documentation via an iPad.
The Senior Manager provides strategic leadership for financial planning and analysis functions by managing a team and coordinating budgeting and forecasting processes. They collaborate with stakeholders to align financial goals with business objectives while ensuring accurate reporting and driving process improvements.
The engineer will design and execute performance tests to identify bottlenecks and improve application scalability and reliability. They will collaborate with cross-functional teams to integrate performance engineering practices throughout the software development lifecycle.
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 based on individual health needs.
Conduct in-home and virtual health evaluations to bridge gaps in care and provide personalized health assessments. Perform medication reviews, physical evaluations, and diagnostic tests while maintaining detailed clinical documentation.
Conduct in-home health evaluations to bridge gaps in care and provide comprehensive health assessments for plan members. Perform medication reviews, physical evaluations, and diagnostic tests while maintaining trusted relationships with patients.
The engineer will ensure the reliability, availability, and performance of GCP-based applications while implementing CI/CD pipelines and automating infrastructure tasks. They will also manage monitoring systems, participate in incident response, and collaborate with cross-functional teams to maintain system health.
The Industrial Engineer is responsible for establishing labor standards through time studies and facilitating process improvement initiatives to enhance productivity. They will also develop standard operating procedures and provide data-driven analysis to improve clinical process efficiency and customer satisfaction.
The Triage Nurse provides telephonic medical, social, and psychological support to patients outside of regular clinic hours. Responsibilities include precise clinical documentation, scheduling appointments, and managing patient requests within the care queue.
The clinician will conduct comprehensive behavioral and physical health assessments to develop and implement individualized care plans. They will also provide crisis intervention and coordinate care across the continuum for members with complex needs.
The UM Nurse Consultant assesses, plans, and coordinates healthcare services by applying clinical criteria to render coverage determinations. They also collaborate with providers and internal constituents to facilitate appropriate care and promote quality benefit utilization.
The Inventory Planning Senior Analyst is responsible for predicting product demand, maintaining target stock levels, and collaborating with merchant teams to support sales growth. They also monitor key performance indicators and develop mitigation strategies for potential supply chain disruptions.
The UM Nurse Consultant assesses, plans, and coordinates healthcare services to facilitate appropriate member benefits and care. They apply clinical criteria and policies to render coverage determinations while collaborating with providers to ensure quality healthcare delivery.
The role involves providing comprehensive administrative support, including managing office operations, data analysis, and financial record-keeping. It also requires maintaining effective communication with stakeholders and ensuring departmental compliance with established policies.
The manager will negotiate competitive contracts with behavioral healthcare providers and manage contract performance to meet financial targets. They will also build strong provider relationships and support the implementation of value-based care initiatives.
The Senior Medical Director provides clinical oversight for DSNP/FIDE populations, developing and implementing strategies to improve health outcomes and cost-efficiency. They collaborate with internal departments and external stakeholders to manage utilization, ensure regulatory compliance, and lead quality improvement initiatives.
The Scrum Master Manager leads Agile teams and coaches Scrum Masters to drive Agile maturity and ensure the successful delivery of strategic initiatives. This role collaborates with stakeholders to remove impediments, manage risks, and improve overall team effectiveness.
The Case Management Specialist coordinates care for members by conducting health risk assessments and addressing social determinants of health. They collaborate with an interdisciplinary team to develop individualized care plans and ensure regulatory compliance.
The Staff Software Development Engineer will lead the design, development, and implementation of scalable Java microservices architecture. They will also mentor team members, oversee system maintenance, and act as a subject matter expert for technical projects.
The Senior Product Manager will lead the Smart Care squad by defining product strategy, managing the backlog, and collaborating with data science and engineering teams to deliver AI-driven healthcare solutions. They are responsible for translating complex clinical and behavioral data into actionable insights while ensuring alignment with business goals and stakeholder expectations.
The Clinical Advisor will drive growth in specialty pharmacy by developing innovative product roadmaps and holistic solutions for oncology and rare disease therapies. They will lead clinical governance, define clinical workflows, and manage cost-effective programs to optimize health outcomes for patients and payors.
The role serves as a dedicated point of contact for a national plan sponsor to manage communications, training, and engagement for an Employee Assistance Program. Responsibilities include coordinating promotional materials, managing training schedules, and collaborating with internal teams to enhance program utilization.
The Cardiopulmonary Patient Educator will provide clinical support and infusion training to patients with Pulmonary Arterial Hypertension in a home care setting. They will collaborate with physicians and pharmacy operations to coordinate comprehensive care plans for patients and their caregivers.
The Cardiopulmonary Patient Educator will provide clinical support and infusion training to patients with Pulmonary Arterial Hypertension in their homes. They will collaborate with physicians and pharmacy operations to coordinate comprehensive care plans for patients.
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 in a cost-effective manner while ensuring safe and appropriate care delivery.
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, monitor progress, and collaborate with multidisciplinary teams to ensure quality of care.
The Pharmacy Technician acts as a liaison between patients, providers, and pharmacists to manage medication refills and renewals. They handle high-volume inbound and outbound calls while documenting patient requests and coordinating with care teams to resolve barriers to care.
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 accurate documentation in electronic health records.
The Senior Data Scientist will lead the analytical and technical execution for member onboarding and customer experience portfolios. They will design, build, and measure data science solutions while mentoring team members and collaborating with cross-functional stakeholders.
The nurse consultant will assess, plan, and coordinate healthcare services while applying clinical criteria to render coverage determinations. They will also consult with internal and external constituents to facilitate effective benefit management and quality healthcare delivery.
The Case Management Coordinator facilitates healthcare outcomes by evaluating member needs, coordinating care plans, and assisting with benefit access. They also collaborate with multidisciplinary teams to ensure quality of care and provide coaching to empower members in their healthcare decision-making.
The Clinical Pharmacist will support Medicaid prior authorization processes by applying evidence-based clinical guidelines and criteria. The role involves reviewing medical records, managing formularies, and working within a high-production team environment.
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 collaborate with providers to facilitate effective treatment plans.
The Utilization Management Nurse Consultant assesses, plans, and coordinates healthcare services to ensure appropriate benefit utilization for members. They apply clinical criteria and guidelines to render coverage determinations while collaborating with providers to facilitate effective treatment.
Process prior authorization requests by utilizing clinical research, medication guidelines, and internal computer systems to support review decisions. Maintain accurate documentation and communicate status updates to providers, pharmacies, and internal partners via phone and electronic channels.
The role involves coordinating Medicaid and Medicare pharmacy services by processing authorization requests and evaluating them against clinical guidelines. You will communicate decisions to healthcare providers and members while maintaining accurate documentation in compliance with regulatory requirements.
The Medical Director will develop, implement, and evaluate clinical programs while providing medical management oversight across the continuum of care. They will also act as a clinical liaison to network providers and support the medical management staff in handling authorizations and appeals.
Provide psychiatric leadership and physician oversight for utilization management, including medical necessity decisions and high-risk case management. Collaborate with clinical teams to develop medical policies, monitor quality improvement activities, and ensure the delivery of appropriate behavioral health care.
The Senior Investigator conducts complex investigations into healthcare fraud, waste, and abuse, including managing sensitive, high-profile cases and coordinating with law enforcement. They also perform data mining to identify aberrant billing patterns, facilitate financial recoveries, and provide training to less experienced staff.
The Appeal Examiner manages resolution and complaint/appeal scenarios by coordinating responses across multiple business units. They are responsible for interpreting policy guidelines, analyzing appeals, and drafting accurate resolution letters.
The Clinical Claims Review Nurse is responsible for reviewing and interpreting clinical documentation to apply appropriate criteria for post-service claims. They also act as a clinical resource for internal teams, provide training, and ensure compliance with relevant laws and regulations.
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 Lead Director will establish and lead the enterprise-wide AI FinOps capability, defining the strategy, governance, and financial frameworks for AI investments. They will partner with cross-functional teams to provide transparency into AI spending and ensure value realization across the organization.
The Care Management Coordinator facilitates healthcare outcomes by providing care coordination, support, and education to members using care management tools. They collaborate with Child and Family Teams to evaluate member needs, implement care plans, and monitor progress while ensuring quality of care.
The Associate Manager will lead the implementation and daily operations of a Community Health Worker pilot program aimed at improving health outcomes for Medicaid members with chronic conditions. They will supervise CHW staff, coordinate with interdisciplinary teams, and monitor performance metrics to ensure effective member engagement and resource connection.
Leads the product strategy and lifecycle for Epic electronic health record platforms and clinical informatics tools. Collaborates with clinical, technical, and operational stakeholders to translate business needs into actionable product requirements and workflows.
The Chief of Staff acts as a strategic partner to the Deputy CISO, driving execution, alignment, and operational discipline across the cybersecurity organization. This role manages critical planning rhythms, coordinates cross-functional programs, and ensures clear communication between leadership and enterprise stakeholders.
The Senior Analyst will formulate pricing strategies and execute financial modeling for PBM client contracts, including retail, mail order, and specialty pharmacy services. They will also collaborate with sales teams to provide negotiation recommendations and present financial analyses to executive leadership.
The Principal Decision Scientist will design and build causal inference studies to quantify clinical outcomes and provide quantitative sizing for new growth opportunities. They will also collaborate across business functions to standardize technical fundamentals and present strategic insights to executive leadership.
The manager will lead billing operations and oversee teams responsible for electronic eligibility, claims billing, and payment posting. They will also collaborate cross-functionally to improve claim rates and ensure compliance with billing guidelines.
The manager will draft executive communications, including speeches, scripts, and leadership messages, while managing projects from inception to completion. They will also collaborate with business leaders to develop presentations and support executive events to ensure consistent messaging across the enterprise.
The Certified Professional Coder will conduct comprehensive medical record audits to ensure billing compliance and identify potential fraud, abuse, or billing errors. They will provide detailed written summaries of findings and articulate these results to investigators, legal counsel, and medical directors.
The specialist implements quality management strategies to meet internal and external regulatory expectations, including NCQA and state Medicaid requirements. They also perform data analysis to support quality committees and drive performance improvement projects.
The Inbound/Outbound Queue Associate will manage health-related communication queues to ensure a connected and compassionate experience for patients. The role involves maintaining safety and quality standards while simplifying health care for individuals and families.
The Senior Manager identifies, evaluates, and advances new growth opportunities by leveraging CVS Health's unique assets and enterprise scale. They collaborate with cross-functional teams to develop business cases, pilot innovative initiatives, and translate market insights into actionable growth strategies.
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 utilizing care management tools.
The Case Manager administers leave of absence requests under FMLA, state regulations, and company policies using the myLeave platform. They also conduct colleague outreach, resolve escalations, and ensure compliance while providing empathetic support throughout the leave process.
The analyst conducts routine care coordination, support, and education to facilitate positive healthcare outcomes for members. They also implement case management projects and consult with multidisciplinary teams to overcome barriers to member health goals.
The Senior Manager will lead provider network strategy for the Louisiana Medicaid market to ensure compliance with LDH and NCQA standards. They will also conduct market analysis, manage provider partnerships, and develop engagement strategies to optimize network performance.
The LPN will process and communicate specialty medication prior authorization requests while coordinating with physician offices, pharmacies, and internal clinical teams. Responsibilities include reviewing clinical criteria, managing case documentation, and providing on-call nurse support for urgent requests.
You will lead a team of engineers to build and scale an enterprise-grade API platform that integrates with gateways like Apigee and Kong. You will also collaborate with cross-functional leadership to define strategy, set OKRs, and foster a high-performing engineering culture.
The role involves coordinating Medicaid and Medicare pharmacy services by processing authorization requests and evaluating clinical criteria. You will communicate decisions to healthcare providers and members while maintaining accurate documentation in compliance with regulatory standards.
The analyst will provide financial consultation and pricing support to help win and retain business while analyzing pharmaceutical data to inform healthcare strategies. They will collaborate with internal teams and clients to formulate data-driven solutions and present recommendations to leadership.
The AVP of Security Risk Management defines and executes the enterprise cybersecurity risk strategy, overseeing risk identification, control validation, and remediation across internal and third-party environments. This leader also manages security due diligence for mergers, acquisitions, and divestitures while partnering with senior leadership to ensure regulatory compliance and operational resilience.
The Executive Director provides enterprise-wide strategic and technical leadership for the Epic EHR platform, overseeing design, build, and delivery across the organization. This role manages a multi-tiered team and serves as the primary executive partner to business-unit leadership to align technology roadmaps with organizational strategy.
The Care Management Associate evaluates patients to identify needed medical services, coordinates care plans, and performs non-medical research to support case management. They also provide support by handling provider and member inquiries, maintaining accurate documentation, and ensuring compliance with regulatory standards.
The Clinical Pharmacist evaluates and reviews prior authorization requests to render coverage determinations based on clinical criteria and plan design. They also collaborate with healthcare providers and internal teams to facilitate requests and ensure timely communication of decisions.
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.
Conduct telephonic case management assessments and develop individualized care plans to address members' medical, behavioral, and social needs. Collaborate with interdisciplinary teams to coordinate care, facilitate referrals, and ensure compliance with regulatory requirements.
The associate coordinates medical services by performing intake, screening requests, and managing referrals via telephone and electronic systems. They also conduct non-medical research, verify eligibility, and maintain accurate documentation in compliance with regulatory and accreditation standards.
The Case Manager RN is responsible for assessing, planning, and coordinating case management activities to evaluate and address the medical, behavioral, and social needs of members. They will use clinical tools and motivational interviewing to engage members, reduce risk factors, and improve overall health outcomes.
Processes prior authorization requests by utilizing clinical guidelines and computer resources to support review decisions. Manages high-volume inquiries from providers and pharmacies while maintaining accurate documentation and productivity standards.
Conduct in-home health evaluations, including physical assessments, medication reviews, and medical history documentation for health plan members. 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 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 and physical assessments, to bridge gaps in patient care. Provide patient education and document findings using an intuitive clinical workflow on an iPad.
The Associate Manager is responsible for monitoring real-time call queues and agent adherence to ensure service level performance targets are met. They also coordinate with operations and vendor management to implement schedule adjustments and resolve service-impacting events.
The Senior Software Engineer will be responsible for the development, maintenance, and deployment of Android applications within the Pharmacy Consumer Wellness organization. They will collaborate with cross-functional teams including product, design, and engineering to build and ship high-quality features for CVS and Health100 applications.
The Lead Director will oversee complex engineering delivery roadmaps and AI-enabled transformations for retail front store modernization. This role involves managing cross-functional teams, tracking KPIs, and building strong relationships with business and technology partners.
The Lead Director will manage regulatory relationships with Boards of Pharmacy and interpret complex pharmacy regulations to guide organizational operations. They are responsible for developing regulatory strategies, representing the company before external stakeholders, and mentoring internal colleagues.
The Senior Clinical Advisor will serve as a strategic leader for key customer relationships, focusing on advancing the myPBM platform through cross-functional collaboration. They are responsible for translating complex clinical and technical requirements into practical solutions while driving continuous improvement and issue resolution.
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 insights.
The Customer Service Representative handles member inquiries via telephone, internet, or written correspondence to resolve issues and provide information regarding health plans. They are responsible for educating members on benefits, documenting contacts, and managing appeals or pre-authorizations.
The nurse will provide telephonic patient education regarding chronic conditions, treatment modalities, and medication side effects. They are also responsible for monitoring patient adherence and reporting adverse drug events while collaborating with clinical staff.
The specialist leads the management of quality data, regulatory reporting, and analytics to drive performance improvement and actionable insights. They design dashboards and reporting frameworks while partnering with clinical and operational leadership to optimize quality metrics like HEDIS and Medicare Stars.
The Quality Manager will transform raw data into actionable insights to support strategic decision-making across Direct-to-Consumer channels. They will lead the development of reporting solutions and quality dashboards while collaborating cross-functionally to ensure data integrity and performance improvement.
The consultant coordinates and evaluates utilization and benefit management programs by applying clinical criteria and evidence-based standards. They also provide triage, crisis support, and facilitate optimal treatment plans while identifying members at risk for poor outcomes.
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.
The clinician will review behavioral health treatment plans to ensure medical necessity and coordinate care decisions with providers. They will also facilitate discharge planning and provide triage support to identify members at risk for poor outcomes.
Lead technical initiatives to design, build, and maintain business-critical, enterprise-grade distributed systems. Collaborate across teams to drive long-term improvements in scalability, performance, and maintainability.
The clinician will review behavioral health services and treatment plans to ensure medical necessity and appropriate care. They will also coordinate with providers and care teams to facilitate effective discharge planning and support positive member outcomes.
The role involves designing and building analytical models to predict and measure performance for CMS Stars reporting. It also requires collaborating with cross-functional teams to integrate analytical insights into quality improvement efforts and communicating findings to senior leadership.
Conduct comprehensive in-home health evaluations, including medication reviews, physical assessments, and diagnostic screenings for health plan members. Provide patient education and bridge gaps in care to improve health outcomes while maintaining accurate clinical documentation.
The Nurse Case Manager assesses, plans, and coordinates medical care for members to facilitate wellness and improve health outcomes. They apply clinical judgment to evaluate member needs, manage risk factors, and ensure compliance with regulatory and company policies.
The analyst performs second-level quality audits of medical records to ensure ICD coding accuracy for CMS risk adjustment. They also provide mentorship to staff and ensure compliance with federal regulations and internal policies.
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 system alignment with organizational strategy and regulatory standards.
The RN Case Manager is responsible for assessing, planning, and coordinating case management activities to evaluate and support the medical needs of members. They will utilize clinical tools and interviewing skills to develop proactive care plans and ensure member engagement.
The Pharmacy Care Representative will manage inbound and outbound calls to assist patients with specialty medication orders, insurance verification, and benefit investigations. They are responsible for coordinating shipments, enrolling new patients, and escalating clinical issues to staff pharmacists.
Design and build sophisticated analytical models to predict and measure performance for Stars reporting. Collaborate with cross-functional teams to integrate analytical insights into quality improvement efforts and communicate findings to senior leadership.
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 while maintaining accurate clinical documentation via an iPad.
The Senior Manager will lead strategic enterprise data modernization initiatives, including cloud enablement and platform migrations. They are responsible for managing program roadmaps, budgets, governance, and cross-functional delivery across technology and business teams.
The Senior Sales Executive builds strategic partnerships to achieve profitable growth and cross-sell objectives for assigned business segments. They manage producer relations, deliver polished presentations, and collaborate with internal teams to ensure product and pricing solutions meet client needs.
You will lead the interoperability strategy and client reporting capabilities for the data platform by defining the product vision and roadmap. This involves establishing bi-directional data exchange using healthcare standards and developing scalable reporting solutions for health plan clients.
The Associate Manager oversees care management staff to ensure high-performing teams and the achievement of health plan goals. They are responsible for implementing clinical initiatives, conducting audits, and managing relationships with community stakeholders and foster care agencies.
The Case Manager conducts in-person patient assessments and coordinates multidisciplinary care plans to facilitate wellness and service access. They also manage member caseloads, advocate for safe transitions, and document care accurately in electronic health records.
The analyst is responsible for documenting business data, conducting root cause analysis, and developing SQL-based reports to support business needs. They will also define and implement system enhancements while executing test scripts to ensure data quality and process efficiency.
Coordinates case management activities with members to evaluate medical needs and facilitate overall wellness. Develops strategies to address health issues and ensures compliance with clinical coverage policies.
Conduct in-home and virtual health evaluations, including medication reviews, physical assessments, and diagnostic screenings. Build trusted relationships with health plan members to bridge gaps in care and provide personalized health education.
Conduct comprehensive 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 using provided digital tools.
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.
The Chief of Staff will serve as the primary partner to the SVP of Healthcare Analytics, managing financial budgets, operational processes, and executive communications. They will also drive strategic planning, talent management, and cross-functional coordination to ensure the organization meets its performance goals.
The Senior Manager, Product Growth Enablement will lead cross-functional initiatives to accelerate product growth by aligning sales, marketing, and clinical teams. This role is responsible for developing product narratives, managing enablement collateral, and ensuring effective market execution for priority products.
The Product Manager will drive key initiatives for the PBM Product Innovation Team by managing daily operations, financial reporting, and commercialization support. They will serve as a liaison between business and technical teams to ensure project alignment, process standardization, and successful delivery of solutions.
Conduct face-to-face assessments with members to evaluate medical needs and overall wellness while helping them access vital services. Collaborate with interdisciplinary teams to develop proactive care plans that enhance short and long-term health outcomes.
The Lead Director will drive product growth by aligning cross-functional teams and executing go-to-market strategies for priority products. This role involves leading a small team to develop sales collateral, manage product launches, and provide strategic support for complex client engagements.
Facilitate healthcare outcomes for waiver members by providing care coordination, support, and education using care management tools. Conduct comprehensive evaluations of member needs and monitor care plan progress while ensuring compliance with regulatory guidelines.
The Strategic Account Executive is responsible for managing the overall account strategy, renewal outcomes, and executive relationships for a portfolio of large employer pharmacy benefit clients. This role involves leading financial negotiations, guiding renewal strategies, and serving as a trusted partner to client and consultant stakeholders.
The Senior Manager directs provider network performance and negotiates value-based contracts to improve health outcomes and cost efficiency in the Louisiana Medicaid market. They also collaborate with internal teams to align network goals and provide strategic recommendations to senior leadership.
The Lead Director is responsible for building strategic relationships with provider partners to develop and manage innovative value-based contracting solutions. This role oversees the entire contracting cycle, including negotiation, financial modeling, and performance management to meet cost and quality objectives.
The Strategic Account Executive owns the multi-year account strategy, renewal outcomes, and executive relationships for a portfolio of large, complex pharmacy benefit manager clients. They are responsible for leading renewal negotiations, managing financial performance, and serving as a trusted partner to client and consultant stakeholders.
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 healthcare services while maintaining accurate clinical documentation.
The Community Health Worker acts 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 community resources to address socio-economic barriers to health.
The Case Management Coordinator evaluates member needs and implements care plans to facilitate appropriate healthcare outcomes for children with complex behavioral health needs. They serve as a single point of contact, collaborating with families and providers to secure necessary services and monitor progress.
The Cardiopulmonary Educator provides clinical support and infusion training to patients with Pulmonary Arterial Hypertension in a home care setting. They collaborate with physicians and pharmacy operations to coordinate comprehensive patient care plans.
The manager will oversee coding quality, compliance auditing, and team management while optimizing Epic workflows and AI-enabled processes. They are responsible for conducting internal audits, managing external RADV readiness, and ensuring adherence to federal coding standards.
Coordinates case management activities to evaluate medical needs and facilitate member wellness. Develops strategies to address health outcomes and ensures compliance with clinical coverage policies.
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 all clinical documentation meets company and health plan standards.
The Senior Finance Manager is responsible for managing broker and technology partner commission payments, including calculation, reconciliation, and compliance. They will also collaborate with Sales, Finance, and Technology teams to implement process improvements and resolve payment inquiries.
Conduct comprehensive in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. Build trusted relationships with patients while providing personalized health education and diagnostic services in their homes.
The Certified Professional Coder will perform comprehensive medical record reviews to ensure billing compliance and identify potential fraud, abuse, or billing errors. They will also articulate findings to various stakeholders, including investigators, legal counsel, and medical directors.
Lead and grow a team of engineers to build agentic AI and enterprise messaging platforms on Google Cloud Platform. Oversee the architecture and delivery of systems that power patient communications while ensuring regulatory compliance.
The Senior Manager will lead the strategy and development of new pharmacy trade programs, managing the product lifecycle from ideation to execution. They will collaborate cross-functionally to drive business cases, monitor product performance, and implement process improvements using data-driven insights.
The Transitional Care Manager facilitates interdisciplinary collaboration and care continuity across various settings to ensure safe patient discharges. They manage patient transitions, advocate for care access, and maintain accurate records while adhering to regulatory compliance standards.
The Senior Manager will lead product management and development for drug cost reduction initiatives while collaborating with cross-functional teams. They are responsible for executing strategic pilots and building long-term relationships to meet organizational goals.
The Executive Director leads Medicaid provider engagement, network contracting, and performance strategies across the Southeast region. This role drives network growth, ensures regulatory compliance, and fosters relationships with health systems and community providers.
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 counseling, medication management, and coordinate care within a multidisciplinary team.
The Case Manager facilitates comprehensive care coordination, assessment, and planning to meet the health needs of members and their families. They act as a liaison between patients, providers, and insurance carriers to ensure cost-effective outcomes and promote wellness.
The HR Technology Strategy & Delivery Lead will define and drive the enterprise HR technology experience strategy, including the design and modernization of digital platforms. This role involves leading discovery, requirements gathering, and solution design while partnering with cross-functional teams to implement scalable HR systems and AI-driven solutions.
The Senior Product Analyst will lead the development of a data-driven product roadmap and define key product metrics. They will also build data models, create dashboards, and apply statistical methods to evaluate product efficacy and business impact.
The Manager, Client Operations serves as the primary operational contact for clients, leading matrixed teams to align success strategies with project execution. They are responsible for overseeing program implementations, managing client deliverables, and ensuring effective communication between internal stakeholders and clients.
The Principal Cloud Architect defines the technical direction for cloud workloads, establishing reference architectures and paved-road patterns for engineering teams. They serve as the primary technical authority for cloud design, ensuring security, resilience, and cost-efficiency across the organization.
The Principal Data Architect is responsible for defining the data architecture, strategy, and reference designs across a multivendor, multicloud environment. They will establish data governance, quality standards, and enable AI and analytics capabilities through robust data infrastructure.
The Principal AI Architect defines the technical direction, reference architectures, and governance for AI capabilities across Aetna Technology. This role establishes paved-road patterns for model and agent development while driving outcomes through technical influence and design authority.
The Principal Architect will own the enterprise cloud-native reference architecture and multi-cloud infrastructure strategy across Azure, AWS, and GCP. They will define standards for security, identity, Kubernetes, and infrastructure-as-code while mentoring engineering teams and driving FinOps maturity.
The Peer Support Specialist will use lived experience to guide, coach, and mentor Aetna members in recovery while assisting care teams with care coordination. They will also collaborate with healthcare and justice system professionals to improve member access to care and support social determinants of health.
The Senior Service Advocate serves as a single point of contact for Medicare members, handling inbound calls to resolve inquiries and provide guidance. They are responsible for documenting interactions, educating members on benefits, and collaborating with internal partners to ensure service quality.
The Senior Analyst will support the development and execution of analytics, measurement, and optimization strategies for health services offerings. They will analyze marketing performance data to provide actionable insights that drive growth across digital and physical channels.
The analyst conducts routine care coordination, support, and education to facilitate appropriate healthcare outcomes for members. They also implement case management programs and consult with multidisciplinary teams to overcome barriers to member health goals.
Provide telephonic case management for Medicare members by conducting comprehensive assessments and developing individualized care plans. Coordinate care with providers and community resources while utilizing motivational interviewing to support positive health outcomes.
The Senior Data Scientist will activate clinical data repositories to improve health outcomes by designing data models and building clinical data feature stores. They will also serve as a subject matter expert, bridging the gap between clinical data assets and analytical stakeholders through documentation, training, and data quality management.
The Care Management Coordinator facilitates healthcare outcomes by providing care coordination, support, and education to members using care management tools. They collaborate with Child and Family Teams to evaluate member needs, implement care plans, and monitor progress while ensuring quality of care.
The Clinical Advisor serves as a subject matter expert on the account team, providing clinical consulting services and analyzing drug utilization trends for PBM clients. They are responsible for delivering quarterly and annual clinical reports and educating clients on CVS Health programs to drive implementation and adoption.
The role involves supporting high-impact reporting initiatives related to claims analysis, demographic data integrity, and coding accuracy. You will analyze EMR data to identify trends, create meaningful reports, and collaborate cross-functionally to drive process improvements.
The Manager of Periodic Access Review oversees the execution, quality, and continuous improvement of the organization's access governance program. This role ensures compliance with identity governance requirements while driving automation and process maturity across internal audit and security functions.
The Service Advocate manages patient appointments by handling inbound and outbound calls while ensuring an unmatched patient experience. They are responsible for accurate data entry, resolving scheduling conflicts, and collaborating with medical staff to maintain efficient operations.
The Senior Medical Director serves as a clinical leader for Medicare Advantage Group Plan Sponsors, driving clinical strategy and improving healthcare outcomes. They act as a trusted advisor to clients, translating complex data into actionable strategies while collaborating with cross-functional teams to enhance member health.
The Senior Manager will design and execute account management strategies to drive profitable growth, cross-selling, and long-term client retention. They are responsible for establishing operational frameworks, managing complex client relationships, and coaching junior staff on account management techniques.
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.
Conduct in-home health evaluations for patients, including medication reviews, physical assessments, and diagnostic screenings. Facilitate connections to appropriate care and maintain accurate clinical documentation using provided digital tools.
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.
Conduct in-home and virtual health evaluations for health plan members, including medication reviews and physical assessments. Build trusted relationships with patients to bridge gaps in care and provide 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.
Conduct comprehensive in-home health evaluations, including medication reviews and physical assessments for health plan members. Build trusted relationships with patients to bridge care gaps and provide necessary health education.
Conduct in-home and virtual 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.
The Case Manager RN is responsible for assessing, planning, and coordinating case management activities to evaluate and support 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 Case Manager RN is responsible for assessing, planning, and coordinating care for dual-eligible members to facilitate their overall wellness. They act as frontline advocates who collaborate with providers and community organizations to address complex health and social determinant needs.
The Case Manager facilitates care coordination, assessment, and planning for members to meet their comprehensive health and social needs. They act as a liaison between members, families, providers, and insurance carriers to promote wellness and cost-effective outcomes.
The Dietitian provides patient-centered nutrition support services, including parenteral and enteral feeding, while ensuring clinical documentation meets Medicare and payer requirements. They also collaborate with internal and external partners to support smooth transitions of care and provide clinical expertise for nutrition therapy.
The Senior Manager will develop, manage, and monitor corporate compliance programs to ensure ethical behavior and mitigate organizational risks. They will also lead regulatory reporting, manage interactions with regulatory bodies, and oversee compliance business process reviews.
The Treasury & Risk Manager oversees strategic financial objectives, including cash flow management, debt financing, and risk mitigation. They collaborate with senior leadership to optimize capital structure and ensure regulatory compliance across the organization.
The Accounts Payable Manager oversees daily department operations, including invoice processing, payment scheduling, and the implementation of financial controls. They also lead the team, drive process improvements, and manage the transition to Oracle NetSuite.
The Tax Manager is responsible for managing and reviewing corporate tax returns while ensuring compliance with all applicable tax laws and regulations. They will also conduct tax research, identify tax-saving opportunities, and collaborate with internal and external stakeholders to optimize the organization's tax position.
The role involves working in a retail customer care call center to assist patients with pharmacy needs and enroll them in pharmacy services. Agents are responsible for receiving inbound calls from retail pharmacies, managing non-preferred drug orders, and providing order status updates.
The Senior Manager of Pricing Strategy will lead the development and implementation of innovative pricing models to drive value for CVS Caremark and its clients. This role involves collaborating with underwriting and cross-functional teams to analyze market trends and ensure pricing strategies align with business objectives.
The Senior Analyst supports regulatory compliance activities by researching issues, gathering facts, and tracking trends to prepare accurate reports. They also assist in responding to internal and external inquiries and collaborate with managers on departmental priorities.
The specialist serves as the enterprise subject matter expert for Hardware Asset Management, driving lifecycle governance and ServiceNow HAM Pro optimization. They are responsible for ensuring data integrity, audit readiness, and cross-functional collaboration with procurement, finance, and IT teams.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic screenings. Facilitate connections to appropriate care and maintain detailed clinical documentation using an iPad-based workflow.
The Senior Data Analyst will lead complex healthcare performance analytics, including Medicare Stars and provider incentive programs. They are responsible for developing member-level targeting lists, conducting root-cause analysis, and creating dashboards to support data-driven decision-making.
The Senior Analyst supports digital experience strategy by coordinating portfolio operations, managing project trackers, and facilitating cross-functional collaboration. They are responsible for documenting business requirements, tracking project health, and preparing executive-level performance reports.
Conduct in-home health evaluations for 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 comprehensive in-home health evaluations for members, including medication reviews and physical assessments. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
The Director of Product Management will define and execute the vision, strategy, and roadmap for healthcare data interoperability solutions. This role involves leading a team of product owners to drive innovation across APIs, data exchange platforms, and integration services while collaborating with cross-functional stakeholders.
The Ombuds Office staff will serve as a strategic thought partner to help visitors explore options for conflict resolution and surface emerging issues to management. They are responsible for providing independent, confidential, and impartial support while facilitating communication between parties in dispute.
The analyst case manager evaluates member needs and eligibility to facilitate appropriate healthcare outcomes through care coordination and support. They collaborate with multidisciplinary teams to implement care plans, monitor progress, and ensure quality of care in compliance with regulatory guidelines.
Conduct in-home health evaluations for health plan members, including physical assessments and medication reviews. Provide comprehensive 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 and physical assessments. Provide patient education and diagnostic services while maintaining accurate clinical documentation via an iPad.
The Lead Director will oversee performance measurement, quality assurance, and continuous optimization across the Payment Integrity editing portfolio. This role involves developing executive-level reporting, managing savings methodologies, and identifying opportunities to improve edit accuracy and financial outcomes.
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 documentation.
The representative will advocate for customers by resolving inquiries regarding benefits and claims while educating them on available healthcare resources. They are responsible for documenting interactions accurately and collaborating with team members to ensure high-quality service and customer satisfaction.
The Territory Sales Executive drives specialty pharmacy sales growth by promoting services to healthcare providers and medical institutions. They are responsible for developing strategic business plans, managing customer relationships, and collaborating with internal clinical partners to achieve sales goals.
The Distinguished Engineer serves as the senior technical leader for Application Security, defining the architectural strategy for securing software across web, mobile, and AI-native environments. They are responsible for integrating security controls into CI/CD pipelines and leading the enterprise adoption of AI-assisted development guardrails.
The Territory Sales Executive drives specialty pharmacy sales growth by promoting services to healthcare providers and institutions within an assigned territory. They are responsible for developing strategic business plans, managing provider relationships, and identifying new business opportunities.
The Case Manager facilitates comprehensive care coordination, assessment, and planning for members to optimize health outcomes and wellness. They act as a liaison between patients, providers, and insurance carriers while monitoring progress and ensuring compliance with regulatory policies.
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 Strategic Account Executive manages a book of business for Meritain Pharmacy Solutions by developing strong internal and external relationships to achieve renewal and membership objectives. They are responsible for executing account strategies, coordinating service delivery, and collaborating cross-functionally to ensure client needs are met.
The Care Manager RN assesses, plans, and coordinates healthcare services for members with complex medical and social needs. They act as a liaison between members, families, and providers to develop individualized care plans that improve health outcomes.
The Case Manager develops and implements proactive care plans to enhance member wellness by assessing medical needs and social determinants of health. They collaborate with interdisciplinary teams and providers to overcome barriers and ensure members receive appropriate care.
The Staff Software Development Engineer will act as a technical lead and individual contributor to design scalable solutions and build next-generation health platforms. They will also mentor junior engineers, drive delivery excellence, and collaborate with business leaders to enhance digital system performance.
The Senior Manager will lead a claims operations team to ensure timely and accurate adjudication of medical and dental claims while optimizing service delivery. They will also implement quality assurance programs and drive process improvements to enhance member and provider satisfaction.
The Medical Director will oversee medical policy implementation, utilization review, and quality assurance programs. They will also act as a clinical liaison to network providers and support medical management teams to ensure consistent member care.
The Field Social Worker conducts in-person assessments and develops member-centered care plans for dual eligible populations. They collaborate with healthcare providers and community organizations to address social determinants of health and ensure members receive necessary care.
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.
Conduct comprehensive in-home health evaluations for patients, including medication reviews and physical assessments. Facilitate connections to appropriate care and ensure health plans are informed of the patient's home environment and overall quality of life.
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.
Provide in-home health care services to patients within the designated region. Ensure high-quality, compassionate, and convenient health experiences for individuals and families.
Provide high-quality in-home health care services to patients as a Nurse Practitioner or Physician Assistant. Ensure a connected and compassionate health experience while maintaining safety and quality standards.
Conduct in-home health evaluations for health plan members, including physical assessments and medication reviews. Provide patient education and bridge gaps in care while traveling across a defined coverage area.
Conduct in-home health evaluations, including physical exams, medication reviews, 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, including medication reviews, physical assessments, and diagnostic testing for health plan members. Build trusted relationships with patients to bridge gaps in care and provide education to improve health outcomes.
Conduct comprehensive in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. Engage with patients to provide health education and facilitate connections to appropriate care services.
Conduct in-home health evaluations, including medication reviews, physical assessments, and diagnostic tests for health plan members. 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 tests for health plan members. 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, physical assessments, and diagnostic testing. Provide patient education and build trusted relationships to help bridge gaps in care and improve health outcomes.
Conduct in-home health evaluations, including physical assessments, 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 physician will conduct in-home health evaluations, including physical exams, medication reviews, and diagnostic tests to bridge gaps in patient care. They are responsible for building trusted relationships with patients and providing comprehensive health assessments while traveling within a defined coverage area.
The clinician will conduct in-home health evaluations, including medication reviews, physical assessments, and diagnostic tests for health plan members. They will also provide patient education and facilitate connections to appropriate care to improve overall health outcomes.
Conduct in-home health evaluations including medication reviews, medical history assessments, and physical examinations for health plan members. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Provide in-home clinical care to patients to ensure a connected and compassionate health experience. Collaborate with a team to simplify health care for individuals, families, and communities.
The pharmacist will be responsible for PV2 verification, restocking, and auditing of automated dispensing cabinets. They will also perform troubleshooting tasks to ensure the efficient operation of pharmacy services in long-term care settings.
Conduct in-home health evaluations for health plan members, including medication reviews and physical assessments. Engage with patients to bridge gaps in care and provide personalized health education.
Conduct in-home health evaluations for patients, including physical assessments and medication reviews. Provide 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. Engage with patients to bridge gaps in care and provide personalized health education.
Conduct in-home health evaluations for health plan members, including physical assessments, medication reviews, and diagnostic testing. Build trusted relationships with patients to bridge care gaps and provide personalized health education.
Conduct in-home health evaluations for health plan members, including physical assessments and medication reviews. Engage with patients to bridge gaps in care and provide education to improve health outcomes.
Conduct comprehensive in-home health evaluations for health plan members, including medication reviews and physical assessments. Engage with patients to bridge gaps in care and provide education to improve health outcomes.
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 traveling across a defined coverage area.
The therapist will provide psychosocial support, education, and evidence-based counseling to patients aged 13 and older. They are responsible for conducting assessments, developing treatment plans, and collaborating with the clinical care team to ensure continuity of care.
Conduct comprehensive in-home health evaluations for health plan members to bridge gaps in care and improve health outcomes. Perform medication reviews, physical assessments, and diagnostic screenings while maintaining accurate clinical documentation via an iPad.
Conduct in-home health evaluations to bridge gaps in care and provide comprehensive health assessments for patients. Engage with individuals to review medical history, perform physical evaluations, and facilitate connections to appropriate care services.
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 using an iPad.
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 to various locations within the coverage area.
Conduct in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide diagnostic and preventive services while maintaining accurate clinical documentation using an iPad.
Conduct outbound calls to patients to provide medication adherence support and resolve refill barriers. Document patient interactions accurately while maintaining HIPAA compliance and escalating clinical concerns to pharmacists.
Conduct in-home health evaluations for patients, including medication reviews, physical assessments, and diagnostic screenings. Build trusted relationships with patients to bridge gaps in care and provide personalized health insights.
Conduct comprehensive in-home health evaluations for health plan members to bridge gaps in care. Perform medication reviews, physical assessments, and diagnostic screenings while maintaining accurate clinical documentation.
The Claim Benefit Specialist reviews and adjudicates medical claims to ensure accurate and timely resolution in accordance with processing guidelines. They are responsible for determining coverage, managing claim costs, and maintaining high quality and production standards.
Conduct in-home health evaluations for health plan members, including physical assessments and medication reviews. Travel extensively within a defined coverage area to provide comprehensive and personalized health services.
The physician will conduct in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. They are responsible for traveling to various locations to provide comprehensive health services while maintaining accurate clinical documentation.
Conduct comprehensive in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. Provide health education and diagnostic services while maintaining accurate clinical documentation via an iPad.
Conduct in-home health evaluations for health plan members to bridge gaps in care and provide personalized health assessments. Perform medication reviews, physical evaluations, and diagnostic tests while maintaining accurate clinical documentation.
Conduct in-home health evaluations for health plan members to bridge gaps in care and provide comprehensive health assessments. Utilize clinical workflows to review medical history, perform physical evaluations, and facilitate diagnostic services while building trusted relationships with patients.
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 personalized health insights.
Conduct comprehensive in-home health evaluations for health plan members to bridge gaps in care and improve health outcomes. Perform medication reviews, physical assessments, and diagnostic screenings while maintaining accurate clinical documentation via an iPad.
The physician will conduct in-home health evaluations, including physical exams and medication reviews, to bridge gaps in patient care. They will travel extensively to provide these services and ensure comprehensive health assessments are delivered in a compassionate manner.
Conduct in-home health evaluations for health plan members to bridge gaps in care and provide personalized health assessments. Perform medication reviews, physical evaluations, and diagnostic tests while maintaining detailed clinical documentation using an iPad.
Conduct comprehensive in-home health evaluations for health plan members to bridge gaps in care. Perform physical assessments, medication reviews, and diagnostic screenings while maintaining accurate clinical documentation.
Conduct in-home health evaluations for health plan members, including physical assessments and medication reviews. Engage with patients to bridge gaps in care and provide education on their health needs.
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 connections to appropriate health services.
Conduct in-home health evaluations for patients to bridge gaps in care and provide comprehensive health assessments. Perform medication reviews, physical evaluations, and diagnostic tests while maintaining detailed clinical documentation.
Conduct comprehensive in-home health evaluations for health plan members to bridge gaps in care. Perform medication reviews, physical assessments, and diagnostic screenings while maintaining accurate clinical documentation.
The role involves overseeing vulnerability management programs and designing security measures for cloud platforms and enterprise databases. You will act as a subject matter expert to drive remediation efforts and foster collaboration between security, operations, and development teams.
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 Senior Manager of Pricing Strategy will lead the development and implementation of innovative pricing models to drive value and competitiveness for CVS Caremark. This role involves collaborating with underwriting, sales, and finance teams to analyze market trends and ensure pricing strategies align with business objectives.
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 within a virtual environment.
Conduct comprehensive in-home health evaluations to bridge gaps in care and build trusted relationships with patients. Perform medication reviews, physical assessments, and diagnostic screenings while documenting findings through an intuitive clinical workflow.
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 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.
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 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 personalized health education.
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.
Conduct in-home health evaluations for health plan members, including medication reviews, medical history assessments, and physical evaluations. Provide patient education and facilitate connections to appropriate care based on individual health needs.
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.
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 physical assessments and medication reviews. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
The Chief Information and Digital Officer will lead technology, cybersecurity, and digital transformation for a $2 billion healthcare organization during its transition to a standalone entity. This executive will define the enterprise technology strategy, modernize pharmacy operating systems, and drive operational excellence through AI and data-driven insights.
The Senior Manager drives Front Store business performance by partnering with merchandising teams to develop data-driven pricing strategies and category growth recommendations. They are responsible for influencing cross-functional stakeholders, monitoring category performance, and coaching team members to foster a collaborative culture.
The Lead Director of Mobile Engineering will oversee multiple mobile engineering teams, ensuring the delivery of scalable, high-quality digital health experiences. This role involves strategic planning, technical guidance, and fostering a culture of accountability and professional growth within the engineering organization.
Lead the development and enforcement of application and AI security policies, standards, and guardrails across traditional and agentic systems. Architect secure designs for AI-enabled applications while influencing engineering teams to integrate security-by-design practices.
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 to improve health outcomes.
Conduct comprehensive in-home health evaluations for 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.
Provide psychosocial support and evidence-based mental health therapy to patients aged 13 and older. Manage treatment planning and care collaboration while maintaining documentation within electronic health record systems.
The manager is responsible for recruiting healthcare providers and negotiating contracts to ensure network adequacy and financial targets. They also manage provider relationships, resolve escalated issues, and support cost-saving initiatives through detailed financial analysis.
The Workforce Management Solutions Architect will lead the design and delivery of enterprise-grade labor forecasting and scheduling capabilities. This role involves configuring WFM platforms, driving functional strategy, and partnering with stakeholders to ensure scalable and well-governed solutions.
The Senior Manager provides strategic advisory on trade-related topics for PBM client underwriting, including formulary and rebate insights. They also manage responses to state market conduct examinations and ensure alignment across cross-functional teams.
The Case Management Coordinator collaborates with members, providers, and community organizations to evaluate needs and facilitate appropriate healthcare outcomes. They monitor care plan progress, identify high-risk factors, and provide coaching to empower members in their healthcare decision-making.
The Lead Director provides strategic and operational leadership for Medicaid risk adjustment analytics, overseeing the end-to-end lifecycle of data management, suspecting, and performance monitoring. They lead a multidisciplinary team to drive revenue accuracy and compliance while partnering with clinical, actuarial, and finance stakeholders.
The Medical Director provides clinical expertise to support medical policy, payment policy, and transactional reviews including appeals and claim assessments. They also serve as a subject matter expert to identify quality improvement opportunities and ensure alignment with clinical coding practices.
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.
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 Medical Director provides oversight for medical policy implementation and manages clinical programs to address member needs across the continuum of care. They are responsible for utilization review, quality assurance, and acting as a clinical liaison to network providers.
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 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 Coordinator facilitates healthcare outcomes by providing care coordination, support, and education to members using case management tools. They collaborate with Child and Family Teams to evaluate member needs, implement care plans, and ensure quality of care across child-serving systems.
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 in-home and virtual health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. Build trusted relationships with patients while providing comprehensive health insights to their care teams.
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 Senior Analyst will analyze client data to provide competitive pricing offers and actionable insights for the pharmacy benefits management industry. They will collaborate with underwriting and proposal teams to deliver analytical solutions that meet RFP requirements and support business decision-making.
The Service Advocate is responsible for managing patient appointments through inbound and outbound calls while ensuring an unmatched patient experience. They must accurately document interactions, resolve scheduling conflicts, and collaborate with medical staff to maintain efficient operations.
The Service Advocate manages patient appointments by handling inbound and outbound calls while ensuring an unmatched patient experience. They are responsible for accurate data entry, resolving scheduling conflicts, and collaborating with medical staff to maintain smooth operations.
The representative will advocate for customers by resolving inquiries, educating them on benefits and claims, and maintaining accurate records. They will collaborate with team members to ensure high-quality service and proactive issue resolution.
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 connections to appropriate care services for health plan members.
The representative will act as an advocate for customers by resolving inquiries regarding benefits and claims while maintaining accurate records. They will also educate customers on available resources and collaborate with internal teams to ensure high-quality service outcomes.
The Staff Software Engineer will lead the design and implementation of complex Agentic AI and cloud-native software solutions to modernize claims adjudication. They will also provide technical leadership, mentor junior staff, and establish best practices for AI-driven development across the organization.
The Case Manager facilitates care coordination, assessment, and planning for dual-eligible members to optimize health outcomes and wellness. They act as a liaison between members, families, providers, and community resources while ensuring compliance with regulatory policies.
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 meets company and health plan standards.
Provide one-on-one home infusion nursing care and patient education according to the physician's treatment plan. Maintain clinical documentation and track patient care activity using Microsoft Office tools.
The Decision Scientist will activate clinical data repositories by building feature stores, documentation, and reusable data assets to support analytics and AI products. They will act as a bridge between clinical data assets and stakeholders, ensuring data is well-documented, compliant with regulatory standards, and fit for purpose.
The manager negotiates and executes complex provider contracts to meet network accessibility, quality, and financial goals. They also collaborate cross-functionally to manage provider compensation, pricing development, and network expansion initiatives.
You will define the multi-year strategic roadmap for the Clinical Insights Engine and serve as the primary liaison between clinical leadership and technical platform teams. Your role involves ensuring that AI-driven clinical solutions are successfully implemented to drive measurable improvements in patient care and business outcomes.
Define and own the product vision and roadmap for operational planning and demand generation to optimize outreach capacity and clinician availability. Lead the development of internal planning tools and recommendation engines while collaborating with cross-functional partners to drive organizational decision-making.
You will lead the design and implementation of platforms, tools, and frameworks that define the software development lifecycle. This includes mentoring engineers, driving technical strategy, and collaborating with cross-functional teams to solve complex deployment challenges.
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 improve overall health outcomes.
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 Telesales Representative is responsible for acquiring new members through inbound and outbound calls using a lead generation platform. They will also manage member relationships, address inquiries regarding benefits and services, and ensure retention of existing members.
The clinician will perform clinical reviews of behavioral health services to ensure appropriate treatment plans and evidence-based care. They will coordinate with providers and members to facilitate optimal healthcare outcomes and manage benefit utilization.
The Care Management Coordinator drives care coordination activities by assessing, planning, and monitoring member care plans to achieve optimal health outcomes. They serve as a single point of contact for members, providing coaching and facilitating access to necessary healthcare resources and social supports.
The Care Manager RN coordinates and manages care for members with complex health needs by developing individualized care plans and facilitating access to resources. They serve as a liaison between members, families, and providers while conducting both telephonic and in-person assessments to improve health outcomes.
The Medical Director will oversee Medicare Part C appeals, supervise appeal nurses, and participate in the Second Look Review process. They will also collaborate with quality and compliance teams to ensure clinical consistency and provide subject matter expertise on Medicare policy.
The Senior Manager of Application Development will lead IT project execution, coordinate with vendor staff, and translate clinical business requirements into technical specifications. They are responsible for overseeing system upgrades, managing project deliverables, and ensuring quality standards are met within the Epic environment.
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 productivity standards.
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.
The Senior Systems Engineer will lead the architecture, development, and support of automated distribution center technology platforms. This role involves providing Tier III support for mission-critical systems and driving modernization projects across the logistics network.
The Sales Executive develops and implements strategies to sell supplemental health products to new large group accounts and public entities within Texas. They manage the full sales cycle, including business development, client relationship management, and cross-functional collaboration to ensure successful product installation and service.
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.
The Senior Advisor serves as a subject matter expert on regulatory guidance to ensure the Pharmacy Network division maintains compliance with emerging requirements. They partner with functional leaders to translate these regulations into operational processes and proactively identify and escalate business risks.
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.
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 a home-based setting.
The manager will negotiate, execute, and analyze contracts with local and small group providers to maintain network quality and financial goals. They will also collaborate cross-functionally to manage provider relationships and resolve escalated issues related to claims and contract interpretation.
The Care Manager RN assesses, plans, and coordinates individualized care for members with complex medical and social needs. They serve as a liaison between members, families, and providers to ensure quality, cost-effective health outcomes.
The role involves preparing and distributing periodic financial statements while ensuring compliance with government regulations and professional standards. Additionally, the analyst will perform consolidation journal entries, analyze complex financial data, and develop KPIs to monitor organizational performance.
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.
The Manager of Product will lead the planning, design, and execution of automation activities and product operations within the Prescription Benefit Management team. They will also engage cross-functionally to build new products and influence stakeholders at all levels of the organization.
The manager will lead product operations, including planning and designing automation activities to drive value for the PBM business. They will also engage cross-functionally to build new products and manage stakeholders to ensure successful program delivery.
The manager will lead product operations, including strategy development, design, and the execution of automation activities for PBM products. They will also engage cross-functionally to build new products and manage internal and external stakeholders to drive program success.
The Care Manager RN assesses, plans, and coordinates case management activities to facilitate member wellness and address complex health and social needs. They collaborate with interdisciplinary teams and stakeholders to overcome barriers and ensure members receive appropriate care in compliance with company policies.
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.
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.
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 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.
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.
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.
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 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 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 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.
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.
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.
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.
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.
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.
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.
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.
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 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 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.
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.
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 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 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 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.
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 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.
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 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 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 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.
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 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. Build trusted relationships with patients to bridge gaps in care and provide health education.
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 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.
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.
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 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 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 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, 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 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 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 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.
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 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.
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 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 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 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, 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 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.
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.
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.
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.
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.
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.
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 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.
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.
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 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 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.
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.
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.
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.
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 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 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.
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.
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 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.
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.
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 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.
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.
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.
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.
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 regarding their health and ensure high-quality care delivery while meeting operational and clinical performance metrics.
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.
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.
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.
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 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.
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 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.
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 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 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.
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 for health plan members, including medication reviews and physical assessments. Provide patient education and facilitate connections to appropriate care services to improve health outcomes.
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.
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 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.
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 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 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 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 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 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 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 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 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.
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.
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.
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.
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.
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 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.
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.
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 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.
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.
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 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 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 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.
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 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 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.
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.
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 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 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.
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.
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.
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.
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.
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.
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.
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. 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. 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.
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.
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 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 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, insurance verification, and enrollment. Coordinate medication shipments and escalate clinical issues to staff pharmacists.
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.
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.
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.
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 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.
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 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.
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.
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 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 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.
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.
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.
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 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.
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 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 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 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 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 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 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 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 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 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.
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.
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 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.
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 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.
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 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 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.
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 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 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 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 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 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.
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.
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 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 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 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 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 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 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.
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 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.
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 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 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.
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.
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.
