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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 Sr. Service Advocate serves as the Single Point of Contact for handling member service inquiries, issues and process requests received via telephone. Acts with fast knowledge using integrated service tools. Engages, consults and educates members based upon the member's unique needs, preferences and understanding of the ISM suite of services. Required Qualifications • Ability to build a trusting relationships by taking accountability to fully understand the member’s needs. • Ability to resolve complex issues with sensitivity and discretion. • Uses communication skills to build relationships with both internal and external members/constituents. • Ability to multitask and handle multiple functions and/or multiple products while maintaining and/or exceeding performance standards. • Demonstrates professionalism and presents a positive image when interacting with members and constituents. • Demonstrates strong member focus and utilizes all available resources to ensure prompt member satisfaction. • Demonstrates functional expertise and leadership ability. • Customer Service experiences in a transaction-based environment such as a call center or retail location preferred, demonstrating ability to be empathetic and compassionate. Preferred Qualifications Strong communication skills Understanding of medical terminology Problem solving skills Computer literate, Microsoft Word and Excel experience a plus Education High School Diploma or G.E.D. Some college preferredAnticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$18.50 - $38.82This 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. 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: 05/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVSHealth

Senior Service Advocate

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 Sr. Analyst will act as a primary resource for all dental products (DHMO, PPO, Medicare) for providers, sales and marketing, and Dental Service Centers to aid in the achievement of Aetna Key Performance Measures. Act as the liaison with the Primary Care Dentists and Specialists in a specific geographic territory responsible for overall maintenance and territory management of the provider network, as a functional subject matter expert, demonstrating a strong understanding of Aetna's Dental Products and market position. Negotiation of contract language and provider compensation. Review quality and service reports with provider and appropriate staff, contacting Dental providers regarding quality reviews conducted where unacceptable results were obtained. Timely response to correspondence from Provider offices, included, but not limited to termination requests, tax id changes, hold requests, claim reimbursement, system, directory accuracy and various contractual issues. Documented resolution and follow through communicated to all parties. Presentation of DHMO and PPO plan design, compensation process, claim / encounter submission, and referral policies during new office orientations and reorientations via the telephone. Knowledge of the competitive market and Aetna's relevant competitive position, to include member appointment access. Presentation of Aetna's electronic capabilities for dental providers to achieve Company goals and targets, promote all EDI initiatives.Required Qualifications 5 years of Experience in a Dental Office and/or payor setting, Sales or Service.Strong verbal and written communication skills. Preferred Qualifications Experience in the dental field and knowledge of PPO, DMO, and Medicare networks. Education - Bachelors Degree or equivalent combination of education and experienceAnticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$46,988.00 - $102,000.00This 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: 05/28/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Senior Analyst, Network Relations Retention (Aetna Dental)

<h1>About Prove </h1> As the world moves to a mobile-first economy, businesses need to modernize how they acquire, engage with and enable consumers. Prove’s phone-centric identity tokenization and passive cryptographic authentication solutions reduce friction, enhance security and privacy across all digital channels, and accelerate revenues while reducing operating expenses and fraud losses. Over 1,000 enterprise customers use Prove’s platform to process 20 billion customer requests annually across industries, including banking, lending, healthcare, gaming, crypto, e-commerce, marketplaces, and payments. For the latest updates from Prove, <a href="https://www.linkedin.com/company/proveidentity/" target="_blank">follow us on LinkedIn.</a> Prove is driving the future of digital identity. We are looking for Provers who know how to make an impact. We’re talking self-starting professionals who thrive in a fast-paced environment, process information quickly, and make intelligent decisions. The work is challenging and requires not only smart but natural curiosity and tenacity. Teamwork is also important to us – we work together and play together. Prove has big plans, and we’re excited about the future. If this sounds like the place for you – come join our team! Title: Fraud Strategy Analyst Reports to: VP, Product Management Location: New York, NY; Remote FLSA Status: F/T Salaried Exempt Position Summary The Fraud Strategy Analyst has experience in fraud prevention and has a knack for understanding bad actor motivations, fraud vulnerabilities, and control recommendations that favor consumer experience. They will ensure Prove products effectively verify identities and mitigate fraud by setting the policy which is enforced through our products. This role will interface with clients from time-to-time to understand fraud trends, make recommendations to the client on how to mitigate fraud using Prove products as well as relay new requirements to help shape Prove Policy as well as Prove Products. This person is critical to the success of the products by investigating fraud attacks, low pass rates with respect to identity verification, understanding root cause, and prescribing recommendations. Success is measured by maximizing client pass rates with effective fraud mitigation. Key Responsibilities: <ul> <li>Partner with Data Science team to refine and enhance Prove Global Fraud Policy through fraud expertise contributions</li> <li>Work with clients on fraud trends including analysis, client communication, recommendations to the client while partnering with leadership</li> <li>Support Platform Product Manager and Data Partnerships to recommend and prioritize new data sources</li> <li>Investigate client pass rate issues through using internal tools and partnership with Data Science and Client Success</li> <li>Create and maintain internal product documentation as well as support Product Marketing to create customer-facing product documentation and marketing collateral</li> <li>Create and maintain client dashboard to measure pass rate and fraud rates </li> <li>Contribute to the success of Prove led client forums to receive client and industry feedback</li> <li>Promote solutions in the market through bylines, webinars, and social media</li> </ul> Qualifications and Experience: <ul> <li>3+ years of fraud risk management, operations, or investigation or related experience.</li> <li>Bachelor's Degree in a relevant field, such as Computer Science, Operations, Business, Mathematics or Finance </li> <li>Demonstrated ability to stay organized and meet deadlines while managing multiple priorities</li> <li>Experience working in a fast-paced environment with a high degree of ambiguity</li> <li>Strong quantitative data analysis and critical thinking skills</li> <li>Ability to communicate effectively with both technical and non-technical individuals.</li> <li>Strong interpersonal skills, including written and oral communication skills</li> <li>Experience in a high growth startup with quickly expanding teams and aggressive revenue growth plans</li> <li>Promoting, maintaining and enhancing our cultural values of humility, passion, inclusion and leadership</li> <li>Exhibiting a strong passion for learning our products and markets through in-house and external training</li> </ul> The salary range for this role in New York City is $100,000-$115,000 plus company bonus. Offered salary will be determined by the applicant’s education, experience, knowledge, skills, geo-location and abilities, as well as internal equity and alignment with market data. Benefits &amp; Perks for FTE Provers: <ul> <li>Competitive salaries &amp; Bonus Plan (for eligible roles) and Equity Plan</li> <li>Modern Health for financial, mental, and physical wellness</li> <li>401(k) Retirement Plan &amp; Match (US Offices) and Local Country Pension (International Offices)</li> <li>Unlimited Vacation and Flexible hours</li> <li>Comprehensive medical benefits for you and your family ❤️</li> <li>Emotional &amp; Physical Wellness – Access to wellness services (EAP &amp; Prove Well-Being Reimbursement)</li> <li>Bottomless snacks &amp; beverages for certain office locations</li> <li>Daily GrubHub stipend for lunch if coming into the office (US Offices)</li> <li>A great place to work and connect with other talented Provers like yourself!</li> </ul> Don’t meet every single requirement? Studies have shown that women and people of color are less likely to apply to jobs unless they meet every single qualification. At Prove we are dedicated to building a diverse, inclusive and authentic workplace, so if you’re excited about this role but your past experience doesn’t align perfectly with every qualification in the job description, we encourage you to apply anyways. You may be just the right candidate for this or other roles. Equal Opportunity Employment: Prove is an equal opportunity employer committed to providing equal employment opportunity for all people regardless of race, color, religion, gender or sexual orientation, age, marital status, national origin, citizenship status, disability, veteran status or other personal characteristics Privacy &amp; Data Protection: When you are applying for a job at Prove, we collect and use your personal information in the job application process. To understand more about how Prove uses your personal information, please see our <a href="https://www.prove.com/legal/overview#Recruitment-Privacy-Policy" target="_blank">Recruitment Privacy Policy</a> on our website.

Prove

Fraud Strategy Analyst

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 We are seeking a highly skilled and experienced Security Engineer to join our Secure Collaboration Team. The successful candidate will be responsible for maintaining and enforcing security policies for various collaboration platforms, including SharePoint, OneDrive, Teams, Slack, SFTP, eShare, and related capabilities. This role will play a critical part in ensuring the security and compliance of these platforms while supporting the organization's overall secure sharing strategy.Primary Job Duties &amp; Responsibilities<ul> <li>Develop, implement, and maintain security policies for collaboration platforms, like M365, Teams, Slack, and SFTP, ensuring alignment with corporate security standards and regulatory compliance requirements.</li> <li>Oversee user access controls, identity management, and permission policies for collaboration platforms to ensure the least privilege access model.</li> <li>Conduct regular risk assessments and vulnerability assessments for collaboration platforms and implement necessary risk mitigation controls.</li> <li>Work with internal teams to integrate collaboration platforms into the enterprise security infrastructure, ensuring secure configuration and setup.</li> <li>Educate employees on best practices for secure usage of collaboration platforms, promoting a culture of security awareness within the organization.</li> <li>Work closely with IT, compliance, and business teams to ensure security requirements are met and any security concerns are addressed promptly.</li> <li>Develop and maintain collaboration dashboards and KPI reports in PowerBI to continuously monitor usage and trends of various collaboration platforms.</li> <li>Track and report usage of unsanctioned file sharing tools and cloud storages, support documentation of security incidents, response actions, and lessons learned.</li> <li>Stay up to date with security features and tools available for platforms like M365, Teams, eShare, Slack, and SFTP, and leverage them to enhance platform security.</li> <li>Create and maintain Azure Runbooks using PowerShell scripts, and automation using PowerApps.</li> <li>Continuously drive a simplified, consistent user experience at points of service engagement.</li> </ul>Required Qualifications<ul> <li>5+ years of experience in a security engineering or administration of collaboration platforms such as SharePoint, OneDrive, Teams, Slack, and cloud sharing tools.</li> <li>3+ years of experience with data at rest and data in motion encryption and other data protection techniques in cloud environments.</li> <li>2+ year of experience with automation of apps utilizing PowerApp.</li> <li>2+ year of experience in cloud sharing security configuration of M365 services and Azure.</li> <li>2+ year of experience with PowerBI and Azure Runbooks using Powershell.</li> </ul> Preferred Qualifications<ul> <li>Experience with eShare collaboration platform.</li> <li>Experience with secure file access and transfer protocols (SFTP).</li> <li>Excellent problem-solving skills and ability to work independently and collaboratively in a fast-paced environment.</li> <li>Strong communication skills to articulate security risks, solutions, and best practices to non-technical stakeholders.</li> <li>Demonstrated experience working with a wide range of internal and external stakeholders at all levels on strategic and operational information security programs.</li> <li>Strong analytical skills and the ability to understand and solve complex problems</li> <li>Experience in documenting and implementing procedures and guidelines.</li> <li>Continuous learner well informed on technology trends, tools, methodologies, and models.</li> <li>Ability to manage a high degree of complexity and distill information that provides clear direction.</li> <li>Comfortable operating within areas of ambiguity to iterate and make progress in a consistent manner.</li> <li>Agility to deal with a constantly changing business environments.</li> </ul> Education<ul><li>Bachelor’s degree or equivalent experience (High School Diploma and 4 years relevant experience)</li></ul>BUSINESS OVERVIEWBring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunitiesAnticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$101,970.00 - $203,940.00This 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: 07/31/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Senior Security Engineer - Secure Collaboration

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 Ready to take your Medical Director skills to the next level with a Fortune 6 company? Check out this opportunity with Aetna, a CVS Health company! This is a remote based work from home role. The Aetna One Advocate model provides the member with a powerful and proactive experience through high touch, personalized communications designed to help the member achieve their health ambition. Some key daily activities: - Partner with other Advocate team members to holistically assess member’s needs - Collaborate with treating providers through personalized, creative solutions to help member’s meet their health care needs. - Lead the clinical staff in the coordination of quality care on behalf of members - Conduct educational and clinical rounds with A1A clinical staff - Provide clinical expertise and business direction in support of medical management and utilization review programs through participation in clinical team activities including precertification, concurrent review/discharge planning, case management, disease management and quality management - Provide clinical guidance in promoting member quality of care and reviewing/addressing potential lapses - Act to engage providers and facilities in improving the quality of care delivered to our members and assure that our shared relationships are maintained and improved - Proactively use data analysis and periodic assessments to identify opportunities for quality improvement - Work collaboratively with other functional areas that interface with medical management including provider relations, sales, benefits, healthcare delivery, national medical services and national accounts to achieve the business goals 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. Preferred Qualifications *Health Plan experience 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: 07/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Medical Director (Aetna One Advocate)

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<ul> <li>Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. </li> <li>Acts as a subject matter expert by providing training, coaching, or responding to complex issues. </li> <li>May handle customer service inquiries and problems.</li> </ul>Additional Responsibilities <ul> <li>Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. </li> <li>Applies medical necessity guidelines, determines coverage, completes eligibility verification, identifies discrepancies, and applies all cost containment. measures to assist in the claim adjudication process.</li> <li>Handles phone and written inquiries related to requests for pre-approval/pre-authorization, reconsiderations, or appeals.</li> <li>Insures all compliance requirements are satisfied and all payments are made against company practices and procedures.</li> <li>Identifies and reports possible claim overpayments, underpayments and any other irregularities.</li> <li>Performs claim rework calculations.</li> <li>Distributes work assignment daily to junior staff.</li> <li>Trains and mentors claim benefit specialists.</li> <li>Makes outbound calls to obtain required information for claim or reconsideration.</li> </ul>Required Qualifications<ul> <li>2+ years medical claim processing experience.</li> <li>Experience in a production environment.</li> <li>Demonstrated ability to handle multiple assignments competently, accurately and efficiently.</li> </ul> Preferred Qualifications<ul> <li>Self funded medical claim processing experience.</li> <li>DG system knowledge.</li> </ul>Education<ul> <li>High School Diploma or GED required.</li> <li>Preferred Associates degree or equivalent work experience.</li> </ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$18.50 - $42.35This 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: 05/23/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Senior Claim Benefit Specialist

Work Flexibility: RemoteAs a Senior Portfolio Manager on Stryker's Sports Medicine team, you will be at the forefront of innovation. In this role, you’ll lead the portfolio development for soft tissue within the foot and ankle and small joints space. This role offers a unique chance to partner and collaborate with top surgeons in the field, the sales force and internal stakeholders, driving success and making a meaningful impact on the way soft tissue reconstruction in foot and ankle is delivered. Join us in this exciting journey to improve patient outcomes and advance your career in a dynamic, supportive environment. This is a remote position and requires marketing experience in the medical device industry, specifically in the foot and ankle space. WHAT YOU WILL DO: <ul> <li>Develop product roadmap and lead strategic planning as it relates to expansion of the Foot and Ankle soft tissue portfolio</li> <li>Execute a product lifecycle management (PLCM) plan as it relates to the overall business and launch strategy </li> <li>Anticipate the needs of customers and patients and create a superior value proposition </li> <li>Obtain insights by leveraging key opinion leaders </li> <li>Understand customers and optimizes value proposition </li> <li>Analyze the validity and reliability of market research results. Understand statistical significance and basic hypothesis testing. </li> <li>Effectively use and interpret qualitative and quantitative research. </li> <li>Collaborate cross-departmentally to lead the new product development (NPDP) process </li> <li>Understand new product development process and its effect on the business </li> <li>Build financial business case model to support new product development funding and product return on investment </li> <li>Responsible for delivering the business objective, marketing objective and leading the discovery process for the pre-commercialization plan </li> <li>Partner with Product Marketing to develop a publication and messaging strategy that aligns with clinical evidence </li> <li>Understand how to target customers based off total market potential and opportunity </li> <li>Understand potential sources of new volume within current customer segment or outside of the current segment and the financial tradeoffs for pursuing each </li> <li>Understand and predict sales trends in the market </li> <li>Develop pricing consistent with the Marketing Strategy and brand positioning </li> <li>Define performance criteria used for evaluating business trends and activities </li> </ul>WHAT YOU NEED: Required:<ul> <li>Bachelor’s degree</li> <li>6 years of work experience</li> <li>3 years medical device or marketing/sales experience in Foot and Ankle Soft Tissue/Sports Medicine. </li> </ul>Preferred:<ul><li>3 years' experience in product management, R&amp;D, or portfolio strategy in Foot and Ankle Soft Tissue/Sports Medicine</li></ul>$100,500 - $215,300 salary plus bonus eligible + benefits. Actual minimum and maximum may vary based on location. Individual pay is based on skills, experience, and other relevant factors.Travel Percentage: 40%Stryker Corporation is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, ethnicity, color, religion, sex, gender identity, sexual orientation, national origin, disability, or protected veteran status. Stryker is an EO employer – M/F/Veteran/Disability.Stryker Corporation will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.

Stryker

Senior Portfolio Manager, Foot & Ankle (Remote)

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 can sit in the surrounding states to Texas**Job Summary<ul> <li>Highly developed project management skill set specific to provider networks and contracts that drives overall network performance, innovation, and enhanced sales opportunities.</li> <li>Advises on provider performance, network adequacy, geographical coverage, and member satisfaction, and makes necessary network modifications or expansions.</li> <li>Provides hands on oversite and direct engagement on team projects.</li> <li>Implements improvement initiatives to ensure that network providers meet all applicable regulatory and quality standards.</li> <li>Develops and expands the network, identifying and contracting with healthcare providers, including hospitals, physicians, specialists, and ancillary service providers.</li> <li>Conducts market analysis, assesses competitive positioning, and recommends strategies to maintain a competitive edge.</li> <li>Interfaces with the finance team on budgeting, cost analysis, and financial forecasting, to manage the financial aspects of provider network management.</li> <li>Consults with internal teams, including medical directors, operations managers, and network development professionals, to align provider network performance goals and objectives.</li> <li>Provides continuous recommendations to senior leadership to guide decision-making and ensure close alignment with the organization's strategic goals and objectives.</li> </ul> Required Qualifications<ul> <li>A minimum of 3 years provider network contracting and/or sales operational experience with a health insurance managed care company</li> <li>Adept at Project Management.</li> <li>Adept at problem solving and decision-making.</li> <li>Adept at collaboration and teamwork.</li> <li>Adept at execution and delivery (planning, delivering, and supporting) skills</li> <li>Adept at business intelligence.</li> <li>Intrinsically Driven.</li> <li>Proactive Initiator.</li> </ul>Preferred Qualifications<ul> <li>A minimum of 7 years relevant work experience.</li> <li>Skilled Communicator.</li> <li>Growth Mindset with Mentorship Capability.</li> <li>Strong Organizational Competence.</li> </ul>Education<ul><li>Bachelor's degree preferred or a combination or professional work experience and education.</li></ul>Pay RangeThe typical pay range for this role is:$67,900.00 - $165,954.00 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: 05/03/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Senior Provider Network Contractor (Texas)

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 SummaryWe are currently recruiting top talent for our CST &amp; MST time zones for Medicare Retiree Solution Customer Service Centers.<ul> <li>Pay: $18.00 per hour non-negotiable.</li> <li>Training: 11 weeks, Monday - Friday 9:30am - 6:00pm CST (100% attendance required)</li> <li>Shift hours: Monday - Friday 9:30am - 6:00pm in their local time zone (CST or MST) for 1 year post training. Once that time is completed, the candidate will enter into the shift bid process and will be working an 8 hr.</li> <li>If you move out of your time zone, you will need to work the call center schedule that you were hired in. </li> <li>All moves need a 30-day notice.</li> </ul>Our goal is to provide compassionate, innovative, and proactive customer service to our Medicare members. We will use our skills and expertise to motivate positive change and collaboration, whenever possible. We are the knowledgeable, trusted, advocates for our members. The key to our success is our people. This position requires a high degree of adaptability, empathy, and patience.Educates plan benefits, answers questions and resolves issues based on incoming telephone member contacts - Utilizes compliant documentation standards - Provides empathetic and member centric service - Exceeding our member’s expectations is our standard - Ensure that every member is shown respect, kindness and all questions are thoroughly answered/resolved Required Qualifications<ul> <li>Must live and work CST or MST Time Zone</li> <li>1+ years of Customer Service experience</li> <li>Basic computer, typing and telephony skills or equivalent military experience.</li> <li>Demonstrated ability to be empathetic and compassionate</li> <li>Ability to apply patience</li> <li>Adaptability</li> </ul>Preferred Qualifications<ul> <li>Customer Service experiences in a healthcare environment</li> <li>Microsoft Office Suite Experience</li> </ul> Education<ul><li>School diploma, G.E.D. or equivalent experience</li></ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$17.00 - $28.46This 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. 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: 05/16/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Customer Service Representative (CST and MST Time Zones)

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 :Aetna, a CVS Health Company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity to help transform health care. We believe that a better care system is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources. This is a remote based (work from home) role preferably resides in Pacific or Mountain Time Zone. In the Medical Director role you will provide oversight for medical policy implementation.You will participate in the development, implementation, and evaluation of clinical / medical programs and expand Aetna's medical management programs to address member needs across the continuum of care.You will support the Medical Management staff ensuring timely and consistent responses to members and providers.As a Medical Director you will focus primarily on overseeing utilization review / quality assurance and be responsible for predetermination reviews.This includes Prior Authorization / Pre Certification / Concurrent Reviews / Peer to Peer Calls / First Level Appeals / Special Projects and Committee participation when needed. The Medical Director will provide clinical expertise as well as directing case management when necessary.In this role you will provide clinical expertise and business direction in support of medical management programs through participation in clinical team activities.The Medical Director will act as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams.Required Qualifications:*Active and current state medical license without encumbrances*M.D. or D.O., Board Certification in an ABMS or AOA recognized specialty including post-graduate direct patient care experience. Preferred Qualifications:Previous UM experience with a Health Plan / Payor.Board Certification in Internal Medicine, Family Medicine, Surgery Specialty Preferred.Education: MD or DOPay 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: 06/27/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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