The Case Management Coordinator evaluates member needs and eligibility to develop and implement effective care plans. They collaborate with multidisciplinary teams to ensure quality of care, facilitate access to benefits, and empower members to make informed healthcare decisions.
The Lead Data Privacy Engineer will drive the strategy, design, and implementation of scalable privacy-enhancing technologies and enterprise data protection solutions. This role involves collaborating with cross-functional teams to embed privacy-by-design principles and ensure compliance with regulatory requirements across the organization.
The Senior Decision Scientist leverages data and analytics to support strategic decision-making and operational excellence within Retail Operations. They translate complex business questions into actionable recommendations while managing cross-functional projects and stakeholder communications.
The Medical Director provides psychiatric leadership and clinical oversight for utilization management teams, ensuring high-quality behavioral health care and medical necessity decisions. They also participate in policy development, quality improvement initiatives, and the management of complex, high-risk patient cases.
The Staff Software Development Engineer will design, develop, and implement digital solutions while serving as a technical lead for complex production issues. They are responsible for driving operational excellence through automation, reliability improvements, and ensuring compliance with system standards.
Coordinates case management activities to evaluate member medical needs and facilitate overall wellness. Develops strategies to address health issues and ensures compliance with clinical coverage policies.
Lead the enterprise delivery of complex Medicaid business process and technology initiatives while ensuring projects meet scope and timeline requirements. Collaborate with stakeholders to drive measurable outcomes, resolve execution obstacles, and mentor project management staff.
The Senior Manager of Medicaid Compliance oversees the execution and deliverables of the compliance program for Aetna’s Ohio Medicaid health plan. This role acts as the primary liaison to state agencies, manages external audits, and ensures all business operations align with regulatory and contractual requirements.
Provide psychosocial support and evidence-based mental health counseling to patients aged 13 and older. Collaborate with the clinical care team to develop treatment plans and ensure continuity of care.
The Nurse Practitioner will deliver holistic, evidence-based virtual care, including assessment, diagnosis, and treatment for patients aged 18 months and older. They are responsible for documenting patient care in an EHR and collaborating with a multidisciplinary team to ensure high-quality health outcomes.
The representative will support plan sponsors by conducting site visits to educate employees on Employee Assistance Program (EAP) benefits. They are responsible for coordinating trainings, managing supply orders, and tracking employee inquiries across various locations.
Conducts routine care coordination, support, and education to facilitate appropriate healthcare outcomes for members. Implements projects and processes for case management while consulting with medical directors to overcome barriers to care.
You will define and own the enterprise data architecture strategy while governing data models and platform tooling across operational, analytical, and AI workloads. Additionally, you will partner with cross-functional teams to ensure data compliance, reliability, and scalability for digital health products.
The Senior Manager will lead application development projects, coordinating with vendor staff and internal teams to execute EHR use cases and system upgrades. They are responsible for defining business requirements, managing project documentation, and ensuring quality standards are met across healthcare delivery systems.
The Telehealth Registered Nurse provides telephonic patient education, support for medication adherence, and develops comprehensive care plans for patients with various disease states. They collaborate with healthcare professionals to ensure continuity of care through specialized telecommunications outreach programs.
The Medical Director will serve as a clinical subject matter expert in Otolaryngology, providing guidance for medical management programs and quality initiatives. Responsibilities include conducting utilization management reviews, overseeing medical necessity determinations, and acting as a liaison with network providers.
The Medical Director will oversee Medicare Part C appeals and provide clinical supervision for appeal nurses and the Second Look Review process. They will also collaborate with quality and compliance teams to ensure adherence to Medicare policy and improve utilization management strategies.
The Mental Health Therapist will provide telehealth therapy and psychosocial support to patients aged 13 and older. They are responsible for developing evidence-based treatment plans and collaborating with the clinical care team to ensure continuity of care.
Provide psychosocial support and evidence-based mental health therapy to individuals, couples, and families aged 13 and older. Manage patient assessment and treatment planning while collaborating with the clinical care team.
Provide telehealth therapy and psychosocial support to patients aged 13 and older. Develop evidence-based treatment plans and collaborate with the clinical care team to ensure continuity of care.
The therapist will provide evidence-based psychosocial support and counseling to individuals, couples, and families aged 13 and older. They are responsible for diagnostic assessment, treatment planning, and maintaining continuity of care within a virtual clinical environment.
The Principal Cloud Infrastructure Engineer will lead the GCP cloud engineering team, setting architectural direction and establishing engineering standards for the enterprise. This role involves hands-on development of infrastructure as code, platform automation, and ensuring the security, scalability, and reliability of the GCP environment.
The Lead Director oversees the software product management for the Security Automation portfolio, defining strategy, roadmaps, and outcome-based success metrics. They are responsible for leading and coaching a team of product managers while partnering with engineering to ensure effective product delivery and adoption.
This position supports attorneys on the Pharmacy Benefit Management contracting team by drafting, processing, and tracking legal contract documents. The role involves incorporating edits from internal partners and ensuring accurate administration of open contract files.
The Associate Manager oversees Integrated Care Management and Long-Term Services and Supports staff to ensure high-performing clinical health service delivery. They also implement change management plans and collaborate with functional managers to maintain consistency in clinical interventions and operational objectives.
The Region Coordinator is responsible for scheduling providers and ancillary staff in Minute Clinics to ensure adequate market coverage and clinic availability. They also analyze market-level scheduling and financial reports to identify staffing trends and optimize budget utilization.
Coordinates case management activities with members to evaluate medical needs and facilitate overall wellness. Develops strategies to address health issues and instructs programs in compliance with clinical coverage policies.
Coordinates case management activities to evaluate medical needs and facilitate member wellness. Develops strategies to address health outcomes and instructs on programs in compliance with clinical policies.
The role involves analyzing financial and business risks for Medicare Part D products, including quarterly forecasting and monthly valuation. The analyst will collaborate with cross-functional teams to model risks and provide analytical support for legislative or regulatory impacts.
The MAC team manages MAC list maintenance, including creating new lists, updating prices, and performing quality control processes. They also handle pharmacy MAC appeals, respond to legal complaints, and monitor pharmacy GER guarantees.
Coordinates case management activities to evaluate medical needs and facilitate member wellness. Develops strategies to address health outcomes and instructs programs in compliance with clinical policies.
The Senior Manager of Pricing Strategy will lead the development and implementation of innovative pricing models to drive profitability and competitiveness. They will collaborate closely with underwriting and cross-functional teams to ensure pricing strategies align with business objectives and regulatory standards.
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.
The Lead Director will oversee technology product strategy for specialty care and partnerships to optimize patient outcomes and reduce medical costs. They will lead multidisciplinary teams to integrate clinical workflows within Epic and external data sources to drive high-quality care delivery.
The Senior Manager, Scrum Master facilitates Scrum events, removes impediments, and promotes collaboration to drive continuous improvement. They also counsel teams on agile principles, interpret metrics, and develop strategies to enhance team productivity and stakeholder communication.
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 connections to appropriate health resources.
The Medical Director provides oversight for medical policy implementation and manages clinical programs to address member needs. They are responsible for utilization review, quality assurance, and acting as a clinical liaison to network providers.
The Senior Epic Analyst leads the design, build, and optimization of Epic solutions for population health and care coordination workflows. This role serves as a subject matter expert, mentoring junior staff and partnering with clinical leadership to translate strategic goals into technical requirements.
The Utilization Management Nurse Consultant reviews authorization requests and evaluates medical necessity using clinical records and evidence-based guidelines. They collaborate with interdisciplinary teams to facilitate quality care while ensuring compliance with health plan policies and regulatory standards.
Conduct concurrent reviews for inpatient admissions to determine medical necessity and facilitate appropriate levels of care. Collaborate with healthcare providers and care teams to monitor treatment, ensure quality standards, and support effective discharge planning.
The Behavioral Health Residential Coordinator manages the referral and admission process for members requiring out-of-home residential treatment services. They act as a liaison between utilization management teams, residential providers, and care management staff to ensure timely and appropriate access to care.
The Medical Director will oversee Medicaid appeals, ensuring timely and consistent responses to member and provider grievances. They will provide clinical expertise to the appeals team and chair committee meetings regarding medical necessity.
The Clinical Advisor manages clinical relationships with health plan clients by developing business plans that drive profitability, clinical goals, and financial targets. They consult on formulary strategies, utilization management programs, and specialty drug strategies to ensure compliance and maximize client value.
Community Health Workers conduct home visits to support members with chronic conditions, helping them navigate the healthcare system and adhere to care plans. They also build relationships with providers and community agencies to address social determinants of health and improve overall health outcomes.
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 and facilities.
The Utilization Management Nurse Consultant assesses, plans, and coordinates healthcare services to facilitate appropriate member benefits. They apply clinical criteria to render coverage determinations and consult with internal and external constituents to manage benefit utilization.
Community Health Workers conduct home visits to support members with chronic conditions, helping them navigate the healthcare system and manage social determinants of health. They also facilitate care plan implementation, assist with medication adherence, and coordinate with community resources to improve overall health outcomes.
The Case Management Coordinator collaborates with members, providers, and community organizations to address the full continuum of healthcare and social determinant needs. They facilitate appropriate healthcare outcomes by assisting with appointment scheduling and identifying benefits and resources for dual-eligible members.
The Associate Manager oversees healthcare management staff and ensures the implementation of high-quality, compliant clinical services. They are responsible for developing high-performing teams, monitoring care plans, and collaborating with functional managers to meet operational and financial objectives.
Community Health Workers serve as a bridge between members and the healthcare system by conducting home visits to reinforce care plans and improve health outcomes. They also identify social determinants of health, assist with resource navigation, and maintain accurate electronic health records.
The Senior Project Program Manager will lead complex, cross-functional projects and programs within the Dental and Vision benefits team. They are responsible for developing journey maps, supporting strategic planning, and ensuring alignment with enterprise priorities.
The Sales Strategy Executive develops and executes cross-sell pursuit strategies to drive dental and vision membership growth within national accounts. They also manage the RFP process, coordinate sales presentations, and collaborate with internal teams to meet business targets.
The nurse consultant applies clinical criteria and practice guidelines to authorize procedures and services requiring precertification. They spend the majority of their time reviewing clinical information from providers and initiating medical director referrals as necessary.
Conduct in-home health evaluations for health plan members, including medication reviews, medical history assessments, and physical evaluations. Travel to various locations within the coverage area to provide comprehensive and personalized health services.
The manager will analyze complex provider, claims, and financial data to support value-based care negotiations and strategy development. They will also collaborate with cross-functional teams to monitor performance, manage agreements, and provide actionable insights to leadership.
You will design, build, and maintain core platform capabilities for the CVS API Platform while collaborating with engineering leaders to turn technical vision into reliable software. Additionally, you will mentor less experienced engineers, participate in on-call rotations, and partner with other teams to ensure successful platform integration.
The Nurse Practitioner delivers holistic, evidence-based patient care through a remote technology platform, including assessment, diagnosis, and treatment. They also coordinate care with a multidisciplinary team and document all patient interactions within an electronic health record system.
The Clinical Case Manager will conduct comprehensive behavioral health assessments and develop individualized care plans for members with complex needs. They will also provide crisis intervention and coordinate psychosocial services while utilizing motivational interviewing to reduce clinical risk factors.
Provide psychosocial support, education, and evidence-based mental health therapy to individuals, couples, and families. Collaborate with clinical care teams to ensure continuity of care and effective treatment planning for patients.
The Peer Support Specialist provides coaching, mentoring, and recovery support to youth and young adults with lived experience in mental health or substance use. They collaborate with clinical teams to assist members in achieving recovery goals and navigating public systems like schools and juvenile justice.
Peer Support Specialists guide and mentor members by sharing lived experience to help them achieve personalized recovery goals. They collaborate with care management teams to coordinate care, conduct field-based visits, and connect members with community-based resources.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic testing. Build trusted relationships with patients to bridge care gaps and provide comprehensive health insights to their care teams.
The associate manages inbound and outbound work queues while processing service authorization requests and documentation for the Florida LTSS team. They collaborate with clinical staff and providers to ensure accurate, timely processing of authorizations while maintaining regulatory compliance.
The Clinical Case Manager facilitates physical and behavioral healthcare by assessing member needs and coordinating psychosocial wraparound services. They are responsible for directing provider collaboration and implementing strategies to ensure cost-effective, high-quality health outcomes.
The Clinical Case Manager facilitates physical and behavioral healthcare by assessing member needs and coordinating psychosocial wraparound services. They are responsible for directing provider collaboration and utilizing resources to achieve cost-effective, optimal health outcomes.
The analyst is responsible for delivering data-driven insights and business intelligence to help healthcare clients make informed decisions regarding pharmacy and healthcare strategies. They collaborate with internal stakeholders and external clients to translate business questions into actionable analytical solutions.
The Representative II processes coverage-related requests such as prior authorizations and appeals via phone and fax for Medicare members. They are responsible for accurate case setup, documentation, and conducting outreach to providers to ensure timely resolution according to CMS guidelines.
The role is responsible for defining portfolio strategy, designing differentiated product solutions, and driving end-to-end portfolio performance. It involves leading cross-functional alignment across a matrixed organization to ensure successful execution and delivery of business objectives.
The Care Manager Registered Nurse facilitates healthcare outcomes by collaborating with members, providers, and community organizations to address complex health and social needs. They utilize critical thinking to manage the case management process, including appointment scheduling and benefit navigation.
The Associate Manager oversees healthcare management staff to ensure high-quality, compliant, and efficient care delivery for members. They are responsible for developing high-performing teams, implementing care plans, and maintaining adherence to regulatory and accreditation standards.
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 overcome barriers to care.
The associate coordinates medical services by performing intake, screening requests, and verifying eligibility and benefits. They also manage outbound calls to providers to obtain clinical information and maintain accurate documentation in compliance with regulatory standards.
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 Care Management Associate conducts telephonic outreach to enroll eligible members into care management programs and facilitates warm transfers to care managers. They are responsible for maintaining accurate documentation, ensuring regulatory compliance, and supporting team efficiency through effective problem-solving.
The Utilization Management Nurse Consultant assesses, plans, and coordinates healthcare services to facilitate appropriate member benefits. They apply clinical criteria to render coverage determinations and consult with providers to ensure quality care delivery.
The specialist performs routine business support tasks, including entering demographic data into provider directories and conducting regular audits. They also support finance and account management teams by responding to inquiries and ensuring data integrity.
The associate coordinates medical services by performing intake, screening requests, and managing referrals via telephone and digital channels. They also maintain accurate documentation and communicate with healthcare providers and internal teams to ensure compliance with regulatory standards.
Design, develop, and maintain scalable microservices and distributed systems on Google Cloud Platform. Implement AI-driven capabilities such as intelligent search and recommendations while ensuring system reliability through observability and DevOps practices.
The Care Management Associate serves as the administrative support partner for the OhioRISE care coordination department, managing referrals and member inquiries. They are responsible for processing Medicaid eligibility, conducting health risk assessments, and maintaining accurate records in complex data systems.
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 patient education.
The Case Management Coordinator evaluates member needs and eligibility to develop and implement effective care plans. They collaborate with healthcare teams to ensure medical appropriateness, quality of care, and optimal health outcomes for members.
The Care Management Associate conducts telephonic outreach to enroll Medicaid members into care management programs and facilitates warm transfers to care managers. They are responsible for maintaining accurate documentation, ensuring regulatory compliance, and providing support to team members to resolve member needs.
The UM Nurse Consultant coordinates and documents the utilization and benefit management process to ensure members receive appropriate, cost-effective care. They review clinical documentation, collaborate with providers, and facilitate discharge planning while adhering to state and federal requirements.
The Care Manager Registered Nurse facilitates healthcare outcomes by collaborating with members, providers, and community organizations to address complex health and social needs. They utilize critical thinking to assist with appointment scheduling, benefit access, and member education through various care management tools.
Design, build, and operate data pipelines and analytic tables to support Medicare revenue projection models. Ensure data quality, lineage, and auditability while partnering with finance and actuarial teams to provide trusted datasets.
The Senior Data Scientist will activate clinical data repositories to improve healthcare outcomes by designing data models and building clinical data feature stores. They will also collaborate with stakeholders to ensure data quality, documentation, and compliance with regulatory standards.
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 clinical teams to ensure quality of care.
The representative will verify insurance coverage for new and existing patients and process prescription orders in a timely manner. They are responsible for providing excellent customer service to patients, healthcare professionals, and insurance carriers.
The Case Management Coordinator facilitates healthcare outcomes by assisting members with appointment scheduling, benefit navigation, and care plan implementation. They utilize critical thinking to evaluate member needs, identify high-risk factors, and provide coaching to promote healthy lifestyle choices.
The Client Service Director leads an account executive team to drive customer satisfaction, retention, and profitable growth within an assigned book of business. They are responsible for overseeing team performance, executing growth strategies, and ensuring consistent service delivery through effective staff training and resource allocation.
Lead the design, development, and delivery of scalable cloud-native software solutions within the Cost Estimation & Navigation AI portfolio. Partner with cross-functional teams to translate business requirements into resilient, secure, and high-performance technical architectures.
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 Referral Coordinator manages daily referrals and diagnostic orders to ensure patients access specialist care in a timely manner. They maintain electronic medical records, obtain necessary authorizations, and coordinate with internal teams and payer partners.
The nurse will perform telephonic counseling for patients with complex conditions, focusing on disease education, treatment adherence, and side effect management. They will also collaborate with clinical staff to resolve issues and report adverse drug events.
Community Health Workers conduct home visits to support Aetna members with chronic conditions by reinforcing care plans and improving access to healthcare services. They also educate providers on social determinants of health and assist members in navigating community resources and social services.
The Care Manager Registered Nurse collaborates with members, providers, and community organizations to address complex health and social needs. They facilitate healthcare outcomes by assisting with appointment scheduling, benefit navigation, and patient education.
The Care Management Associate conducts telephonic outreach to enroll Medicaid members into care management programs and facilitates warm transfers to care managers. They are responsible for maintaining accurate documentation, ensuring regulatory compliance, and providing support to the multidisciplinary team.
The analyst conducts routine care coordination, assessments, and education to help members navigate healthcare services and achieve optimal health outcomes. They collaborate with interdisciplinary teams and community partners to address barriers to care and empower members in their healthcare decision-making.
The analyst conducts routine care coordination, assessments, and education to help members navigate healthcare resources and achieve optimal health outcomes. They collaborate with interdisciplinary teams and healthcare providers to address member needs while maintaining accurate and compliant documentation.
The Care Manager Registered Nurse 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 patient education using clinical care management tools.
The engineer will design, code, test, and debug software applications for the CVS Application Platform (CAP) to support digital health experiences. They will also collaborate with cross-functional teams to implement features, perform testing, and participate in on-call rotations.
The analyst conducts comprehensive assessments and provides routine care coordination to support members in achieving optimal health outcomes. They collaborate with healthcare providers and community partners to address barriers to care and facilitate access to necessary services.
The Treasury and Risk Manager will oversee strategic financial objectives, including cash flow management, debt structure, and risk mitigation. They will collaborate with senior leadership to optimize treasury operations and ensure regulatory compliance through data-driven financial insights.
The Care Management Associate conducts telephonic outreach to enroll Medicaid members into care management programs and facilitates warm transfers to care managers. They are responsible for maintaining accurate member records, meeting daily productivity metrics, and ensuring compliance with regulatory and privacy standards.
The Case Management Registered Nurse collaborates with members, providers, and community organizations to facilitate healthcare outcomes for dual-eligible populations. They utilize critical thinking to assist with appointment scheduling, benefit access, and patient education while managing complex health and social needs.
The Case Management Coordinator facilitates healthcare outcomes by assisting members with appointment scheduling, benefit navigation, and care plan implementation. They also collaborate with clinical teams to identify high-risk factors and ensure quality of care through ongoing monitoring and documentation.
The Network Configuration Specialist is responsible for reviewing, designing, and auditing complex provider contracts and fee schedules to ensure network integrity. They also provide technical expertise and support recruitment efforts while collaborating with internal teams to meet accessibility and financial goals.
The Case Manager facilitates comprehensive care coordination, assessment, and planning for members to promote quality, cost-effective health outcomes. They act as a liaison between members, families, providers, and insurance carriers to ensure appropriate benefit utilization and wellness support.
The Analyst conducts routine care coordination, assessments, and education to help members navigate healthcare resources and achieve optimal health outcomes. They collaborate with interdisciplinary teams and healthcare providers to address barriers to care while maintaining accurate documentation and compliance standards.
The Case Management Coordinator facilitates healthcare outcomes by providing care coordination, support, and education to children with complex behavioral health needs. They collaborate with Child and Family Teams to monitor care plans and ensure appropriate service delivery.
The 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 needs, implement care plans, and monitor progress while ensuring compliance with regulatory guidelines.
The analyst will support the implementation, maintenance, and optimization of digital communication platforms for outbound messaging. They will collaborate with cross-functional teams to execute campaigns, ensure quality assurance, and define user stories within an Agile framework.
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, coordinate care activities, and provide coaching to promote healthy lifestyle choices.
The Case Management Coordinator collaborates with members, providers, and community organizations to address health and social determinant needs. They facilitate healthcare outcomes by assisting with appointment scheduling, benefit access, and member education.
The Case Manager facilitates healthcare outcomes by collaborating with members, providers, and community organizations to address complex health and social needs. They utilize critical thinking to assist with appointment scheduling, benefit access, and member education through established care management tools.
The analyst will support Medicaid managed care compliance programs by maintaining regulatory tracking tools and preparing required reports. They will also assist in developing compliant business processes and supporting external audit reviews.
The Accounts Payable Manager will oversee daily department operations, including invoice processing, payment scheduling, and the implementation of financial controls. They will also lead team performance, drive process improvements, and manage the transition to Oracle NetSuite.
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 Financial Analyst manages revenue-cycle operations for the PBM business, including ticket queue management and client-specific task execution. They collaborate with internal partners to resolve cycle processing errors and support larger billing initiatives through project work.
The Case Management Coordinator evaluates member needs and eligibility to recommend appropriate care resolutions and service plans. They facilitate healthcare outcomes by coordinating care activities, monitoring progress, and providing coaching to empower members in their healthcare decision-making.
The analyst will prepare and review accounting entries, reconcile accounts, and compile financial statements for Medicare Part D. They will also coordinate accounting matters across departments and assist with various audits.
The Tax Manager will oversee corporate tax returns, ensure regulatory compliance, and conduct tax research to identify saving opportunities. They will also collaborate with finance teams and external auditors to provide strategic tax planning and manage tax-related risks.
The pharmacist provides one-on-one medication therapy management consultations via phone or video to identify and resolve medication-related problems. They collaborate with multidisciplinary teams to develop personal care plans and monitor patient drug therapy outcomes.
The Senior Manager will develop, manage, and monitor compliance strategies to ensure ethical behavior and mitigate organizational risks. They will also lead regulatory reporting, conduct audits, and maintain positive relationships with internal and external stakeholders.
The Care Management Associate manages member enrollment and coordinates medical services for children and families within the OhioRISE program. Responsibilities include developing wellness plans, conducting health screenings, and facilitating referrals to ensure effective healthcare utilization.
Provide one-on-one virtual nutrition coaching to help members achieve wellness goals through personalized care plans and behavior change strategies. Collaborate with interdisciplinary healthcare teams to deliver integrated care and document all coaching sessions and outcomes.
The Clinical Case Manager utilizes advanced clinical judgment to conduct comprehensive assessments and develop care plans for members. They perform crisis intervention, coordinate with healthcare providers, and monitor member progress to ensure optimal, cost-effective health outcomes.
The role involves managing patient complaints, appeals, and grievances while ensuring regulatory compliance and process excellence. You will also conduct case analysis, draft decision letters, and mentor team members to improve operational performance.
The Care Plan Reviewer utilizes clinical judgment to review assessments and care plans to support behavioral healthcare for children with complex needs. They provide coaching to care coordination staff and consult with multidisciplinary teams to ensure optimal, cost-effective outcomes.
The Care Plan Reviewer facilitates physical and behavioral healthcare through comprehensive assessments, care planning, and direct provider coordination. They perform crisis intervention, monitor care plans, and utilize clinical judgment to ensure optimal, cost-effective health outcomes for members.
The Care Management Coordinator facilitates healthcare outcomes by providing care coordination, support, and education to members using established care management tools. They collaborate with Child and Family Teams to evaluate member needs, implement care plans, and monitor progress while ensuring compliance with regulatory guidelines.
Conduct comprehensive in-home health evaluations, including medication reviews, physical assessments, and diagnostic screenings. Build trusted relationships with patients to bridge care gaps and provide health education in their own homes.
The Case Manager acts as a liaison to coordinate care for dual-eligible members, performing assessments and developing care plans to optimize health outcomes. They conduct home and worksite visits to facilitate benefit eligibility, wellness activities, and timely return-to-work strategies.
The Care Management Coordinator facilitates healthcare outcomes by providing care coordination, support, and education to children and families with complex behavioral health needs. They conduct comprehensive evaluations, implement care plans, and serve as a single point of contact to remediate gaps in care.
The analyst supports financial planning, budgeting, and forecasting for SG&A expenses while providing transparency on vendor spend and savings initiatives. They are responsible for creating variance analysis reports, financial models, and presenting detailed monthly financial reports to management.
The Senior Software Development Engineer will collaborate with a cross-functional team to design and develop high-quality, user-centered software products. Responsibilities include building both frontend and backend code using test-driven development and agile methodologies.
The Case Management Coordinator facilitates healthcare outcomes by providing care coordination, support, and education to children with complex behavioral health needs. They collaborate with Child and Family Teams to evaluate member needs, monitor care plans, and ensure access to necessary services.
The Community Health Worker conducts home visits to support Aetna members with chronic conditions by reinforcing care plans and improving access to healthcare services. They also act as a bridge between members and providers to address social determinants of health and facilitate community resource utilization.
The Case Management Coordinator collaborates on the case management process by evaluating member needs, coordinating care plans, and facilitating healthcare outcomes. They utilize negotiation and motivational interviewing skills to engage members and ensure appropriate access to benefits and services.
The Senior Analyst manages the organization's financial assets, cash flow, and liquidity through forecasting and optimization strategies. They also ensure compliance with financial regulations and maintain relationships with banks and internal stakeholders.
The Population Health Specialist leads initiatives to improve health outcomes and reduce disparities for the OhioRISE population by applying quality improvement science. This role involves analyzing population health data, designing targeted interventions, and collaborating with diverse stakeholders to ensure measurable impact.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic testing. Provide patient education and facilitate connections to appropriate care to improve health outcomes.
The role involves providing oversight for data-driven decision-making within the Medicare Stars Program Management team by developing analysis strategies and impactful reporting. You will collaborate with cross-functional teams to identify improvement initiatives and communicate actionable insights to executive leadership.
The Senior Adversary Operations Engineer conducts advanced penetration testing and adversary simulation to identify high-risk vulnerabilities across enterprise and cloud environments. They also collaborate with blue teams to translate offensive findings into actionable defensive enhancements and improved security telemetry.
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 monitor care plans and ensure appropriate service delivery for children with complex behavioral health needs.
You will be responsible for uncovering and synthesizing customer attitudes and perceptions to provide actionable insights for the retail pharmacy business. This involves planning research studies, managing external suppliers, and collaborating with multifunctional teams to support data-driven decision making.
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 counseling on health maintenance, STI prevention, and contraceptive care while documenting all interactions in an EHR.
The Senior Business Solutions Consultant acts as a strategic partner to drive operational efficiency and enhance user experiences across business and technology teams. This role involves managing complex initiatives from concept through implementation while facilitating cross-functional collaboration and stakeholder alignment.
The manager will oversee day-to-day operations of customer experience programs for healthcare delivery lines, including reporting and actionable insight generation. They will act as a voice of the customer champion, collaborating cross-functionally to drive improvements in patient experience.
The role involves managing leave of absence inquiries and providing support to colleagues through the myLeave call center. Responsibilities include documenting cases, meeting service level metrics, and educating colleagues on self-service tools.
The Senior Manager will lead the governance, acquisition, and lifecycle management of software investments for enterprise infrastructure. They will act as a liaison between engineering, procurement, and finance teams to optimize technology portfolios and ensure alignment with business objectives.
The Vice President of Digital Engineering will lead cross-functional teams to deliver and scale the Health100 platform, including digital identity, payments, and AI solutions. This role involves partnering with Product leadership to define the roadmap while ensuring high-quality, resilient, and secure engineering execution.
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, 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 including medication reviews, physical assessments, and diagnostic screenings for health plan members. Build trusted relationships with patients to bridge gaps in care and provide education on their health needs.
The Senior Analyst is responsible for coordinating, managing, and reviewing multiple rebate audits while working closely with clients and internal departments. They must ensure the timely resolution of audit exceptions and maintain accurate documentation of all audit progress and deliverables.
The Senior Data Engineer will design and implement robust ETL/ELT data pipelines to support analytical and machine learning workloads. They are responsible for modeling the core data domain and ensuring high standards of data quality, governance, and performance optimization.
The Senior Manager will lead the development and execution of strategic provider relationships and value-based care models for Specialty and Medicaid portfolios. They will collaborate with cross-functional teams to perform market analysis, design financial models, and ensure the successful deployment of reimbursement initiatives.
The Director of Product Management will define and execute the strategic vision for health data interoperability solutions while leading a team of product owners. This role involves driving innovation across data exchange platforms and APIs to ensure secure, compliant, and seamless information sharing across the healthcare ecosystem.
The Senior Manager manages the organization's website content, ensuring it supports business needs and provides accurate information to users. They also lead prototype development projects, drive site improvements through data analysis, and coach junior team members.
The Medical Director provides psychiatric leadership and physician oversight for utilization management teams, ensuring high-quality behavioral health care and medical necessity decisions. They also participate in clinical quality improvement activities, policy development, and the management of complex, high-risk patient cases.
The Senior iOS Engineer will design and build scalable platform solutions to enable other teams to deliver features more efficiently. Responsibilities include developing automation tools, maintaining CI/CD pipelines, and driving engineering excellence through code reviews and best practices.
The Senior Analyst will design and support automation solutions and testing frameworks while utilizing SQL and Power BI to provide actionable insights. They will also collaborate with technical teams to validate healthcare data and mentor team members on quality assurance best practices.
Lead the technology product strategy and execution for clinical care delivery products, including virtual care and inventory management. Partner with clinical and business leaders to build scalable technology roadmaps that optimize patient outcomes and reduce administrative burden.
Lead multidisciplinary technology teams to develop and execute product strategies for admission prevention and patient segmentation. Partner with clinical and business leaders to integrate technology solutions that optimize patient outcomes and reduce total cost of care.
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 while maintaining accurate clinical documentation.
Design, build, and deploy scalable AI and Generative AI applications using LLMs, RAG architectures, and agentic frameworks. Lead technical design discussions while collaborating with cross-functional teams to integrate AI capabilities into enterprise-grade systems.
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 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, physical assessments, and diagnostic screenings. Build trusted relationships with patients to bridge gaps in care and provide personalized health education.
The Clinician Field Mentor conducts in-home evaluations for patients 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-quality care standards.
The analyst manages pharmacy network enrollment, maintenance, and administration to ensure accurate participation and member access. They also resolve enrollment issues, process provider data updates, and support operational communications with pharmacy partners.
Conduct comprehensive in-home health evaluations for health plan members, including physical exams and medication reviews. Facilitate connections to appropriate care and document findings using an intuitive clinical workflow on an iPad.
Conduct in-home health evaluations for health plan members to bridge gaps in care and provide comprehensive health assessments. Utilize clinical workflows to perform medication reviews, physical evaluations, and diagnostic tests while building trusted relationships with patients.
Conduct in-home health evaluations for health plan members, including medication reviews and physical assessments. Travel extensively to provide comprehensive health services and bridge gaps in care for patients.
Conduct in-home health evaluations for patients to bridge gaps in care and provide comprehensive health assessments. Engage with patients to review medical history, perform physical evaluations, and facilitate necessary diagnostic tests.
Conduct comprehensive in-home health evaluations for health plan members to bridge gaps in care. Perform medication reviews, physical assessments, and diagnostic tests while building trusted relationships with patients.
The physician will conduct in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. The role involves traveling to various locations to provide comprehensive health services and build trusted relationships with patients.
The physician will conduct in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. They will travel extensively to provide these services and document findings using an intuitive clinical workflow on an iPad.
The Distinguished Engineer will define technical strategy and architecture for developer experience platforms while leading AI-enabled software development initiatives. They will influence enterprise-wide architectural decisions and foster engineering excellence across the organization.
Conduct in-home health evaluations for health plan members, including physical assessments and medication reviews. Travel extensively within the assigned coverage area to provide comprehensive health services and bridge gaps in care.
The role supports high-impact reporting initiatives including claims analysis, demographic data integrity, and coding accuracy. You will analyze EMR data to identify trends and develop business cases to drive process improvements.
The Legal Counsel will draft and interpret commercial prescription benefit management (PBM) contracts while providing actionable legal and regulatory advice to internal business partners. They are responsible for identifying legal risks and recommending solutions that align with the organization's strategic business objectives.
The physician will conduct in-home health evaluations, including physical exams and medication reviews, to bridge gaps in patient care. They are responsible for traveling to various locations to provide comprehensive health assessments while maintaining accurate clinical documentation.
Conduct in-home health evaluations for patients to bridge gaps in care and provide comprehensive health assessments. Engage with patients to review medical history, perform physical evaluations, and facilitate connections to appropriate care services.
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 detailed clinical documentation.
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 tests while maintaining detailed clinical documentation.
Conduct in-home health evaluations for patients to bridge gaps in care and provide comprehensive health assessments. Utilize clinical workflows to review medical history, perform physical evaluations, and facilitate diagnostic services.
Conduct in-home health evaluations for patients to bridge gaps in care and provide comprehensive health assessments. Engage with patients to review medical history, perform physical evaluations, and facilitate connections to appropriate care services.
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 comprehensive in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct in-home health evaluations 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 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 care gaps and provide personalized health insights.
The Workforce Management Solutions Architect will lead the design and delivery of enterprise-grade labor forecasting and scheduling capabilities. This role involves partnering with business stakeholders to translate requirements into scalable platform configurations and driving the end-to-end functional lifecycle.
Conduct in-home assessments for members with complex needs and develop individualized care plans to support their health and safety. Collaborate with interdisciplinary teams and providers to ensure coordinated, holistic care and document all activities in the electronic health record.
Conduct in-home assessments for members with complex needs and develop individualized care plans to promote safety and independence. Collaborate with interdisciplinary teams and providers to ensure coordinated, holistic care while documenting activities in the electronic health record.
The Registered Nurse Case Manager will conduct face-to-face home visits to assess member needs and develop individualized care plans for MLTSS and D-SNP programs. They will collaborate with interdisciplinary teams and providers to ensure effective resource utilization and safe transitions of 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 interdisciplinary teams and providers to ensure cost-effective service delivery and safe transitions of care.
The Cardiopulmonary 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 patient care plans while maintaining high standards of safety and quality.
The Case Manager conducts face-to-face home visits to assess medical needs and develop comprehensive care plans for members in MLTSS and D-SNP programs. They collaborate with care teams and providers to ensure cost-effective service delivery and advocate for the member's overall wellness and safe discharge.
Conduct in-home health evaluations for health plan members to bridge gaps in care and provide personalized health assessments. Utilize clinical workflows and diagnostic tools to review medical history and medication while maintaining detailed patient records.
The clinician will conduct in-home health evaluations, including physical assessments and medication reviews, to bridge gaps in patient care. They are responsible for traveling to various locations to provide personalized health 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.
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 assigned coverage area.
Conduct in-home health evaluations for health plan members, including physical assessments and medication reviews. Provide diagnostic and preventive services while maintaining accurate clinical documentation via an iPad.
The clinician 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.
The Senior Analyst will develop and maintain expert knowledge of the healthcare marketplace to provide analytical insights for pricing partners. They will perform data analytics to support client-specific setups and translate complex results into actionable business strategies.
The Lead Director will develop and execute state-specific Medicaid strategies to drive business growth and align with healthcare policy. This role involves building relationships with key stakeholders and representing the organization at conferences and legislative meetings.
Provide psychosocial support and evidence-based mental health counseling to individuals, couples, and families ages 13 and older. Conduct assessments and develop treatment plans while collaborating with the clinical care team to ensure continuity of care.
The Senior Analyst will manage revenue accounting, accounts receivable, and intercompany transactions while executing monthly, quarterly, and annual close activities. They will also perform flux analysis, prepare complex journal entries, and partner with stakeholders to ensure accurate financial reporting and process improvements.
This role is responsible for driving provider adoption and onboarding of clinical data connections within an assigned region. The specialist coordinates onboarding activities, resolves barriers, and maintains strong relationships with internal and external stakeholders to improve interoperability performance.
The Utilization Management Nurse Consultant reviews clinical information and applies evidence-based criteria to support coverage determinations and care recommendations. They also collaborate with providers and care teams to coordinate treatment and identify opportunities to improve healthcare quality and outcomes.
The legal counsel will negotiate pharmacy benefit contracts with employer plan sponsors and support sales teams on new business initiatives. They will also provide legal advice to business departments and collaborate with internal teams including regulatory and government affairs.
The Senior Manager will define and execute the omnichannel commercialized solutions strategy, focusing on digital order journeys and clinical interventions. They will lead cross-functional teams to develop business cases, manage pilot evaluations, and optimize program performance to drive growth.
The Clinical Support Coordinator provides non-clinical administrative support to clinical teams to ensure efficient coordination of patient care activities. This role manages administrative workflows, maintains patient records, and supports therapy-related processes while ensuring compliance with regulatory standards.
The role involves handling incoming calls from customers and healthcare providers to verify prescription information and provide medication guidance. Additionally, the technician will document customer concerns, update records, and monitor call center performance metrics to ensure quality standards.
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 via an iPad.
You will design, build, and maintain data platform automation while managing distributed event streaming technologies. Additionally, you will troubleshoot complex performance issues and mentor junior engineers on database administration and best practices.
Perform in-home health evaluations for health plan members, including medication reviews and physical assessments. Engage with patients to bridge gaps in care and provide connections to appropriate health resources.
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 manager oversees compliance with state Medicaid contractual requirements and leads the development of value-based provider networks. They are responsible for negotiating payment arrangements, managing contract performance, and deploying strategic initiatives to meet cost and quality goals.
The Utilization Management Nurse Consultant reviews clinical information against evidence-based criteria to support coverage determinations and facilitate appropriate treatment plans. They also collaborate with care teams to monitor healthcare services and identify opportunities to improve quality and efficiency.
The Scrum Master will manage agile-based SDLC processes for complex technology and business projects while coaching teams on agile principles. They are responsible for facilitating team productivity, removing impediments, and ensuring project delivery within scope, budget, and quality parameters.
The Lead Director provides strategic leadership and organizational oversight for coding audit and compliance functions to ensure accuracy and adherence to regulatory requirements. They are responsible for establishing governance, audit methodologies, and risk-management processes while advising executive leadership on material coding risks and trends.
You will lead and oversee external coding vendor operations to ensure contractual obligations, quality performance, and accurate ICD-10/HCC coding deliverables are met. Additionally, you will serve as the primary operational liaison between vendor leadership and internal teams to drive volume planning and regulatory compliance.
The Staff Software Development Engineer will design, develop, and implement scalable digital health solutions while collaborating with cross-functional teams. They are also responsible for providing technical mentorship to junior developers and ensuring adherence to high-quality coding standards.
The Manager of Lab Operations oversees lab standards, regulatory compliance, and vendor relationships across over 200 centers. They are responsible for optimizing lab performance, managing test compendiums, and developing training structures for clinical staff.
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 supply and demand while overseeing multi-channel marketing and provider engagement initiatives.
The Executive Medical Director will lead the centralized MD Quality function to ensure clinical rigor, consistency, and accountability across all MD review processes. This role involves overseeing a multidisciplinary team, analyzing decision trends, and serving as a clinical advisor to drive enterprise-wide quality improvement.
The Cardiopulmonary Patient Educator provides infusion training and clinical support to patients with Pulmonary Arterial Hypertension in a home care setting. They collaborate with physicians and pharmacy operations to coordinate patient care plans and develop one-on-one relationships with patients and caregivers.
The role involves designing and maintaining financial reporting solutions, dashboards, and planning applications using Oracle Hyperion and Power BI. You will collaborate with cross-functional teams to drive reporting modernization, data integration, and financial analysis initiatives.
Conduct comprehensive in-home health evaluations, including physical assessments and medication reviews, to bridge gaps in patient care. Engage with patients to provide health education and facilitate connections to appropriate care services.
The Senior Analyst will evaluate IT application controls and assess the design and operating effectiveness of SOX compliance across the enterprise. This role involves executing audit testing, documenting work papers, and collaborating with cross-functional teams to improve financial compliance processes.
The Care 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 Stop Loss Claims Analyst manages the filing, tracking, and reconciliation of stop loss claims for self-funded employer groups. They act as a liaison between internal teams and external carriers to ensure accurate and timely reimbursement.
Develop, test, and support features for the Aetna Health website, while improving the application’s stability, performance, maintainability, and scalability. Contribute to architecture and technical direction, collaborate with product and design teams, and mentor junior developers through code reviews and knowledge sharing.
The analyst will prepare statutory financial deliverables, including quarterly and annual audited financial statements and supplementary regulatory filings. Additionally, the role involves performing financial analytics on legal entities and contributing to the automation and transformation of financial reporting processes.
The Case Manager conducts face-to-face home visits to assess member medical needs and develops comprehensive care plans to facilitate wellness. They collaborate with care teams and providers to authorize services cost-effectively while ensuring safe discharge and proper resource utilization.
The Registered Nurse Case Manager will conduct in-home assessments and coordinate individualized care plans for members in managed long-term services and support programs. They will collaborate with interdisciplinary teams and caregivers to ensure high-quality, cost-effective care and safe transitions for patients.
Design network models, plan initiatives, and negotiate Commercial and Medicare Advantage agreements with Texas providers, including health systems, clinically integrated networks, IPAs, and FQHCs. Coordinate across functions to strengthen provider networks and meet accessibility, quality, compliance, regulatory, financial, and medical-cost goals.
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 via an iPad.
The Senior Manager will develop and execute executive communication strategies for senior technology leaders to enhance the company's reputation. They will manage complex initiatives, oversee speaking engagements, and produce high-quality content including talking points and newsletters.
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 in-home health evaluations for health plan members, including medication reviews, medical history assessments, and physical examinations. Provide diagnostic and preventive services while building trusted relationships to help bridge gaps in patient care.
The technician handles inbound calls for the prior authorization process and maintains accurate documentation of reviews. They also assist with outbound calls, process faxed authorizations, and manage department inquiries.
Build and maintain standardized finance reporting, analytics, and data assets for Medicaid markets, using automation to streamline recurring workflows. Develop templates and documentation, support adoption of standardized processes, and assist with data quality, controls, governance, and ad hoc analysis.
Design, build, and operate secure, scalable cloud platforms, backend services, infrastructure-as-code, and AI-enabled CI/CD and operational tooling. Enable product teams through self-service platform capabilities while partnering with SRE, security, and engineering teams on reliability, developer experience, architecture, and technical standards.
Develop research partnerships and identify grant-funded opportunities with academic, government, and public health organizations, positioning the organization as a research partner. Support and lead real-world evidence research through complex healthcare data analysis, research concept and protocol development, quality review, and scientific publications and presentations.
The Strategic Account Director leads teams of account executives to drive revenue growth, client retention, and profitability for large, complex PBM clients. They serve as a senior escalation point and executive partner, utilizing data and AI-enabled insights to guide renewal and expansion strategies.
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 while maintaining accurate clinical documentation.
Conduct comprehensive in-home health evaluations, including medication reviews and physical assessments for health plan members. Build trusted relationships with patients to bridge gaps in care and provide necessary health education.
Conduct in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. Engage with patients to provide personalized health insights and facilitate connections to appropriate care services.
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 education on their health needs.
Conduct comprehensive 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 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.
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 close gaps in preventative care.
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, 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 overall quality of life.
Develops and implements sales strategies to secure new large group accounts and government programs within an assigned territory. Manages complex negotiations, oversees the sales process, and collaborates cross-functionally to ensure successful product integration and revenue growth.
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 privacy regulations.
The Senior Manager will lead the platform engineering and DevOps team to deliver secure, scalable GCP-based solutions while enforcing engineering standards. They are responsible for managing the platform roadmap, overseeing incident response, and mentoring a team of engineers to ensure operational reliability.
The Principal Software Development Engineer will lead the architecture, design, and delivery of scalable digital healthcare solutions leveraging AI across major cloud platforms. This role involves defining technical strategy, mentoring engineering teams, and ensuring the development of secure, high-performance applications.
Lead and grow a team of engineers to build and maintain agentic AI systems and enterprise messaging platforms on Google Cloud. Oversee the architecture, delivery, and regulatory compliance of omnichannel messaging systems that power patient communications.
The Case Management Coordinator facilitates healthcare outcomes by providing care coordination, support, and education to members through comprehensive care management tools. They collaborate with multidisciplinary teams and families to evaluate needs, implement care plans, and ensure compliance with regulatory guidelines.
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 implement care plans and monitor progress while ensuring compliance with regulatory guidelines.
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 drive creative solutions and resolve complex business issues.
The Case Manager acts as a frontline advocate for members, assessing their medical and social needs to develop and implement proactive care plans. They collaborate with interdisciplinary teams and stakeholders to facilitate wellness and overcome barriers to care.
The Proposal Writer will develop strategic, compliant, and compelling responses to RFPs while collaborating with subject matter experts and proposal teams. They will also manage content for the Medicaid Content Library and drive internal process improvements to support business growth.
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 maintaining detailed records of patient interactions.
The role involves managing and tracking Plan of Treatment documents within electronic medical records. You will be responsible for contacting prescriber offices to obtain necessary signatures and documentation to ensure regulatory compliance.
The Senior Data Insights Specialist will utilize SQL, Python, and other tools to analyze network changes and their impact on client retention. They are responsible for developing new reporting solutions and producing custom reports regarding retail pharmacy network accessibility.
The Lead Director will oversee the strategy, architecture, and delivery of enterprise AI platform capabilities and reusable data products. This role involves leading high-performing engineering teams to scale AI/ML solutions while establishing operational standards for governance, security, and platform reliability.
The Senior Director leads a team of Account Executives to drive customer retention, profitable growth, and client satisfaction for complex National Accounts. They coordinate cross-functional enterprise teams to manage business risks, execute account strategies, and deliver measurable value to clients.
The Senior Actuary provides financial tools and analytics to support network strategy, including discount reviews and emerging trend analytics. They also assist with pricing for performance networks and provide strategic support for provider contracting.
The Medical Director will perform utilization management, medical necessity reviews, and prior authorization determinations to ensure clinically sound decisions. They will also collaborate with multidisciplinary teams and participate in a rotating on-call schedule for clinical support.
Lead a national team of clinicians to provide clinical support to Commercial plan sponsors and prospects while cultivating key relationships with brokers and consultants. Act as the clinical voice of the customer to inform product roadmaps and ensure clinical offerings meet market requirements.
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 analyst will provide consultative support and medical cost-based analysis to identify utilization and unit cost drivers. They will also manage projects and collaborate with local market leaders to develop actionable items for improving care and managing costs.
Conduct in-home health evaluations for health plan members, including physical assessments and medication reviews. Provide education and bridge gaps in care while maintaining accurate clinical documentation using provided technology.
The Service Advocate manages comprehensive patient care by handling inbound and outbound calls to schedule, reschedule, and cancel appointments. They are responsible for maintaining accurate patient records and ensuring an unmatched experience through professional communication and problem resolution.
The Care 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.
Lead multidisciplinary technology teams to develop and execute product strategies for medical cost initiatives, including care transitions and chronic condition pathways. Partner with clinical and business leaders to integrate technology solutions that improve patient outcomes and reduce total cost of care.
The Senior Medical Director will lead clinical informatics and healthcare delivery technology products, serving as a physician advisor to drive Epic-enabled solutions and enterprise governance. They are responsible for optimizing clinical workflows, improving patient outcomes, and partnering with leadership to align technology roadmaps with organizational strategy.
Conduct comprehensive in-home health evaluations, including physical exams and medication reviews, to bridge gaps in patient care. Provide health education and facilitate connections to appropriate care services based on individual patient 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 to improve overall health outcomes.
The Registered Nurse Case Manager conducts member assessments and reassessments through field-based home visits across assigned New York counties. They are responsible for maintaining accurate clinical documentation and collaborating with interdisciplinary teams to support effective care planning.
The Quality Management Nurse Consultant develops and implements quality improvement programs to monitor healthcare services and ensure alignment with regulatory standards. They also facilitate workgroups and analyze organizational performance to drive evidence-based interventions that improve patient outcomes and HEDIS/CAHPS goals.
The Case Management Coordinator facilitates healthcare outcomes by evaluating member needs, coordinating care plans, and assisting with appointment scheduling and benefit access. They also utilize motivational interviewing and negotiation skills to engage members and ensure appropriate quality of care.
The Account Associate is responsible for making outbound calls to prospective Medicare members for retention and sales support. They also respond to incoming customer service inquiries as needed to support business operations.
The Quality Management Nurse Consultant develops and implements quality improvement programs to enhance healthcare services and clinical outcomes. They analyze organizational performance against regulatory standards and facilitate cross-functional workgroups to achieve HEDIS and CAHPS goals.
Co-lead daily outreach call center operations, monitor agent performance against KPIs, and provide coaching, feedback, and action plans to improve results and ensure adherence to policies and schedules. Manage real-time productivity, queues, escalations, and team meetings while supporting hiring, training coordination, and continuous improvement.
Manage relationships with assigned global client stakeholders, providing strategic account support, operational guidance, and responsive resolution of complex healthcare and service issues. Coordinate across internal teams and external partners to monitor performance, improve service delivery, support healthcare access, and maintain account communications, training, and documentation.
Reviews and adjudicates complex medical claims, applying coverage and medical necessity guidelines, verifying eligibility, ensuring compliance, and identifying payment discrepancies or irregularities. Provides guidance and training to colleagues, resolves member inquiries, and contacts parties to obtain information needed for claims or reconsiderations.
Assess members’ physical and behavioral health needs, develop and monitor care plans, coordinate with providers and multidisciplinary teams, and connect members with psychosocial support services. Provide crisis intervention and follow-up, promote member engagement and informed healthcare decisions, and document care in accordance with regulatory and company requirements.
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 education to improve health outcomes.
The analyst identifies and develops healthcare fraud, waste, and abuse leads through data mining and claims analysis. They also conduct research, evaluate billing patterns, and provide actionable recommendations to SIU leadership.
The Senior Manager will lead engineering teams in designing and delivering scalable, cloud-native, and AI-enabled solutions for the Health100 platform. They are responsible for architectural leadership, talent development, and ensuring operational excellence through secure and compliant technology practices.
The analyst identifies and develops healthcare fraud, waste, and abuse leads through data mining and claims analysis. They evaluate billing patterns and present actionable investigative findings to leadership to determine if formal investigations are warranted.
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.
The Senior Analyst provides analytical insight and operational support for Front-End operations by monitoring key performance indicators and reporting on therapy-level performance. They also drive process improvements and serve as a central point of contact for cross-functional projects to enhance patient experience.
Lead product strategy and roadmap development for the Epic EHR platform and integrated clinical informatics tools within the Revenue Cycle Management domain. Collaborate with cross-functional teams including engineering, data science, and design to drive product adoption, quality, and safety across the enterprise.
You will lead the product vision and strategic delivery for the Documents Domain within the Epic EHR platform. This involves collaborating with engineering and business stakeholders to manage product roadmaps, document ingestion pipelines, and user experience enhancements.
Lead Quality Engineering strategy and software delivery transformation for the Medicare Sales & Acquisition ecosystem, including AI-augmented and agent-orchestrated testing, AWS-native infrastructure, and automated SDLC pipelines. Manage and develop an SDET team, establish quality standards and metrics, and partner with business and technology stakeholders to deliver scalable, compliant automation.
Lead the architecture, development, and operation of Lumina, CVS Health’s enterprise agentic AI platform, including its agents, retrieval systems, integrations, services, and user experiences. Guide platform reliability, security, governance, and engineering practices while coaching engineers and data scientists and partnering with product, security, compliance, and engineering teams.
Lead Quality Engineering strategy and software delivery transformation for the Medicare Sales & Acquisition ecosystem, including AI-augmented and agent-orchestrated testing, AWS-native infrastructure, and automated SDLC pipelines. Manage and develop an SDET team, establish governance and quality metrics, and partner with business and technology stakeholders to deliver scalable, compliant automation solutions.
The Staff Data Engineer will design, build, and operate scalable Databricks-based data pipelines and lakehouse solutions for observability and security data. They will collaborate with cross-functional engineering teams to establish data quality standards, governance, and operational reliability.
You will design and build foundational AI/GenAI platform services, including LLM routing, cost governance, and orchestration tools. The role involves collaborating with senior engineers to ensure these services are fast, safe, and compliant with healthcare regulations.
The Pharmacy Technician acts as a liaison between patients, providers, and pharmacists to manage medication refills and renewals. They are responsible for handling high-volume inbound and outbound calls, documenting patient requests, and coordinating with care teams to resolve barriers to medication access.
The Senior Manager will lead financial planning and analysis for the New York Medicaid Health Plan, supporting the CFO in achieving strategic and financial goals. Responsibilities include overseeing budgets, financial forecasts, cost optimization initiatives, and providing actionable insights to executive leadership.
Conduct in-home assessments for members with complex needs to evaluate their medical, behavioral, and social requirements. Develop and manage individualized care plans while collaborating with interdisciplinary teams to ensure holistic and coordinated care.
The Health Coach Consultant utilizes a collaborative process of assessment, planning, and education to help members manage chronic conditions and achieve optimal health. They monitor care plans, interpret clinical guidelines, and provide ongoing support to empower members in their healthcare decision-making.
The Provider Network Relationship Manager assesses network composition and manages partnerships to advance the OhioRISE program. They are responsible for executing contracts, resolving escalated issues, and driving provider engagement to meet network adequacy and quality goals.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic screenings. Build trusted relationships with patients to bridge care gaps and provide education on their health needs.
Lead and shape enterprise-wide technical architecture initiatives while driving strategic technology direction across multiple portfolios. Serve as a trusted technical advisor to senior executives to translate complex architectural decisions into clear business outcomes.
Provide psychosocial support and evidence-based counseling to patients aged 13 and older. Conduct patient assessments and develop treatment plans while collaborating with the clinical care team.
Provide one-on-one home infusion nursing care and patient education in accordance with physician treatment plans. Maintain accurate documentation of patient care activities using Microsoft Office tools.
Provide psychosocial support, education, and evidence-based mental health therapy to individuals, couples, and families aged 13 and older. Manage assessment and treatment planning while collaborating with the clinical care team to ensure continuity of care.
The role involves designing, developing, and implementing AI solutions by architecting and coding software applications. You will also conduct system testing, debugging, and collaborate with cross-functional teams to drive technical innovation.
The Automation Developer & Revenue Cycle Systems Analyst will design, develop, and maintain automated solutions to improve operational efficiency within the revenue cycle organization. This role involves collaborating with stakeholders to identify workflow opportunities, troubleshooting automation issues, and ensuring compliance with data security and healthcare regulations.
The Case Manager assesses, plans, and coordinates medical and psychosocial needs for members through regular in-person or telephonic contact. They develop proactive care plans to enhance member wellness and facilitate transitions to appropriate health programs.
The Contract Negotiation Manager serves as a subject matter expert responsible for negotiating, executing, and auditing complex provider contracts to meet network quality and financial goals. They collaborate cross-functionally to manage provider relationships, resolve disputes, and implement strategic network configurations.
The Clinical Case Manager partners with a registered nurse to assess, plan, and advocate for members' health and benefit needs. Responsibilities include researching community resources for medical, financial, and housing support while empowering members to make positive lifestyle choices.
Coordinate the effective resolution of member and provider appeals, complaints, and grievances while ensuring compliance with legislative and regulatory requirements. Manage a team of clinical and non-clinical personnel to achieve performance standards and maintain consistent operational infrastructure.
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 health education during 45-minute visits.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic screenings. Build trusted relationships with patients to bridge care gaps and provide personalized health education.
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, including medication reviews, medical history assessments, and physical examinations. Provide patient education and bridge gaps in care to improve health outcomes for members.
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 comprehensive in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic screenings. Build trusted relationships with patients to bridge gaps in care and provide health education.
Conduct in-home 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 screenings. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
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 comprehensive health education.
Review clinical information and apply evidence-based guidelines to support coverage and care decisions. Collaborate with providers and care teams to coordinate appropriate healthcare services and improve care quality.
The Senior Manager leads end-to-end contract negotiations and manages performance for hospital and physician group networks. They also drive the development of value-based arrangements and analyze financial data to meet network expansion and cost-saving goals.
The manager will design and maintain technical solutions within the Apptio platform to enable IT financial management and cost optimization. They will also oversee monthly IT chargeback processes and collaborate with cross-functional teams to improve financial transparency.
The Manager of Process Engineering leads high-impact process improvement and Business Process Management initiatives across Information Security and Technology Solutions. This role designs, standardizes, and governs processes using Lean Six Sigma methodologies to drive operational excellence and efficiency.
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 Utilization Management Nurse Consultant reviews clinical information to support coverage determinations and coordinates care plans with interdisciplinary teams. They serve as a clinical resource to ensure high-quality healthcare utilization and effective member-centered outcomes.
The Senior Data Engineer will design, build, and operate scalable Databricks-based data pipelines and lakehouse solutions for observability and security data. They will collaborate with cross-functional engineering teams to establish data quality standards, governance, and operational reliability.
Lead the development and delivery of enterprise risk adjustment analytics and business intelligence solutions to drive provider performance and operational efficiency. Manage a high-performing team while partnering with executive leaders to translate complex data into actionable insights and strategic recommendations.
The Case Manager is responsible for conducting comprehensive in-home assessments and developing person-centered care plans for dual-eligible Medicare and Medicaid members. They coordinate services across interdisciplinary teams to ensure members receive appropriate community-based support while maintaining regulatory compliance.
The Utilization Management Nurse Consultant reviews clinical information to support coverage determinations and coordinates healthcare services across the continuum of care. They collaborate with providers and care teams to facilitate appropriate treatment planning and identify opportunities to improve member outcomes.
Conduct approximately 30-minute virtual video visits with health plan members to perform medication and medical history reviews. Provide health education and ensure high-quality care delivery while meeting specific operational and clinical performance metrics.
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 while maintaining accurate clinical documentation.
The Senior Analyst is responsible for directing all aspects of customer benefit plan implementation for self-funded new business clients. They act as a single point of contact, mediating project deliverables and developing implementation strategies to ensure customer expectations are met.
Conduct comprehensive in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. Engage with health plan members to provide education and facilitate connections to appropriate care services.
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 services based on individual health needs.
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 connections to appropriate health resources.
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.
Processes prior authorization requests by reviewing clinical criteria and medication guidelines to support approval or denial decisions. Communicates status updates to providers and pharmacies while maintaining accurate documentation and meeting productivity standards.
Conduct comprehensive in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. Engage with health plan members to provide education and facilitate connections to appropriate healthcare services.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic testing. Provide patient education and facilitate connections to appropriate care to improve health outcomes.
The associate manager coordinates the resolution of member and provider appeals, complaints, and grievances while managing team productivity and performance. They ensure compliance with federal and state regulations and identify trends to recommend operational improvements.
Conduct comprehensive in-home health evaluations for health plan members, including medication reviews and physical assessments. Facilitate connections to appropriate care and provide health education to improve patient outcomes.
Conduct in-home health evaluations including medication reviews, medical history assessments, and physical evaluations for health plan members. Provide patient education and diagnostic services while maintaining accurate clinical documentation via an iPad.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic screenings. Build trusted relationships with patients to bridge gaps in care and provide health education.
The Cardiopulmonary Patient Educator will provide clinical support and education to patients initiating complex pulmonary arterial hypertension therapies. This role involves coordinating care plans with physicians and pharmacy operations while conducting both remote and in-person patient visits.
The Cardiopulmonary Patient Educator will provide clinical support and education to patients initiating complex pulmonary arterial hypertension therapies. They will collaborate with physicians and pharmacy operations to coordinate care plans while conducting both virtual and in-person patient visits.
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 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 facilitate connections to appropriate care based on individual health needs.
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 in-home health evaluations including physical assessments, medication reviews, and diagnostic tests for health plan members. Build trusted relationships with patients to bridge gaps in care and provide personalized health education.
The role involves overseeing vulnerability management programs across cloud and database environments while designing secure configurations. The specialist will lead strategic security initiatives and foster collaboration between security, operations, and development teams to remediate threats.
The Strategic Account Advisor manages day-to-day client relationships and executes strategies to ensure operational excellence and financial profitability. They are responsible for identifying process improvements, monitoring account performance, and driving client satisfaction within the PBM marketplace.
Conduct face-to-face assessments with members to evaluate medical needs and wellness while helping them access vital community services. Collaborate with interdisciplinary teams to develop proactive care plans that enhance long-term health outcomes.
The Staff Engineer will lead DevSecOps implementation, migration, and automation initiatives across the Health 100 portfolio to strengthen security and release readiness. This role involves designing secure CI/CD workflows, managing security tool migrations, and driving vulnerability remediation through scalable engineering solutions.
The Senior Manager oversees the strategic planning, financial management, and enterprise alignment for the Epic EHR program and clinical informatics initiatives. They act as a bridge between business and technical teams to translate requirements into actionable deliverables while managing risks and vendor roadmaps.
The Utilization Management Nurse Consultant reviews clinical information to support coverage determinations and assesses healthcare services across the continuum of care. They collaborate with providers and care teams to facilitate appropriate treatment planning and identify opportunities to improve member outcomes.
Conduct in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide virtual visits as needed and facilitate connections to appropriate care based on individual health needs.
The Quality Practice Liaison is responsible for presenting HEDIS gaps in care data to provider groups and educating them on best practices. They also perform medical record abstraction and data entry to support supplemental data processes and improve member outcomes.
The Utilization Management Nurse Consultant reviews clinical information to support coverage determinations and coordinates healthcare services across the continuum of care. They also collaborate with providers to facilitate appropriate treatment planning and connect members with necessary health resources.
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 the quality and efficiency of health care services while ensuring alignment with company policies.
The analyst supports the build, maintenance, and optimization of Epic-based tools to improve Medicare Star Ratings and HEDIS quality measure performance. They are responsible for data validation, reporting, and collaborating with clinical stakeholders to ensure accurate care gap identification.
The Executive Director leads the enterprise-wide rollout of Warehouse Management Systems, overseeing strategy, technical integration, and operational readiness across multiple distribution centers. This role manages cross-functional teams, establishes governance frameworks, and drives change management to ensure successful system adoption and performance.
The Solution Architect is responsible for designing and optimizing Epic-based solutions to support Medicare Star Ratings, HEDIS, and NCQA quality measures. This role bridges clinical quality strategy with technical build requirements to ensure accurate data capture and reporting across the organization.
The manager oversees inventory governance, maintains analytical rubrics, and ensures traceability of inventory parameter changes across planning systems. They also support cross-functional teams by designing experiments, tracking financial impacts, and developing SOPs to standardize inventory planning processes.
The role serves as a principal utilization management reviewer for Applied Behavior Analysis and psychological testing cases. It also involves providing clinical guidance to authorization teams and contributing to the development of medical management programs for neurodevelopmental disorders.
The Staff Security Engineer will drive operational excellence by developing governance frameworks, executive dashboards, and KPI reporting for security and infrastructure organizations. They will act as a strategic advisor to leadership, facilitating cross-functional alignment and leading initiatives to improve organizational performance and maturity.
The manager will analyze, build, and maintain financial and operational tools to support network value and underwriting modeling. They will also develop data outputs, dashboards, and financial models to assist leadership in strategic decision-making.
The Medical Director will lead utilization review, quality assurance, and case management programs while providing clinical expertise to support medical management. They will also act as a clinical liaison to network providers and facilities to ensure effective execution of medical services.
Provide one-on-one virtual nutrition coaching to help members achieve wellness goals through personalized care plans. Collaborate with interdisciplinary healthcare teams to deliver integrated care and document patient progress.
The associate will review and resolve pharmacy inquiries related to Non-MAC pricing while ensuring compliance with legal requirements. They will also support IT implementation testing and provide accurate responses to regulatory inquiries from state agencies.
The Contract Negotiation Manager leads end-to-end contract negotiations and manages provider relationships to enhance network access, quality, and cost efficiency. They also develop value-based contracting strategies and analyze financial data to support organizational business goals.
The Manager will execute omnichannel commercialized solutions strategies by developing data-driven business cases and scaling customer-focused health solutions. They will collaborate with cross-functional teams to design pilot programs and ensure operational readiness for new pharmacy and health initiatives.
The Senior Implementation Manager directs all aspects of customer benefit plan implementation for self-funded new business clients. They lead project planning, manage cross-functional teams, and ensure organizational goals are met while maintaining high quality and customer satisfaction.
The Staff Software Engineer will architect and build large-scale, enterprise-grade distributed systems to support clinician-facing experiences. They will lead technical initiatives, mentor team members, and drive long-term improvements in system maintainability and performance.
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 comprehensive in-home health evaluations, including medication reviews, physical assessments, and diagnostic testing for health plan members. Facilitate connections to appropriate care and maintain accurate clinical documentation using an iPad-based workflow.
The Principal Data Scientist will lead the Excalibur team in designing, deploying, and monitoring enterprise-scale machine learning models and generative AI solutions. They will also architect scalable data pipelines on Databricks while mentoring a team of data scientists and engineers to drive operational excellence.
The Sales Executive builds strategic partnerships with brokers and customers to drive profitable growth for Aetna's dental and vision products in the small to midsize business segment. They are responsible for managing producer relations, delivering presentations, and collaborating with internal teams to ensure successful sales and client retention.
The Lead Director defines clinical program requirements and workflow intent to drive technology enablement for complex care coordination programs. This role acts as a bridge between clinical leadership and technical teams to ensure systems effectively support high-risk patient outcomes.
The analyst is responsible for conducting psychosocial assessments and developing person-centered service plans for members in the Managed Long Term Care plan. They collaborate with interdisciplinary teams and caregivers to coordinate medical, behavioral, and community resources to improve health outcomes.
The Medical Director will lead utilization management, predetermination reviews, and case management activities while providing clinical oversight for medical policy implementation. Additionally, the role involves serving as a clinical liaison to network providers and presenting to plan sponsors to support effective medical service execution.
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 Case 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, monitor care plan progress, and ensure appropriate service delivery.
The Senior Investigator conducts complex investigations into healthcare fraud and abuse, utilizing data mining and claims analysis to identify aberrant billing patterns. They also collaborate with clinical and legal teams, law enforcement, and stakeholders to facilitate case outcomes and ensure regulatory compliance.
The Senior Software Development Engineer will lead the configuration, maintenance, and documentation of Epic EHR environments while facilitating design sessions with business leaders. They will collaborate with cross-functional teams to translate clinical workflows into technical specifications and ensure quality standards are met.
The Case Manager conducts face-to-face home visits to assess member medical needs and develop comprehensive care plans for MLTSS and D-SNP programs. They collaborate with care teams and providers to authorize services and ensure safe, cost-effective care delivery.
The District Asset Protection Leader implements asset protection objectives and manages shrinkage control programs across assigned retail locations. They conduct internal theft investigations, ensure operational compliance, and provide training to field teams to mitigate loss.
The Case Management Analyst facilitates healthcare outcomes for LTSS members by conducting comprehensive evaluations and coordinating care plans. They provide ongoing support, education, and coaching to members while monitoring progress and ensuring compliance with regulatory guidelines.
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 Lead Director, Payer Relations manages strategic relationships and contract negotiations with PBMs, health plans, and government programs to drive financial performance. This role also involves mentoring team members and collaborating with internal departments to ensure favorable business outcomes and market growth.
The Senior Manager of Customer Insights will lead the strategy and execution of integrated CRM programs to drive patient acquisition, engagement, and retention. This role involves managing a team of campaign strategists and collaborating with cross-functional partners to optimize omnichannel marketing initiatives.
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 medication reviews and physical assessments. Build trusted relationships with patients to bridge gaps in care and provide necessary health education.
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 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.
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 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 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 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 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 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.
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.
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 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 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 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 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.
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.
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.
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 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 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 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 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 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 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 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 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 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.
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 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 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 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 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.
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 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.
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 and physical assessments, to bridge gaps in patient care. Provide patient education and document findings using an intuitive clinical workflow on an iPad.
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.
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.
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.
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.
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 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 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.
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.
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.
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 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 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 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 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.
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.
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 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 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 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 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 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.
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.
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 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.
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.
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 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 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.
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 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.
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, 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, 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.
Provide in-home health care services to patients within the designated region. Ensure high-quality, compassionate, and convenient health experiences for individuals and families.
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.
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 medication reviews and physical assessments. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct in-home health evaluations, including medication reviews, physical assessments, and diagnostic 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, 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 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.
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 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.
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 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.
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.
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 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 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.
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 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 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 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 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 patients, including medication reviews, physical assessments, and diagnostic screenings. Build trusted relationships with patients to bridge gaps in care and provide personalized health insights.
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 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.
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 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.
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, 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.
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.
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 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 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 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.
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 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 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, 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, physical assessments, and diagnostic testing. 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 physical assessments and medication reviews. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct in-home health evaluations for health plan members, including medication reviews and physical assessments. 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.
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.
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.
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.
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 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 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 health evaluations for health plan members, including medication reviews and physical assessments. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct in-home 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.
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.
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.
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.
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 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.
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.
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, 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 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 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.
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.
Conduct in-home health evaluations, including medication reviews, physical assessments, and diagnostic testing for health plan members. Build trusted relationships with patients to bridge gaps in care and provide personalized health education.
Conduct comprehensive in-home health evaluations 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.
The clinician will conduct comprehensive in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. They will also perform virtual visits and provide health education to help patients manage their unique health needs.
Conduct comprehensive in-home health evaluations for patients, including medication reviews and physical assessments. Build trusted relationships with patients to bridge gaps in care and improve overall health outcomes.
Conduct comprehensive in-home health evaluations for health plan members, including medication reviews and physical assessments. Build trusted relationships with patients to help bridge gaps in care and improve overall health outcomes.
The physician will conduct in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. They will also perform virtual visits and provide diagnostic services while maintaining detailed clinical documentation.
Conduct comprehensive in-home health evaluations, including medication reviews, physical assessments, and diagnostic screenings for health plan members. Build trusted relationships with patients to bridge gaps in care and provide health education in a home-based setting.
Conduct comprehensive in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. Engage with patients to answer health questions and provide diagnostic services while maintaining accurate clinical documentation via an iPad.
Conduct in-home health evaluations for patients, including medication reviews, physical assessments, and diagnostic screenings. Build trusted relationships with patients to bridge care gaps and provide comprehensive health insights to their care teams.
Provide high-quality clinical care to patients in their homes as a Nurse Practitioner or Physician Assistant. Conduct comprehensive health assessments and manage patient treatment plans effectively.
The 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.
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.
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.
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.
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 and physical 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. 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.
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.
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, 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 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.
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 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 testing. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic testing. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct comprehensive in-home health evaluations, including 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 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 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.
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 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, medical history assessments, and physical evaluations. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation using an iPad.
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.
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 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 and physical assessments. Facilitate connections to appropriate care and document findings using an intuitive clinical workflow.
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.
The physician will conduct in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. They will also perform diagnostic and preventive services while maintaining clinical documentation via an iPad.
Conduct in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide health education and bridge gaps in care while maintaining accurate clinical documentation using an iPad.
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.
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.
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.
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.
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.
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.
Conduct in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide patient education and bridge gaps in care while traveling across a defined coverage area.
Conduct comprehensive in-home health evaluations 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 comprehensive in-home health evaluations, including medication reviews, physical assessments, and diagnostic screenings. Build trusted relationships with patients to bridge gaps in care and provide personalized health education.
Conduct comprehensive in-home health evaluations, including medication reviews, medical history assessments, and physical examinations. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct 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 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 comprehensive in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide patient education and facilitate connections to appropriate care services to improve health outcomes.
Provide one-on-one home infusion nursing care and patient education in accordance with the physician’s plan of treatment. Perform infusion therapies in patient homes and participate in telephonic on-call rotations.
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 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.
Conduct in-home health evaluations for health plan members, including medication reviews, physical assessments, and diagnostic screenings. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct in-home health evaluations for patients, including medication reviews, physical assessments, and diagnostic testing. Build trusted relationships with patients to bridge gaps in care and provide personalized health insights.
Conduct in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide patient education and bridge gaps in care while traveling across a defined coverage area.
Conduct comprehensive in-home health evaluations, including physical assessments and medication reviews, to bridge gaps in patient care. Provide patient education and facilitate connections to appropriate care services while maintaining accurate clinical documentation.
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 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 physician will conduct in-home health evaluations, including medication reviews, physical assessments, and diagnostic screenings to bridge gaps in patient care. They will build trusted relationships with patients and provide comprehensive health insights to support their ongoing care needs.
The 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 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.
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 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.
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 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.
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.
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.
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.
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 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.
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.
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 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 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.
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, including medication reviews and physical assessments, to bridge gaps in patient care. Engage with patients to build trusted relationships and provide connections to appropriate care services.
Conduct comprehensive in-home health evaluations for patients, including medication reviews and physical assessments. Build trusted relationships with patients to bridge gaps in care and provide connections to appropriate health resources.
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 comprehensive in-home health evaluations, including medication reviews and physical assessments, to bridge gaps in patient care. Engage with patients to build trusted relationships and provide connections to appropriate care based on their unique health needs.
Conduct in-home health evaluations for patients, including medication reviews, medical history assessments, and physical examinations. Facilitate connections to appropriate care and document findings using an intuitive clinical workflow on an iPad.
Conduct in-home health evaluations for 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 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 comprehensive in-home health evaluations for health plan members, including medication reviews and physical assessments. Provide patient education and bridge gaps in care while maintaining accurate clinical documentation via an iPad.
Conduct in-home health evaluations 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 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 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.
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.
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.
This role involves providing in-home care as a Nurse Practitioner or Physician Assistant, contributing to building a connected, convenient, and compassionate health experience for individuals. The position is full-time, anticipating 40 weekly hours, and is part of a team dedicated to simplifying healthcare one person, one family, and one community at a time.
The clinician will provide 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 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 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. This role involves building trusted relationships and providing personalized health evaluations.
The physician will conduct in-home health evaluations, engaging with patients to answer health questions and review their medical history. They will also help bridge gaps in care and connect patients to the right services.
The 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 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, 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.
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.
Responsible for all population health management components and oversee the strategic design, implementation, and evaluation of population health initiatives. Develop and implement operational plans that align with established population health goals and coordinate with various stakeholders on population health activities.
The Care Management Coordinator collaborates and informs the case management process to facilitate appropriate healthcare outcomes for members. This includes conducting comprehensive evaluations, coordinating care plans, and monitoring progress to ensure quality of care.
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 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 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 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 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 precertification as well as concurrent review.
The Medical Director will direct daily work on Part C appeals and provide support to appeal nurses. They will also monitor IRE and collaborate with Medicare Quality and Compliance.
The Medical Director will ensure timely and consistent responses to members and providers related to precertification, concurrent review, and appeal requests. This position is primarily responsible for Utilization Management, including prior authorization and pre-certification as well as concurrent review.
The Medical Director will 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 Case Manager is responsible for assessing, planning, implementing, and coordinating case management activities to evaluate the medical needs of members. They develop proactive care plans and collaborate with various stakeholders to enhance member wellness and address health and social challenges.
Lead the design and development of solutions for complex technical projects while acting as a subject matter expert. Collaborate with various stakeholders to solve technical problems and ensure timely progress of system design and development tasks.
The Manager will support key financial initiatives through financial modeling, capital planning, and business case development. This role involves collaboration across teams to drive data-informed decisions and operational efficiency.
The Staff Software Development Engineer will design, build, and deploy infrastructure capabilities for database technologies in various cloud environments. They will collaborate with multiple teams to create automation and improve customer experiences.
The Case Manager RN is responsible for assessing, planning, implementing, and coordinating case management activities with members to evaluate their medical needs. This role involves developing proactive strategies to enhance members' overall wellness and facilitate smooth transitions to Aetna programs and plans.
The Care Management Associate will interface with various groups providing care coordination services for eligible children and young adults receiving Medicaid services in Ohio. They will handle administrative tasks, including managing inbound care management inquiries and processing referrals.
The Care Management Associate manages enrollment for the Children’s Specialty program and supports comprehensive coordination of medical services. This includes developing wellness plans, engaging community resources, and ensuring effective utilization of healthcare services.
The 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.
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.
As a Medical Economics Analyst, you will provide consultative support and medical cost-based analysis of markets and network initiatives. You will analyze utilization and unit cost medical cost drivers and manage multiple projects to improve patient care.
This role ensures clinical programs and workflows are delivered accurately and on time, focusing on evaluating population health programs within Value Based Contracting. The Clinical Consultant provides consultative solutions to improve quality, increase efficiency, and drive cost savings within client organizations.
As a Product Manager, you will provide technical, analytical, and business support for Medicare, Medicaid, and Commercial products. You will develop business requirements, analyze program reporting, and ensure compliance with client and regulatory requirements.
