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<h3> Position Summary </h3> Are you an experienced, passionate pioneer in technology who wants to work in a collaborative environment? As an experienced Epic Certified Systems Administrator (ECSA) you will have the ability to share new ideas and collaborate on projects as a consultant without the extensive demands of travel. If so, consider an opportunity with Deloitte under our Project Delivery Talent Model. Project Delivery Model (PDM) is a talent model that is tailored specifically for long-term, onsite client service delivery. Work you’ll do/Responsibilities We are seeking a highly skilled and certified Epic Client Systems Administrator (ECSA) to join our IT team. The ideal candidate will be responsible for the installation, configuration, and maintenance of Epic systems and related applications. This role requires a deep understanding of Epic infrastructure and the ability to ensure optimal performance and reliability of the Epic environment, preferably in a public cloud environment Key Responsibilities: <ul> <li>Install, configure, and maintain Epic client systems and applications in a public cloud environment</li> <li>Monitor system performance and troubleshoot issues to ensure optimal operation.</li> <li>Collaborate with Epic application teams to support and implement system changes.</li> <li>Manage and maintain system security and compliance with organizational policies.</li> <li>Provide technical support and training to end-users and other IT staff.</li> <li>Perform regular system updates and upgrades in coordination with Epic guidelines.</li> <li>Develop and maintain documentation for system configurations, processes, and procedures.</li> <li>Participate in on-call rotation to provide after-hours support as needed.</li> <li>Independently and collaboratively lead client engagement workstreams focused on improvement, optimization, and transformation of processes including implementing leading practice workflows, addressing deficits in quality, and driving operational outcomes</li> </ul> The Team Our Core Technology Operations (CTO) team offers differentiated operate services for our clients with solutions to help organizations scale and optimize critical business operations, drive speed to outcome, deliver business transformation, and build resilience in an uncertain future. Qualifications Required <ul> <li>Epic Certification: Must possess current Epic Client Systems Administrator (ECSA) certification.</li> <li>3-5 years of experience in IT systems administration, with at least 2 years specifically working with Epic systems.</li> <li>Proficiency in Windows Server and desktop operating systems.</li> <li>Experience with virtualization technologies such as VMware or Hyper-V.</li> <li>Strong understanding of network protocols and configurations.</li> <li>Familiarity with scripting languages (e.g., PowerShell, Python) for automation tasks.</li> <li>Bachelor's degree, preferably in Computer Science, Information Technology, Computer Engineering, or related IT discipline; or equivalent experience</li> <li>Limited immigration sponsorship may be available</li> <li>Ability to work remotely, be on-call (rotation for after-hours support), ability to work flexible hours, including nights and weekends, as needed, travel 10% on average, based on the work you do and the clients and industries/sectors you serve</li> </ul> Preferred <ul> <li>Previous Consulting experience</li> <li>Experience with Epic Hyperspace, Interconnect, and Web BLOB</li> <li>Cloud knowledge such as AWS, GCP, Azure.</li> <li>Previous experience in a healthcare IT environment.</li> <li>Analytical ability to manage multiple projects and prioritize tasks into manageable work products</li> <li>Previous leadership experience preferred.</li> <li>Can operate independently or with minimum supervision</li> <li>Excellent written and communication skills</li> <li>Ability to deliver technical demonstrations</li> </ul> The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $97,875 to $145,000. You may also be eligible to participate in a discretionary annual incentive program, subject to the rules governing the program, whereby an award, if any, depends on various factors, including, without limitation, individual and organizational performance. Information for applicants with a need for accommodation: <a href="https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html" target="_blank">https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html</a> Recruiting tips From developing a stand out resume to putting your best foot forward in the interview, we want you to feel prepared and confident as you explore opportunities at Deloitte. <a href="https://www2.deloitte.com/us/en/pages/careers/topics/recruiting-tips.html" target="_blank">Check out recruiting tips from Deloitte recruiters.</a> Benefits At Deloitte, we know that great people make a great organization. We value our people and offer employees a broad range of benefits. <a href="https://www2.deloitte.com/us/en/pages/careers/articles/life-at-deloitte-benefits-and-rewards-usdc.html" target="_blank">Learn more about what working at Deloitte can mean for you.</a> Our people and culture Our inclusive culture empowers our people to be who they are, contribute their unique perspectives, and make a difference individually and collectively. It enables us to leverage different ideas and perspectives, and bring more creativity and innovation to help solve our client most complex challenges. This makes Deloitte one of the most rewarding places to work. Our purpose Deloitte’s purpose is to make an impact that matters for our clients, our people, and in our communities. We are creating trust and confidence in a more equitable society. At Deloitte, purpose is synonymous with how we work every day. It defines who we are. We are focusing our collective efforts to advance sustainability, equity, and trust that come to life through our core commitments. <a href="https://www2.deloitte.com/us/en/pages/about-deloitte/articles/purpose-at-deloitte-us.html" target="_blank">Learn more about Deloitte's purpose, commitments, and impact.</a> Professional development From entry-level employees to senior leaders, we believe there’s always room to learn. We offer opportunities to build new skills, take on leadership opportunities and connect and grow through mentorship. From on-the-job learning experiences to formal development programs, our professionals have a variety of opportunities to continue to grow throughout their career.

Deloitte

Epic Certified System Administrator

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary The Analyst will develop test plans, test cases and test scripts for projects, among other assigned duties. The Analyst will perform testing on various software and reporting systems. The Analyst will work closely with PA Admin and Medicare Operations to test and validate the utilization management (UM) criteria, decision trees, drug lists, and letters that are loaded and functioning properly in the PA (MHK) system. Also, the analyst will be responsible for configuration quality control, code testing and test case writing. Additional responsibilities: include ensuring the quality of PA Admin products for internal/external business users by testing cases and doing regression testing. As a Analyst developing and executing formal test plans to ensure the delivery of quality software and to ensure that all information systems products and services meet minimum organization standards and end-user requirements. Required Qualifications - 1 plus years of quality assurances or testing - 5 plus years Software knowledge (MS Office Suite including Access and Project) Preferred Qualifications - PBM Knowledge - Analytical Skills - Ability to work in teams or independent - Time Management skills - Medicare Knowledge - Able to thrive in time sensitive situations - Written and Verbal Communication Skills - IT certification Education Bachelor’s degree or Equivalent work experience Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$43,888.00 - $85,068.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 03/28/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVSHealth

Clinical Service Analyst

Sr Business Analyst, Business Planning Analyst - Capital One Shopping (Remote-Eligible)This is your opportunity to join Capital One's fast-growing consumer app. Within Capital One, the Shopping team is working on a new consumer product that seeks to change the way people buy things online. Our mission is to deliver a best-in-class shopping and savings experience for our millions of customers while driving incremental and sustainable sales for our merchant partners.The Strategic Planning team is looking to hire a Business Planning Analyst, who will play a crucial role in shaping our growth trajectory. This is an exciting opportunity to contribute to our success by focusing on strategic hiring planning and optimizing capital allocation in a fast paced environment. You will serve as a key partner to leadership and delivery teams, providing insights and support to achieve our ambitious goals.To be successful in the role, you will need to be a well-rounded 'business athlete’ - a creative, analytical, and technically proficient problem solver who understands both the dynamics of the business and the tech landscape. The ideal candidate is resourceful, motivated, and self-sufficient, with demonstrated success in spearheading cross-functional projects that drive the growth and success of a business.General Responsibilities: <ul> <li>Develop and maintain comprehensive investment plans aligning with business objectives and growth projections</li> <li>Build business cases and conduct analysis to assess the potential and performance and of R&amp;D investments</li> <li>Create and manage financial models to forecast product level revenue and ROI metrics</li> <li>Work closely with Sales, Growth, and Product teams to understand and influence revenue impacts from operational strategies</li> <li>Partner with talent acquisition and department leaders to ensure effective execution of growth plans and delivery goals</li> <li>Establish and track key performance indicators (KPIs) to monitor team progress and delivery against commitments</li> <li>Develop and maintain reporting dashboards to provide real-time visibility into portfolio performance</li> <li>Work closely with colleagues across Capital One including: IT, Sales, Operations, Finance and others to drive improvement in quality, volume, service, and profitability </li> <li>A proven track record of decision making and problem solving based on analytics</li> <li>Strong business judgment, leadership and integrity: He/she should be a tenacious decision maker, able to bring a healthy, aggressive, yet responsible approach to business </li> <li>Solid people leadership experience: Ability to build and leverage the capabilities of a high-performing team, as well as business partners across the enterprise. He/she should foster innovation, drive critical decisions, hold business partners accountable, and be able to consistently deliver results </li> <li>Strong executive communication skills: Impeccable written and oral communication credentials, coupled with strategic influencing skills and the ability to drive agreement through intellect, interpersonal and negotiation skills </li> <li>Clear results orientation: display an intense focus on achieving both short and long term goals. He/she should be able to drive and execute an agenda in an uncertain and fluid environment </li> <li>Successful track record of thriving in a fast paced, entrepreneurial and dynamic environment. Previous consulting experience is a plus </li> </ul>Capital One is open to hiring a Remote Employee for this opportunity.Basic Qualifications:<ul> <li>Bachelor’s Degree in any quantitative field (Business, Math, Economics, Finance, Statistics, Science, Engineering)</li> <li>At least 1 year of experience in analysis</li> <li>At least 1 year of experience in SQL querying</li> </ul>Preferred Qualifications:<ul> <li>Master’s Degree in Business or quantitative field such as Finance, Economics, Physical Sciences, Math, Statistics, Engineering</li> <li>1+ years of experience in Statistical model building</li> <li>1+ years of experience in market research</li> <li>2+ years of experience in SQL querying</li> <li>2+ years of experience in business analysis</li> <li>1+ years of experience in consulting</li> </ul>Capital One will consider sponsoring a new qualified applicant for employment authorization for this position.The minimum and maximum full-time annual salaries for this role are listed below, by location. Please note that this salary information is solely for candidates hired to perform work within one of these locations, and refers to the amount Capital One is willing to pay at the time of this posting. Salaries for part-time roles will be prorated based upon the agreed upon number of hours to be regularly worked.New York, NY: $118,900 - $135,700 for Sr. Business Analyst Remote (Regardless of Location): $99,100 - $113,100 for Sr. Business Analyst McLean, VA: $109,000 - $124,400 for Sr. Business Analyst Candidates hired to work in other locations will be subject to the pay range associated with that location, and the actual annualized salary amount offered to any candidate at the time of hire will be reflected solely in the candidate’s offer letter.This role is also eligible to earn performance based incentive compensation, which may include cash bonus(es) and/or long term incentives (LTI). Incentives could be discretionary or non discretionary depending on the plan.Capital One offers a comprehensive, competitive, and inclusive set of health, financial and other benefits that support your total well-being. Learn more at the <a href="https://www.capitalonecareers.com/benefits" target="_blank">Capital One Careers website</a>. Eligibility varies based on full or part-time status, exempt or non-exempt status, and management level.This role is expected to accept applications for a minimum of 5 business days.No agencies please. Capital One is an equal opportunity employer committed to diversity and inclusion in the workplace. All qualified applicants will receive consideration for employment without regard to sex (including pregnancy, childbirth or related medical conditions), race, color, age, national origin, religion, disability, genetic information, marital status, sexual orientation, gender identity, gender reassignment, citizenship, immigration status, protected veteran status, or any other basis prohibited under applicable federal, state or local law. Capital One promotes a drug-free workplace. Capital One will consider for employment qualified applicants with a criminal history in a manner consistent with the requirements of applicable laws regarding criminal background inquiries, including, to the extent applicable, Article 23-A of the New York Correction Law; San Francisco, California Police Code Article 49, Sections 4901-4920; New York City’s Fair Chance Act; Philadelphia’s Fair Criminal Records Screening Act; and other applicable federal, state, and local laws and regulations regarding criminal background inquiries.If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation, please contact Capital One Recruiting at 1-800-304-9102 or via email at <a href="#">RecruitingAccommodation@capitalone.com</a>. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodations.For technical support or questions about Capital One's recruiting process, please send an email to <a href="#">Careers@capitalone.com</a>Capital One does not provide, endorse nor guarantee and is not liable for third-party products, services, educational tools or other information available through this site.Capital One Financial is made up of several different entities. Please note that any position posted in Canada is for Capital One Canada, any position posted in the United Kingdom is for Capital One Europe and any position posted in the Philippines is for Capital One Philippines Service Corp. (COPSSC).

Capital One

Sr Business Analyst, Business Planning Analyst - Capital One Shopping (Remote-Eligible)

<h3> Position Summary </h3> Deloitte’s Enterprise Performance professionals are leaders in optimizing operations that span the entire enterprise of an organization, from strategy to implementation and operation. By joining our team, you can help clients achieve impact and value from their investments in both people and technology that support enterprise-wide operations, as well as solutions for specific functions in the organization, from IT to finance and the supply chain. The team Deloitte’s Government and Public Services (GPS) practice – our people, ideas, technology and outcomes—is designed for impact. Serving federal, state, &amp; local government clients as well as public higher education institutions, our team of over 15,000+ professionals brings fresh perspective to help clients anticipate disruption, reimagine the possible, and fulfill their mission promise. The SAP Offering provides design, implementation, and ongoing operations and maintenance of SAP applications and technology. Deloitte is SAP’s #1 Partner in North America and works with clients to improve their ability to react in the digital world. Teams help enable scalability while also minimizing performance barriers, promoting innovation, modernizing core systems and helping clients reimagine their business with SAP digital solutions. Required Qualifications <ul> <li>Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future</li> <li>Must be able to acquire/maintain required level of Security clearance.</li> <li>Analyze documented requirements developed as a result of the analysis of the change request</li> <li>Develop technical design documents with the appropriate templates</li> <li>Expertise and hands on experience with S/4 data conversion with greenfield implementation</li> <li>Expertise and hands on experience in SAP Business Object Data Services</li> <li>Experience with S/4HANA data migration tools and ABAP</li> <li>Ability to source data from Oracle and load to HANA databases</li> <li>Strong knowledge of SQL and database development skills</li> <li>Develop an end-to-end process in SAP Data Services (BODS) which is fully automated with shell scripts and data flows</li> </ul> Preferred Skills <ul><li>Functional knowledge in SAP Finance, Funds Management and S/4 experience</li></ul> The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $97,875 to $163,125. You may also be eligible to participate in a discretionary annual incentive program, subject to the rules governing the program, whereby an award, if any, depends on various factors, including, without limitation, individual and organizational performance. Information for applicants with a need for accommodation: <a href="https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html" target="_blank">https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-as…</a> Recruiting tips From developing a stand out resume to putting your best foot forward in the interview, we want you to feel prepared and confident as you explore opportunities at Deloitte. <a href="https://www2.deloitte.com/us/en/pages/careers/topics/recruiting-tips.html" target="_blank">Check out recruiting tips from Deloitte recruiters.</a> Benefits At Deloitte, we know that great people make a great organization. We value our people and offer employees a broad range of benefits. <a href="https://www2.deloitte.com/us/en/pages/careers/articles/life-at-deloitte-benefits-and-rewards-usdc.html" target="_blank">Learn more about what working at Deloitte can mean for you.</a> Our people and culture Our diverse, equitable, and inclusive culture empowers our people to be who they are, contribute their unique perspectives, and make a difference individually and collectively. It enables us to leverage different ideas and perspectives, and bring more creativity and innovation to help solve our client most complex challenges. This makes Deloitte one of the most rewarding places to work. <a href="https://www2.deloitte.com/us/en/pages/about-deloitte/articles/deloitte-inclusion.html" target="_blank">Learn more about our inclusive culture.</a> Our purpose Deloitte’s purpose is to make an impact that matters for our clients, our people, and in our communities. We are creating trust and confidence in a more equitable society. At Deloitte, purpose is synonymous with how we work every day. It defines who we are. We are focusing our collective efforts to advance sustainability, equity, and trust that come to life through our core commitments. <a href="https://www2.deloitte.com/us/en/pages/about-deloitte/articles/purpose-at-deloitte-us.html" target="_blank">Learn more about Deloitte's purpose, commitments, and impact.</a> Professional development From entry-level employees to senior leaders, we believe there’s always room to learn. We offer opportunities to build new skills, take on leadership opportunities and connect and grow through mentorship. From on-the-job learning experiences to formal development programs, our professionals have a variety of opportunities to continue to grow throughout their career.

SAP S/4 HANA Data Conversion Developer

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position SummaryUtilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours.<ul> <li>Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.</li> <li> Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care</li> <li>Communicates with providers and other parties to facilitate care/treatment Identifies members for referral opportunities to integrate with other products, services and/or programs</li> <li>Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization</li> <li>Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function.</li> <li>Typical office working environment with productivity and quality expectations.</li> <li>Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.</li> <li>Sedentary work involving periods of sitting, talking, listening.</li> <li>Work requires sitting for extended periods, talking on the telephone and typing on the computer. Ability to multitask, prioritize and effectively adapt to a fast paced changing environment.</li> <li>Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding.</li> <li>Effective communication skills, both verbal and written</li> </ul> Required Qualifications- 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active current and unrestricted RN licensure in state of residence- Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours Preferred Qualifications- 2+ years of clinical experience required in med surg or specialty area - Managed Care experience preferred, especially Utilization Management- Preference for those residing in zones EducationAssociates Degree requiredBSN preferredAnticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$32.01 - $68.55This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 04/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Utilization Management Nurse Consultant

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position SummaryCVS Health is currently looking for a dynamic individual to join our team in an Sr. Analyst role. This is a client facing project management / auditor position that is responsible for coordinating, managing, tracking, reviewing, researching and assisting with multiple complex audit activities initiated by CMS / States. In this position, the Sr. Analyst will work closely with multiple clients and various Government / State auditors, the client account team, legal, and many other internal departments to ensure the completion of requested audits with consistency and minimal disruption to the business. This position needs to be able to manage many audits at the same time with short turnaround times. The Sr. Analyst will be responsible for the timely and satisfactory resolution of exceptions identified during the audit process, specifically related to pharmacy claims and manufacturer rebates. This includes having a working knowledge base around pharmacy claim adjudication principles, such as (but not limited to) benefit setup, discount pricing, prior authorizations, formulary, and accumulation tracking in order to review and respond to all the auditor’s questions in a short window of time. This position will also be expected to identify process enhancement opportunities to reduce or eliminate risk of future audit exceptions, as well as ensuring any concerns / issues are raised immediately to senior management. Skills must include abilities to analytically identify, track and encourage business owners in process enhancement opportunities to reduce risks, as well as researching claim specific questions. As a Sr. Analyst of Client Audit, you will be responsible for the following:<ul> <li>Work directly with the government auditors, the client and all the internal business areas involved in the audit</li> <li>Manage the work load successfully as there is no room for error with government audits and these audits come in waves across many clients at the same time which the position needs to be able to juggle all of the competing priorities</li> <li>Work independently with limited direction from the Director</li> <li>Coordinate, manage, track the audits from start to closure</li> <li>Review and researching all questions from the auditor and client </li> <li>Work through and resolve any alleged issues; working strategically and achieving results </li> <li>Respond back to the auditor / client</li> <li>Raise appropriate at risk items to the Director timely</li> <li>Documenting correspondence with internal partners, clients, and auditors</li> <li>Tracking all audit progress to ensure that all deliverables are provided by due dates</li> </ul>The ideal candidate will possess the following:<ul> <li>Understanding of pharmacy claim adjudication</li> <li>Understanding of pharmacy manufacturer rebates</li> <li>Ability to actively seek new ways to grow and be challenged</li> <li>Critical thinking which translates into strategic actions</li> <li>Easily adapting to change</li> <li>Excellent verbal and written communications skills</li> <li>Strong Project Management skills that include the ability to adapt and deal effectively in dynamic, possibly unpredictable, environments while efficiently managing multiple projects from initiation through to completion. A working contributor responsible for each project’s success.</li> <li>Ability to interact effectively with Government Auditors and Clients while under pressure during an audit is a must. Strong tolerance for ambiguity and stress</li> <li>Strong ability to maintain attention to detail and organizational skills.</li> <li>Strong ability to hold oneself and others accountable for mitigating risk and achieving results.</li> </ul> Required Qualifications3+ years of prior relevant experience in audit and/or project management Preferred QualificationsProject management experience.Proficiency in Microsoft Word, Excel, PowerPoint.PBM experience.CPA, CIA, or MBA EducationBS/BA required or equivalent years of education and experienceAnticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$46,988.00 - $112,200.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 04/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Senior Analyst - Client Audit

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Who You Are·Strong organizational skills and working knowledge in application security across multiple platformsWorking experience with creating and presenting actionable metrics in quick turn around timeframesDeeply experienced in coding with a nuanced understanding of Object-Oriented and Functional programming concepts, capable of writing and reviewing code across multiple languages and paradigms.· Highly passionate about building and operating secure, reliable systems at scale, with a proven track record in similar environments.· Demonstrated ability to innovate and automate security processes and functions through code, enhancing efficiency and effectiveness.· Demonstrated managerial skills with the ability to lead, mentor, and develop a diverse security engineering team, fostering an inclusive culture of continuous learning, excellence, and innovation.· Strong technical expertise with Application, Cloud, Data, and Network Security best practices.· Strong technical expertise with multi-cloud environments, including container/serverless and other microservice architectures.· Strong technical expertise with older technology stacks, including mainframes and monolithic architectures.· Strong technical expertise with SDLC, CI/CD tools, and Deployment Automation.· Strong technical expertise with operating security for Windows Server and Linux Server systems.· Strong technical expertise with configuration management, version control, and DevOps operational support.· Strong experience with implementing security measures for both applications and data, with an understanding of the unique security requirements of data warehouse technologies such as Snowflake.Role ResponsibilitiesManage a team of application security operations engineers in efforts related to code scanning, CDN, metrics, presentations, interfacing with technical and business partners to drive results.Development &amp; Enforcement· Develop and enforce engineering security policies and standards.· Develop and enforce data security policies and standards.· Drive security awareness across the organization.· Oversee the development and enforcement of comprehensive security policies and standards, ensuring advanced security practices are integrated throughout the software development lifecycle to mitigate risks and maintain alignment with industry-leading security protocols. Facilitate collaboration between security, development, and operations teams to foster a unified approach to secure software development.· Regularly review and update security policies and standards to reflect evolving threat landscapes and technological advancements, embedding a culture of continuous improvement within the team.Collaboration &amp; Expertise· Build and maintain strong relationships with product management, engineering leaders, and other key stakeholders to seamlessly integrate security considerations into product development lifecycles and operational processes.· Serve as a key security figure, orchestrating the integration of secure engineering practices across the organization and ensuring alignment with business objectives through strategic communication with senior management and other stakeholders.Analysis &amp; Configuration· Analyze, develop, and configure security solutions across multi-cloud, on-premises, and colocation environments, ensuring application security, integrity, confidentiality, and availability of data.· Lead security testing, vulnerability analysis, and documentation.· Spearhead the evaluation and strategic deployment of cutting-edge security solutions, emphasizing scalability, performance, and adaptability, to fortify the organization's defense against evolving threats.· Enhance and maintain a dynamic security architecture framework that empowers project teams to develop secure solutions, fostering agility and innovation within secure boundaries, thus aligning security measures with business objectives.Operational Support· Participate in operational on-call duties to support a 24/7 infrastructure across multiple regions and environments (cloud, on-premises, colocation).· Manage the security incident response team, ensuring rapid and effective handling of all security incidents, and leverage these experiences to develop and refine a resilient incident response strategy.· Implement a metrics-driven approach to security operations, using key performance indicators (KPIs) and key risk indicators (KRIs) to effectively measure and report on the security posture, incident response efficacy, and continuous improvement of security practices.Mentorship and Training· Demonstrated leadership skills with developing a comprehensive mentorship program for junior engineers, including organizing regular training sessions to elevate the team's technical and security skills. This role requires a commitment to fostering a culture of continuous improvement and knowledge sharing.· Establish a targeted leadership development program within the security team to cultivate future leaders by enhancing specific competencies and experiences, emphasizing the development of both technical skills and leadership qualities.Innovation and Research· Proven track record with participation in security research and the exploration of next-generation security tools and practices. This includes encouraging the team to engage with the wider security community, contributing to open-source projects, and staying well-informed of emerging threats and innovative defense mechanisms.· Encourage a culture of innovation within the team by allocating resources for research into emerging security technologies and practices, and by recognizing and rewarding innovative ideas and solutions.Strategic Planning· Lead the strategic planning of the organization's security roadmap, including conducting comprehensive risk assessments, managing budgets for security initiatives, and aligning the security strategy with overarching business goals. Champion security within the organization to ensure it is a key consideration in all business decisions and technology investments.· Advocate for the necessary resources and investments in security initiatives, demonstrating the ability to communicate the value and necessity of security to both technical and non-technical stakeholders effectively.QualificationsBasic Qualifications· 7+ years of experience in developing and deploying security technologies.· 7+ years of managing a team· Proficiency in Active Directory· Proficiency in Public Cloud (AWS/Azure/GCP) &amp; Network Security.· Experience with Docker, Kubernetes, Security-as-Code, and Infrastructure-as-Code.· Experience with one or more general-purpose programming/script languages including but not limited to: Java, C/C++, C#, Python, JavaScript, Shell Script, PowerShell.· Strong experience with implementing and managing data protection measures and compliance with data protection regulations (e.g., GDPR, CCPA).· Proven track record in leading security initiatives from inception through to successful deployment, demonstrating exceptional project management skills and the ability to navigate complex stakeholder landscapes.· Demonstrated experience in managing and leading high-performance security teams, showcasing strong organizational navigation skills and the ability to inspire, challenge, and support team members towards achieving personal and organizational goals.Preferred Qualifications· Strong technical expertise with Architecting Public Cloud solutions and processes.· Strong technical expertise with Networking and Software-Defined Networking (SDN) principles.· Strong technical expertise with developing and interpreting Network, Sequence, and Dataflow diagrams.· Experience with direct, remote, and virtual teams.· Understanding of at least one compliance framework (HIPAA, HITRUST, PCI, NIST, CSA).· Strong technical expertise with security solutions for data warehouses and big data platforms, particularly with technologies like Snowflake.· Strong technical expertise in defining and implementing cyber resilience standards, policies, and programs for distributed cloud and network infrastructure, ensuring robust redundancy and system reliability.· Experience in influencing industry security standards and contributing to open-source projects or security communities, highlighting a broader impact beyond the immediate organization.· Proven ability to foster a collaborative team environment, encouraging cross-functional teamwork and knowledge sharing to solve complex security challenges.Education· A minimum of a Bachelor’s degree in Computer Science, Software Development, Software Engineering, or a related field, or equivalent alternative education, skills, and/or practical experience is required.Pay RangeThe typical pay range for this role is:$118,450.00 - $260,590.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 05/23/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Senior Manager Application Security Ecosystem and Threat Management Engineer

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary The Analyst will develop test plans, test cases and test scripts for projects, among other assigned duties. The Analyst will perform testing on various software and reporting systems. The Analyst will work closely with PA Admin and Medicare Operations to test and validate the utilization management (UM) criteria, decision trees, drug lists, and letters that are loaded and functioning properly in the PA (MHK) system. Also, the analyst will be responsible for configuration quality control, code testing and test case writing. Additional responsibilities: include ensuring the quality of PA Admin products for internal/external business users by testing cases and doing regression testing. As a Analyst developing and executing formal test plans to ensure the delivery of quality software and to ensure that all information systems products and services meet minimum organization standards and end-user requirements. Required Qualifications - 1 plus years of quality assurances or testing - 5 plus years Software knowledge (MS Office Suite including Access and Project) Preferred Qualifications - PBM Knowledge - Analytical Skills - Ability to work in teams or independent - Time Management skills - Medicare Knowledge - Able to thrive in time sensitive situations - Written and Verbal Communication Skills - IT certification Education Bachelor’s degree or Equivalent work experience Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$43,888.00 - $85,068.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 03/28/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Analyst, Clinical Services

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position SummaryAetna, a CVS Health company has an outstanding opportunity for a Medical Director. Ready to take your career to the next level with a Fortune 6 company? This is a remote Work at Home position and can be located anywhere in the United States. In this role as Medical Director MPO (Medical Policy &amp; Operations) you will be responsible for providing clinical expertise and business direction in support of medical management programs to promote the delivery of high quality, constituent focused medical care with a focus on clinical and payment policy. This Medical Director provides subject matter expertise to provide clinical support and business direction in these areas. Knowledge of Aetna clinical and coding policy and experience with appeals, claim review, reimbursement issues, and coding is preferable, but a willingness to learn is essential. The Primary Responsibilities of the Medical Director include support of the appeal process, clinical claim review process, pre-certification, and predetermination of covered benefits in the Commercial and Medicare environment. This Medical Director provides subject matter expertise in clinical and payment policy to provide clinical support and business direction in these areas. In this role you will: ◾Participate on work groups as a clinical subject matter expert to identify and promote opportunities to improve the quality and efficiency of health care services. ◾Apply clinical coding and reimbursement expertise to ensure alignment and correct application of Aetna policies and practices to service and payment requests.◾Proactively use data analysis to identify opportunities for quality improvement and positively influence the effective delivery of quality care services. ◾ Be a subject matter expert and internal consultant and payment policy contributor subject matter expertise and internal consultant. ◾Demonstrate the ability to work within and lead as necessary teams comprised of a diverse group of health delivery professionals in order to manage the business objectives of the company. ◾Work Collaboratively with the functional areas. Required Qualifications*Five (5) or more years of experience in Health Care Delivery System e.g., Clinical Practice and Health Care Industry. *Active and current state medical license without encumbrances. *M.D. or D.O., Board Certification in an ABMS recognized specialty including post-graduate direct patient care experience Preferred Qualifications* Health plan/payor experience. * Foundational baseline skills in Medicine, Health Policy, Coding: HCPCS / CPT, Clinical Policy, Reimbursement and Health Care Systems. * Strong communication skills both written and verbal. Education* M.D. or D.O., Board Certification in an ABMS recognized specialty including post-graduate direct patient care experiencePay RangeThe typical pay range for this role is:$174,070.00 - $374,920.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 04/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Medical Director (Medical Policy & Operations)

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position SummaryAs a Manager, Network Disruption you will be responsible for managing inbound network disruption requests from the CVS Health Sales and Proposals teams in response to Requests for Proposals (RFP) which are used to win new clients and retain existing clients. You will distribute and track requests, review reporting for accuracy, assist in the creation of new tools and processes used to run network disruption reports, and communicate with internal partners in Sales, Account Management, Network Development, and Retail Analysis. You will also work with large claims datasets, analyze differences between current and proposed networks, manage multiple requests/priorities, and produce/develop custom reports for multiple lines of business and specific clients regarding retail pharmacy network accessibility using SQL, SAS, Tableau, Microsoft Access, Microsoft Excel, and other related applications. Key Responsibilities:<ul> <li> Request Management: Manage, distribute, and track network disruption requests from Sales and Proposals teams ensuring timely and accurate responses.</li> <li> Cross-Team Collaboration: Act as a liaison between the Network Disruption team and other internal departments, including Sales, Account Management, Network Development, and Retail Analysis, to ensure seamless communication and collaboration.</li> <li> Data Management: Build queries, perform data imports and extracts, analyze data, compare networks, and create reports to support network disruption requests from internal customers.</li> <li> Innovation: Assist in the development of new tools and processes for network disruption reporting.</li> <li> Custom Reporting: Produce and develop custom reports for various lines of business and specific clients regarding retail pharmacy network accessibility.</li> </ul> Required Qualifications<ul> <li>5+ years of experience in data analysis, network analysis, or a similar role.</li> <li>5+ years experience utilizing SQL, Big Query, Tableau, Microsoft Access, Microsoft Excel, or other related applications.</li> </ul> Preferred Qualifications<ul> <li>Experience in the PBM, healthcare or pharmacy industry.</li> <li>Familiarity with Requests for Proposals (RFP) processes.</li> <li>Advanced proficiency in data analysis and reporting tools.</li> <li>Excellent communication and interpersonal skills.</li> <li>Proven ability to manage multiple priorities and meet deadlines.</li> <li>Experience in network development or retail analysis is a plus.</li> <li>Strong analytical skills with experience in handling large datasets.</li> </ul> Education<ul> <li>Bachelors degree or relevant work experience required.</li> <li>Bachelor's degree in Computer Science, Information Technology, Data Analytics, or related field preferred.</li> </ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$54,300.00 - $145,860.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 04/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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