field_remote_option

job_industry

field_job_occupational_field_parents_all

job_organization_name

job_upgrade_is_featured

About Tala Tala is on a mission to unleash the economic power of the Global Majority – the 4 billion people overlooked by existing financial systems. With nearly half a billion dollars raised from equity and debt, we are serving millions of customers across three continents. Tala has been named by the Fortune Impact 20 list, CNBC’s Disruptor 50 five years in a row, CNBC’s World's Top Fintech Company, Forbes’ Fintech 50 list for eight years running, and Chief's The New Era of Leadership Award. We are expanding across product offerings, countries and crypto and are looking for people who have an entrepreneurial spirit and are passionate about our <a href="http://mission.By" target="_blank">m</a>ission. By creating a unique platform that enables lending and other financial services around the globe, people in emerging markets are able to start and expand small businesses, manage day-to-day needs, and pursue their financial goals with confidence. Currently, over nine million people across Kenya, the Philippines, Mexico, and India have used Tala products. Due to our global team, we have a remote-first approach, and also have offices in Santa Monica, CA (HQ); Nairobi, Kenya; Mexico City, Mexico; Manila, the Philippines; and Bangalore, India. Most Talazens join us because they connect with our mission. If you are energized by the impact you can make at Tala, we’d love to hear from you! The Role We're seeking a highly motivated and analytical Senior Finance Manager to join our Strategic finance team and become a critical business partner to our product team. In this role, you'll play a pivotal part in driving product strategy and profitability by providing insightful financial analysis, forecasting, and strategic recommendations. An ideal candidate operates with significant autonomy and independence, showing high judgment in decisions that have financial, business, operational, or customer implications. This candidate will have advanced financial modeling skills and the ability and the ability to influence the decisions of business partners through effective verbal and written communication.<h3>What You'll Do </h3> <ul> <li> Strategic Business Partnering: Serve as the primary finance partner to the product team, providing financial guidance and support for strategic decision-making.</li> <li> Business Case Development: Partner with product team to create robust business cases for new product initiatives, features, and investments, evaluating potential ROI and financial impact.</li> <li> Financial Modeling &amp; Forecasting: Develop and maintain sophisticated financial models to forecast product revenue, costs, and profitability, ensuring accuracy and alignment with business objectives.</li> <li> Performance &amp; ROI Analysis: Evaluate ROI and analyze product performance against targets, identify key trends, and provide actionable insights to drive product optimization and growth.</li> <li> Reporting &amp; Communication: Prepare and present clear and concise financial reports and insights to senior management, facilitating effective communication and decision-making.</li> <li>Create bridges between teams and ensure shared understanding. Provide ongoing updates to the Finance (Local and Global teams) and leadership team</li> <li>Work closely with accounting to ensure accurate product-related financial reporting.</li> </ul><h3>What You'll Need </h3> <ul> <li>5+ years of experience in business finance, forecast &amp; budgeting, or other finance-focused competency experience</li> <li>Demonstrated experience partnering closely with product managers to build products at scale.</li> <li>Experience in managing multiple competing priorities effectively</li> <li>Strategic thinking with demonstrated business judgement and quantitative skills</li> <li>Expertise in financial modeling, forecasting, and business case development</li> <li>Strong understanding of financial statements</li> <li>Excellent analytical and problem-solving skills, with the ability to translate complex financial data into actionable insights.</li> <li>Exceptional communication and presentation skills, with the ability to influence stakeholders at all levels.</li> </ul>Our vision is to build a new financial ecosystem where everyone can participate on equal footing and access the tools they need to be financially healthy. We strongly believe that inclusion fosters innovation and we’re proud to have a diverse global team that represents a multitude of backgrounds, cultures, and experience. We hire talented people regardless of race, religion, color, national origin, gender, gender expression, sexual orientation, age, marital status, veteran status, or disability status.

Tala

Senior Strategic Finance Manager

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Assist with the analysis and correction of data migrated from one provider application to another. Review ongoing provider set up to ensure compliance with standards.<ul> <li>Maintain spreadsheets and collect, track, prepare, compile, and distribute statistical data for daily, weekly and monthly reports</li> <li>Analyze reports to determine if data is accurate or requires modification</li> <li>Manipulate existing data, edit current information and validate new entries in database for accuracy</li> <li>Maintain and update the organization's provider data applications and coordinate the data verification process for enrolled providers</li> <li>Update the organization's Provider Data applications</li> <li>Resolve complex provider data issues</li> <li>Assist with Provider projects to meet Service Level Agreement targets</li> <li>Ability to work weekends and overtime as required</li> </ul>Health Insurance (Nice to have)Microsoft Excel (data manipulation)Excellent writing skillsMust reside in FL100% RemoteEducation/Experience: High school diploma or equivalent. 2+ years of data analysis experience, preferably in the healthcare or insurance industry with provider information systems. Auditing, Amisys and/or Portico preferred.Pay Range: $22.79 - $38.84 per hourCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Oklahoma Complete Health

Provider Data Analyst

Job Description:We are seeking an experienced Software Engineering Manager with a strong background in API-driven development within the product security, authentication, and authorization domains. Additionally, the ideal candidate will also have expertise in database and messaging systems at scale.In this role, you will lead a team of full-stack engineers, guiding them to build scalable, reliable, and maintainable solutions. As a hands-on leader, you will influence technical strategy, mentor engineers, and collaborate closely with product and operations teams to deliver best-in-class servicesWho you’re committed to being:<ul> <li>You enjoy learning and are open to new ways of doing things.</li> <li>You are not afraid to be yourself, experiment, make mistakes and learn from them, ask questions, or voice your concerns.</li> <li>When communicating you are self-aware, insightful, and proactive.</li> <li>You are a team member first and individual contributor second. You are aware that high-performing teams are only as strong as their weakest link.</li> <li>You believe in continuous improvement and request frequent feedback from others.</li> </ul>What you’ll do:Team Leadership &amp; Mentorship:<ul> <li>Coach and mentor full-stack engineers, fostering a culture of continuous learning and professional growth.</li> <li>Set clear performance goals and support career development plans.</li> </ul>Technical Strategy &amp; Architecture:<ul> <li>Define and evolve technical strategy for Skills Platform ensuring alignment with product objectives.</li> <li>Champion API-first principles and scalable architectures.</li> </ul>Software Development &amp; Delivery:<ul> <li>Manage the entire software development lifecycle from requirements to maintenance.</li> <li>Implement coding standards and best practices to maintain high code quality.</li> <li>Drive continuous integration and deployment (CI/CD) pipelines to enhance productivity.</li> </ul>Security, Compliance, Observability &amp; Quality:<ul> <li>Embed security best practices into the development process.</li> <li>Implement monitoring solutions to diagnose issues and optimize performance.</li> <li>Enforce Quality Standards throughout the development cycle by integrating unit testing with tools like Jest for automated test execution, ensuring code reliability and early detection of issues..</li> </ul>Cross-Functional Collaboration:<ul> <li>Partner with product management and stakeholders on feature requirements and delivery timelines.</li> <li>Communicate technical decisions and roadmap updates across the organization.</li> </ul>Experience you’ll bring:<ul> <li>Proven ability to focus engineering work on the top corporate objectives and priorities, and accountability for keeping strategic work on track</li> <li>Hands-on experience with AWS services</li> <li>Hands-on experience with Infrastructure as a Code (Terraform), deployment orchestration (Docker, Kubernetes), and version control tools</li> <li>Experience with REST API management &amp; documentation, observability &amp; analytics tooling (New Relic, Grafana), continuous development and integration, and security and audit concerns</li> </ul>Requirements:<ul> <li>3+ years of experience as a manager of software development teams with large-scale projects delivered</li> <li>Experience leading technical team that support and partner with international technology and product peers</li> </ul>Travel Requirements:While Pluralsight operates under a remote and hybrid work model, we believe that in-person connection and collaboration are important. Recurring travel to our HQ in Utah may be required depending on the role and team member location.Why you’ll love working here:<ul> <li>We’re a blended workplace, where team members work remotely or in a hybrid setup depending on their role and location</li> <li>We’re mission driven and guided by our culture pillars</li> <li>We have a strong commitment to diversity and belonging</li> <li>We cultivate a culture of trust, autonomy, and collaboration</li> <li>We’re lifelong learners and champion team member growth and advancement</li> <li>We’ve got you covered - team member benefits include competitive compensation packages, medical coverage, unlimited PTO and Summer Fridays, wellness reimbursements, Pluralsight subscription, professional development funds and more.</li> </ul>About us:Pluralsight provides the only learning platform dedicated to accelerating the technology skills and capabilities of today’s tech workforce. Thousands of companies, government organizations and individuals around the world rely on Pluralsight to support critical technology skill development in areas that are crucial to innovation including artificial intelligence, cloud computing, cybersecurity, software development, and machine learning. Pluralsight provides highly curated content developed by vetted technology experts, industry leading skill assessments, and hands on, immersive learning experiences designed to help individuals skill-up faster.Physical and Mental Requirements:Work is performed in an office (or home office) environment and requires the ability to operate office equipment and keyboards. Sedentary work. Repetitive work. Ability to perform tasks related to documentation, data analysis, transcription and extensive content analysis. Learn new tasks, remember processes, complete tasks independently, and make timely decisions in the context of a workflow.EEOC StatementBring yourself. Pluralsight is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability, age or protected veteran status. Pluralsight will also consider for employment qualified applicants with criminal histories in a manner consistent with EEOC guidelines and applicable local law.We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please visit the <a href="https://www.pluralsight.com/careers" target="_blank">bottom of our website</a> to learn how to request an accommodation.For more information on Pluralsight’s commitment to building a more diverse and inclusive workforce, please review our most recent Diversity, Equity, Inclusion and Belonging report <a href="https://www.pluralsight.com/about/diversity-and-belonging" target="_blank">here</a>.The annual US base salary range for this role is $142,200 - $175,600 USD. Pluralsight's pay ranges vary based on work location. Talent Acquisition can share more detail during the hiring process when applicable. Each candidate’s compensation offer will be based on multiple factors including, but not limited to, geography, experience, skills, job duties, and business need, among other things. In addition to the base salary, this role may also be eligible for benefits and bonuses.Applications must be submitted within 90 days after the initial posting date to be considered. #LI-JM2

Pluralsight

Sr Engineering Manager - Identity

<h2 id="who-we-are">Who we are</h2> <h3 id="about-stripe">About Stripe</h3> Stripe is a financial infrastructure platform for businesses. Millions of companies—from the world’s largest enterprises to the most ambitious startups—use Stripe to accept payments, grow their revenue, and accelerate new business opportunities. Our mission is to increase the GDP of the internet, and we have a staggering amount of work ahead. That means you have an unprecedented opportunity to put the global economy within everyone’s reach while doing the most important work of your career. <h3 id="about-the-team">About the team</h3> Ever wonder how Stripe achieves craft &amp; beauty at scale? We built a platform for designing and building great user interfaces called Sail. Whether you’re building a massive web application, embedded UIs, or an SEO-friendly site, Sail has you covered. Sail provides not only a robust design system with reusable components (available in Figma and React), but also all the templates / patterns (e.g. list views, drawers), APIs (e.g. data fetching, access control, observability), and built-in standards (e.g. mobile responsiveness, light/dark mode, embeddability) you need to build a web application. The team is responsible for making web development at Stripe performant, high quality, and easy for developers. We’re hiring a product manager to define the future of Sail, inflect its impact across the company, and accelerate Stripe’s mission to increase the GDP of the internet. <h2 id="what-youll-do">What you’ll do</h2> You will evolve our design system and web platform to be powerful and opinionated so craft &amp; quality are inevitable across Stripe’s products. Lead our frontend design system and components, used by all products. Bring our web platform to the next level on speed and performance. Develop a vision for how our components get used by non-merchant facing teams (e.g. Link for consumers), third-party developers, and platform customers. Bring data to life with powerful real-time charting experiences. Up-level our opinionated product style, in big (new workflows) and small (surprisingly great) ways. <h3 id="responsibilities">Responsibilities</h3> <ul> <li> Make the development of products at Stripe faster, easier, and a surprisingly great experience for designers and developers </li> <li>Partner with senior leadership to understand and uphold our ambitions for quality at scale </li> <li>Develop a strategy and roadmap that transforms Sail into what Stripe will need to achieve its 10-year goals </li> <li>Collaborate with engineering and design across time zones (PST, EST, CET) to ship high impact functionality that delights designers, developers, and users </li> <li>Define and track success metrics for quality and performance </li> </ul> <h2 id="who-you-are">Who you are</h2> This is an unorthodox role. And you have an unorthodox background. You probably look more like a designer, engineer, or design engineer. We’re looking for someone who meets the minimum requirements to be considered for the role. If you meet these requirements, you are encouraged to apply. The preferred qualifications are a bonus, not a requirement. <h3 id="minimum-requirements">Minimum requirements</h3> <ul> <li>10+ years of experience in product management, design, or engineering with at least 3+ years in senior capacity making company-level product decisions </li> <li>Strong understanding of user interface (UI) and user experience (UX) principles and best practices </li> <li>Technical familiarity with frontend development technologies including HTML, CSS, JavaScript, and frameworks such as React, Angular, or Vue.js </li> <li>Strong written and verbal communication across business, design, and engineering audiences </li> <li>Demonstrated experience leading company-wide initiatives influencing technical roadmaps </li> </ul> <h3 id="preferred-qualifications">Preferred qualifications</h3> <ul> <li>Believe that <a href="https://craigmod.com/essays/fast_software/" target="_blank">fast software is the best software</a> </li> <li>Built robust design systems at scale </li> <li>Developed complex frontend applications with sub-1000ms load times </li> <li>Strong (informed) point of view on how we web applications should be built and composed </li> <li>Enjoy using social media to interact directly with customers for feedback </li> </ul> This role is available either in an office or a remote location (typically, 35+ miles or 56+ km from a Stripe office). Office-assigned Stripes spend at least 50% of the time in a given month in their local office or with users. This hits a balance between bringing people together for in-person collaboration and learning from each other, while supporting flexibility about how to do this in a way that makes sense for individuals and their teams. A remote location, in most cases, is defined as being 35 miles (56 kilometers) or more from one of our offices. While you would be welcome to come into the office for team/business meetings, on-sites, meet-ups, and events, our expectation is you would regularly work from home rather than a Stripe office. Stripe does not cover the cost of relocating to a remote location. We encourage you to apply for roles that match the location where you currently or plan to live. The annual US base salary range for this role is $214,300 - $321,500. For sales roles, the range provided is the role’s On Target Earnings ("OTE") range, meaning that the range includes both the sales commissions/sales bonuses target and annual base salary for the role. This salary range may be inclusive of several career levels at Stripe and will be narrowed during the interview process based on a number of factors, including the candidate’s experience, qualifications, and location. Applicants interested in this role and who are not located in the US may request the annual salary range for their location during the interview process. Additional benefits for this role may include: equity, company bonus or sales commissions/bonuses; 401(k) plan; medical, dental, and vision benefits; and wellness stipends. Office locations New York Remote locations Remote in United States Team Platform Job type Full time <a href="#">Apply for this role </a>

Stripe

Product Manager, Sail

<a href="#"> </a> <a href="#">About Us</a> <a href="#">Current Employee Job Search</a> <a href="#">Go to Hillcrest HealthCare System Careers</a> <ul> <li> <a href="#">Home</a> <a href="#">Home</a> </li> <li> <a href="#">Locations</a> <a href="#">Locations</a> </li> <li> <a href="#">Nursing Careers</a> <a href="#">Nursing Careers</a> </li> <li> <a href="#">Provider Careers</a> <a href="#">Provider Careers</a> </li> <li> <a href="#">Corporate Careers</a> <a href="#">Corporate Careers</a> </li> <li> <a href="#">Executive Careers</a> <a href="#">Executive Careers</a> </li> <li> <a href="#">Join Talent Community</a> <a href="#">Join Talent Community</a> </li> </ul> <ul> <li> <a href="#">Home</a> </li> <li> <a href="#">Locations</a> </li> <li> <a href="#">Nursing Careers</a> </li> <li> <a href="#">Provider Careers</a> </li> <li> <a href="#">Corporate Careers</a> </li> <li> <a href="#">Executive Careers</a> </li> <li> <a href="#">Join Talent Community</a> </li> <li> <ul> <li><a href="#">Careers Home</a></li> <li><a href="#">Search Jobs</a></li> </ul> </li> </ul> Candidates residing in the following states, CA, CO, CT, HI, IL, MA, MD, ME, MI, MN, NH, NV, NY, OR, RI, VT, WA, Washington DC and WV, must be willing to relocate if they are hired in a remote role. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. FOLLOW US <a href="https://www.linkedin.com/company/hillcrest-healthcare-system" target="_blank"> </a> <a href="https://www.youtube.com/user/HillcrestMedicalCtr" target="_blank"> </a> <a href="https://www.facebook.com/UticaPark" target="_blank"> </a> <h4>ARDENT HEALTH SERVICES</h4> Ardent Health Services invests in quality health care. In people, technology, facilities and communities, Ardent makes considerable investments – producing high quality care and extraordinary results. <h4>CONTACT US</h4> 340 Seven Springs Way Suite 100, Brentwood, TN 37027 (615) 296-3000 We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Copyright © Ardent Health Services. All rights reserved. <a href="#">Providerrecruitment@ardenthealth.com</a> <a href="#">Providerrecruitment@ardenthealth.com</a> <a href="#">Providerrecruitment@ardenthealth.com</a> <a href="#">Providerrecruitment@ardenthealth.com</a> <a href="#">Providerrecruitment@ardenthealth.com</a> <a href="#">Providerrecruitment@ardenthealth.com</a>

Utica Park Clinic

Medical Assistant / MA Gastroenterology

<a href="#"> </a> <a href="#">About Us</a> <a href="#">Current Employee Job Search</a> <a href="#">Ardent Health Careers</a> <a href="https://hillcrest.com/rncareers" target="_blank">Nurse Residency Program</a> <ul> <li> <a href="#">Home</a> <a href="#">Home</a> </li> <li> <a href="#">Locations</a> <a href="#">Locations</a> </li> <li> <a href="#">Nursing Careers</a> <a href="#">Nursing Careers</a> </li> <li> <a href="#">Provider Careers</a> <a href="#">Provider Careers</a> </li> <li> <a href="#">Corporate Careers</a> <a href="#">Corporate Careers</a> </li> <li> <a href="#">Executive Careers</a> <a href="#">Executive Careers</a> </li> <li> <a href="#">Join Talent Community</a> <a href="#">Join Talent Community</a> </li> </ul> <ul> <li> <a href="#">Home</a> </li> <li> <a href="#">Locations</a> </li> <li> <a href="#">Nursing Careers</a> </li> <li> <a href="#">Provider Careers</a> </li> <li> <a href="#">Corporate Careers</a> </li> <li> <a href="#">Executive Careers</a> </li> <li> <a href="#">Join Talent Community</a> </li> <li> <ul> <li><a href="#">Careers Home</a></li> <li><a href="#">Search Jobs</a></li> </ul> </li> </ul> Candidates residing in the following states, CA, CO, CT, HI, IL, MA, MD, ME, MI, MN, NH, NV, NY, OR, RI, VT, WA, Washington DC and WV, must be willing to relocate if they are hired in a remote role. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. FOLLOW US <a href="https://www.linkedin.com/company/hillcrest-healthcare-system" target="_blank"> </a> <a href="https://www.youtube.com/user/HillcrestMedicalCtr" target="_blank"> </a> <a href="https://www.facebook.com/hillcrestmedicalcenter" target="_blank"> </a> <h4>ARDENT HEALTH SERVICES</h4> Ardent Health Services invests in quality health care. In people, technology, facilities and communities, Ardent makes considerable investments – producing high quality care and extraordinary results. <h4>CONTACT US</h4> 340 Seven Springs Way Suite 100, Brentwood, TN 37027 (615) 296-3000 We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Copyright © Ardent Health Services. All rights reserved. <a href="#">Providerrecruitment@ardenthealth.com</a> <a href="#">Providerrecruitment@ardenthealth.com</a> <a href="#">Providerrecruitment@ardenthealth.com</a> <a href="#">Providerrecruitment@ardenthealth.com</a> <a href="#">Providerrecruitment@ardenthealth.com</a> <a href="#">Providerrecruitment@ardenthealth.com</a>

Hillcrest Healthcare System

Medical Assistant / MA OBGYN

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.

CVSHealth

Manager, Network Disruption

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.<h2>Position Summary</h2>This position is 100% remote Working hours will be Tuesday-Friday 9:30AM – 6:00PM EST, Saturday 8:00AM - 4:30PM EST. Holidays will be on rotation. No travel is required. Applicants from any state can apply. Job DescriptionUtilizes clinical and critical thinking skills to complete notice of action (NOA) letters members and providers for approved or denied services. Requires LPN/LVN with unrestricted active license. Promotes/supports quality effectiveness of Healthcare Services and benefit utilization Utilizes clinical and critical thinking skills to write and audit notice of action letters to members and providers for approved or denied services. Collects information to support the process of rendering appropriate, member friendly, notice of action letters. Utilizes clinical experience, criteria/guidelines, policies, and procedures in support of ensuring that letters are timely and accurate. We work closely with the utilization management team.Required Qualifications- 1 year of clinical experience required- LPN/LVN with current unrestricted licensure requiredPreferred Qualifications- 2 years managed care experience.- 2 years prior authorization experience.- Prior experience using Quadient and/or MedCompass.- Effective communication and organization skills.- Outpatient Clinical experience- Knowledge of Medicare/Medicaid- Computer literacy to navigate through Internal/external computer systems, including Excel and Microsoft Word. EducationLicensed Practical/ Vocational Nurse diploma/ Associate DegreeAnticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$21.10 - $43.78This 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.

LPN - Notice Of Action Letter Auditor

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 SummaryThe Medicare Product Implementation department is accountable for ensuring Medicare’s mandatory core Part C benefits and supplemental benefits are administered correctly. On occasion, CMS (Centers for Medicare Medicaid Services) requires regulatory changes during the plan year. The Medicare Benefits Standards &amp; Guidance Lead Director ensures accountability for the implementation, management, and maintenance of the Medicare Part C benefits when regulatory changes are required across Medicare including Individual general enrollment, Special Needs Plans (SNP) and Employer Groups. The Medicare Benefits Standards &amp; Guidance Lead Director acts as the point of contact to our corporate partners, such as Benefit &amp; Product Strategy, Benefits &amp; Product claims configuration, Medicare Service Operations (MSO), Medical Policy &amp; Program Solutions (MPPS), Provider Network, and Compliance. This role is primarily responsible for the project management support for implementing mid-year regulatory changes to Medicare benefits and claims system SNOW tickets that are misaligned to strategic intent. As the Medicare Benefits Standards &amp; Guidance Lead Director, you will be responsible for creating requirement documentation through partnering with Medicare Benefit &amp; Product Strategy that will clearly describe the benefit intent for claims setup and administration. The requirement documentation will be the primary source of truth for claims setup and policy administration. This role is also responsible for assembling testing scenarios, in collaboration with Product Quality Assurance for QA execution and alignment of CMS (Center for Medicare Medicaid Services) regulatory changes. · Provide strategic direction for Medicare benefit claims processing outcome for Medicare regulation changes and SNOW ticket resolution tying back to strategic intent.· Point of contact to Compliance and MSO for Medicare regulation changes to benefits and impacts on Medicare product standards. · Provide strategic insights and recommendations of Medicare regulation changes in collaboration with the Medicare Benefit and Product Strategy department to ensure compliance.· Develops and advances a comprehensive implementation strategy aligned with the organization's goals and objectives to successfully enhance the organization's competitive advantage and brand recognition.· Approves metrics and key performance indicators (KPIs) used to evaluate the product implementation's success and impact while preparing regular reports for management.· Provide project management to ensure required Medicare regulation changes are implemented, tested and approved by Medicare Benefits and Product Strategy department. · Provide project management to ensure required changes due to SNOW ticket resolution is implemented, tested and approved by Medicare Benefits and Product Strategy department.· Ensure the completion of clear and concise benefit intent and member journey as designed by Product Ideation and Strategy are handed over for implementation. · Collaborate with cross-functional teams to define and document clear and detailed claim requirements, ensuring accurate adjudication and payment processes.· Facilitate and document deep-dive discussions with strategy and operational partners to close gaps in benefit design necessary for benefit setup.· Obtain operational partner attestation that benefit design and intent are understood ensuring accurate setup.· Participate in the review of CMS regulatory changes Business Requirements Documentation (BRD) developed by claims configuration partner to ensure the configuration aligns to benefit intent. · Responsible for approving assigned BRD intent so that configuration can commence. · In coordination with Product Implementation leadership, develop a post-production process for continued monitoring of benefit intent alignment by reviewing production reporting and involving escalation protocols to solve claims payment issues and ensuring the correction is completed.· Participate in building test scenarios and QA sign-off of benefit and policy setup for CMS regulatory changes and SNOW ticket solution.· Utilize existing benefit source of truth repository and processes to intake and prioritize work and organize requirement documents.Track and communicate progress. Required Qualifications· 10 years Medicare Advantage experience in any area such as: product, claims, compliance, or operations.· Familiarity of Special Needs Plans (SNP) benefits and cost sharing setup.· Familiarity of the company’s core functions i.e., claim processing, provider billing, benefit configuration, ID Cards, provider set up, etc.· Decision-making, including analysis, creativity, collaboration, and leadership skills.· 6+ years related cross-functional, project management experience.· Must demonstrate strong project management skills: multi-tasking priorities and facilitating/executing multiple projects.· Highly organized and detailed oriented with proof-reading and quality control skills. · Excellent analytical skills.· Proven record of accomplishment of delivery results.· Strong written and verbal communication skills.· Strong interpersonal skills and the ability to work independently and lead in a team environment. Proven ability to collaborate across boundaries. Preferred Qualifications<ul> <li>10 years’ hands-on experience in Medicare benefit development, benefit verification, benefit implementation, claims configuration, claims processing or benefit/clinical policy.</li> <li>Lead multiple team leaders on complex initiatives</li> <li>Intermediate knowledge of the company’s core functions i.e., claim processing, provider billing, benefit configuration, ID Cards, provider set up, etc.</li> <li>PMP (Project Management Professional) or Six Sigma Certification i.e., Lean or Green Belt.</li> </ul> Education· Bachelor's degree or equivalent experiencePay RangeThe typical pay range for this role is:$100,000.00 - $231,540.00 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: 03/31/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

3,277 Jobs