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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 Enrollment Representative position will be supporting multiple health plans. Under general supervision, verifies enrollment status, makes changes to member/client records, and addresses a variety of enrollment questions or concerns. Maintains enrollment databases and coordinates transfer of non-electronic eligibility data. • Responds, researches, and resolves eligibility and/or billing related issues involving member specific information; •Works directly with clients, field marketing offices and/or local claim operations to achieve positive service outcomes.(*) • Monitors daily status reports assessing output for developing trends potentially impacting service levels. (*) • Applies all appropriate considerations associated with technical requirements, legislative/regulatory policies, account structure and benefit parameters in addressing eligibility matters. (*) • Validates benefit plan enrollment information for assigned clients for accuracy and completeness; coordinates the distribution of membership ID cards and partnering with appropriate internal/external support areas involving any requests for ID card customization. (*) • Completes screen coding and data entry requirements related to the systems processes impacting the generation and release of member-specific and plan sponsor products (e.g., ID cards, change applications, audit lists, in-force lists, HIPAA certificates and various reports). (*) • Completes data entry requirements for finalizing new enrollment information as well as for changes and/or terminations. (*) • When necessary, reviews and corrects transaction errors impacting eligibility interfaces and prepares eligibility/enrollment information for imaging. (*) • Interprets and translates client benefits and supporting account structure against internal systems/applications(i.e.,GEBAR, AAS, and CCI). (*) • Determines and communicates standard service charges to internal/external customers related to paper eligibility activities; May include negotiating and communicating charges pertaining to non-standard services. • Partners with other team functions to coordinate the release of eligibility and benefit plan information; reproduces group bills if requested by clients. Required Qualifications <ul> <li>Attention to detail and accuracy.</li> <li>Problem solving skills.</li> <li>Strong organization skills.</li> <li>Understands the impact of work to other teams and downstream support areas.</li> <li>Ability to analyze and research data to make appropriate corrections as necessary.</li> <li>Strong verbal and written communication skills.</li> <li>Workplace flexibility - ability to adapt to change.</li> <li>Required to maintain work schedule within EST time zone (9:30am- 6:00pm EST).</li> <li>Ability to remain available for overtime, with possible weekend work where needed.</li> </ul> Preferred Qualifications <ul> <li>Knowledge of Health Care and/or MCO’s.</li> <li>Knowledge of Enrollment.</li> <li>Knowledge Medicaid and/or Medicare.</li> <li>Knowledge and comfortability with learning different systems and using Excel (VLOOKUP).</li> </ul> Education <ul><li>High School Diploma or equivalent.</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: 05/27/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVSHealth

Eligibility Consultant

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Company: Oak Street Health Title: Sr Analyst,Prod Serv/SupptLocation: RemoteRole Description: As a Sr Analyst, Production Services/Support, your job will be to act as a bridge between the engineering and operations teams during production incidents, Change management, and problem management. You will collaborate with application owners, varying levels of management, and other team members to plan and implement Incident, Problem, and Change management related process improvements, report service management metrics, and serve as a liaison to software vendors and various IT staff for multiple applications and their infrastructure.This role requires on-call availability during evenings, overnight hours, and weekends on a rotating schedule.Core Responsibilities:<ul> <li>Serve as the first responder for major production issues for the Production Management support team.</li> <li>Lead major incident bridges, guiding resolver teams to achieve incident resolution within SLAs.</li> <li>Continuously assess business impact and communicate effectively across various groups and channels, including executive management.</li> <li>Engage necessary resources, including technical, product, and vendor personnel.</li> <li>Provide timely and accurate communication to all affected parties, including executive management.</li> <li>Maintain accurate incident and problem records in ticketing systems (e.g., JIRA, ServiceNow).</li> <li>Document incident timelines and remediation actions.</li> <li>Join forces with problem management in Root Cause Analysis (RCA), corrective actions through closure and proactive problem management.</li> <li>Prepare and present metrics, status and service health reports.</li> <li>Conduct training and knowledge-sharing sessions for various teams and new hires to support standardized processes.</li> <li>Drive the continuous improvement of service management processes and procedures to maintain high service quality.</li> <li>Regularly provide input and status updates for project tracking activities.</li> <li>Maintain the repository of troubleshooting documentation (Run book, Job Aids, Scripts, and Standard Operating procedures)</li> <li>Provide on-call support during non-business hours (team provides 24x7 support for incidents)</li> <li>Write scripts and automate as much of the production support as possible.</li> <li>Other duties as assigned</li> </ul>What are we looking for?<ul> <li>3 years of Production support experience and relevant experience in Service Now, DevOps, TechOps, Monitoring tools, and Process Improvements</li> <li>Preferred ITIL certification</li> <li>Ability to do complex, in-depth analysis and develop innovative methods to accelerate resolution with systems comprising custom developed products, SaaS, and other platforms.</li> <li>Advanced verbal and written communication skills necessary to present/explain technical knowledge, and provide advice to management, regulators, reviewers, and stakeholders.</li> <li>Experience and skills needed for customer support to include a focus on listening, rapport-building, clear communication, friendly and approachable nature, and courtesy and respect.</li> <li>They must possess an operations-oriented mindset and a knack for technical firefighting, diagnostics, troubleshooting and problem solving.</li> <li>Experience with ticketing systems (e.g. ServiceNow, Jira Service Management) is strongly preferred</li> <li>US work authorization.</li> <li>Someone who embodies being "Oaky".</li> </ul> What does being "Oaky" look like?<ul> <li>Radiating positive energy</li> <li>Assuming good intentions</li> <li>Creating an unmatched patient experience</li> <li>Driving clinical excellence</li> <li>Taking ownership and delivering results</li> <li>Being relentlessly determined</li> </ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$46,988.00 - $122,400.00This 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: 06/23/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Sr Analyst,Prod Serv/Suppt (Major Incident Management)

Liberty Mutual Strategic Ventures

Account Consultant II, Risk Control

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position SummaryAetna, a CVS Health company has an outstanding opportunity for a Medical Director. Ready to take your career to the next level with a Fortune 6 company? This is a remote Work at Home position and can be located anywhere in the United States. In this role as Medical Director MPO (Medical Policy &amp; Operations) you will be responsible for providing clinical expertise and business direction in support of medical management programs to promote the delivery of high quality, constituent focused medical care with a focus on clinical and payment policy. This Medical Director provides subject matter expertise to provide clinical support and business direction in these areas. Knowledge of Aetna clinical and coding policy and experience with appeals, claim review, reimbursement issues, and coding is preferable, but a willingness to learn is essential. The Primary Responsibilities of the Medical Director include support of the appeal process, clinical claim review process, pre-certification, and predetermination of covered benefits in the Commercial and Medicare environment. This Medical Director provides subject matter expertise in clinical and payment policy to provide clinical support and business direction in these areas. In this role you will: ◾Participate on work groups as a clinical subject matter expert to identify and promote opportunities to improve the quality and efficiency of health care services. ◾Apply clinical coding and reimbursement expertise to ensure alignment and correct application of Aetna policies and practices to service and payment requests.◾Proactively use data analysis to identify opportunities for quality improvement and positively influence the effective delivery of quality care services. ◾ Be a subject matter expert and internal consultant and payment policy contributor subject matter expertise and internal consultant. ◾Demonstrate the ability to work within and lead as necessary teams comprised of a diverse group of health delivery professionals in order to manage the business objectives of the company. ◾Work Collaboratively with the functional areas. Required Qualifications*Five (5) or more years of experience in Health Care Delivery System e.g., Clinical Practice and Health Care Industry. *Active and current state medical license without encumbrances. *M.D. or D.O., Board Certification in an ABMS recognized specialty including post-graduate direct patient care experience Preferred Qualifications* Health plan/payor experience. * Foundational baseline skills in Medicine, Health Policy, Coding: HCPCS / CPT, Clinical Policy, Reimbursement and Health Care Systems. * Strong communication skills both written and verbal. Education* M.D. or D.O., Board Certification in an ABMS recognized specialty including post-graduate direct patient care experiencePay RangeThe typical pay range for this role is:$174,070.00 - $374,920.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 07/14/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Medical Director (Medical Policy & Operations)

Bring 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.Position Summary <h3>Accountable for driving innovation and operational excellence from ideation to delivery for small to moderate scale, complex, high value initiatives and parts of larger initiatives that impact the delivery of products and services to the internal and external environment.</h3> <ul> <li><h3>Evaluating, designing, and implementing new growth strategies</h3></li> <li><h3>Partnering cross-functionally to identify colleague and customer needs and develop solutions and tactics to drive growth</h3></li> <li><h3>Tracking progress against key milestones, and creating and implementing value-based metrics and analysis to measure outcomes</h3></li> <li><h3>Delivering quantitative and qualitative analyses with slide presentations and storytelling that will simplify complex problems into simple for solutions for leadership to weigh in on</h3></li> <li><h3>Assisting in creating executive level readouts and presentation materials for leadership</h3></li> <li><h3>Developing dashboards to be leveraged by key stakeholders to monitor performance of our business</h3></li> <li><h3>Conducting deep dive analytics to identify opportunities for innovation and process improvement</h3></li> <li><h3>Performing root cause analysis and ad hoc research to diagnose gaps in our workflow and patient experience</h3></li> <li><h3>Simplifying complex datasets and identifying actionable insights that drive value</h3></li> </ul> <h3>This job might be for you if:</h3> <ul> <li><h3>You're energized by being part of a large cross functional team working in a fast-paced environment. You enjoy working in teams with a diverse set of experiences and backgrounds. You listen to others’ ideas with an open mind.</h3></li> <li><h3>You’re a leader. And you know this means more than leading people. You know that it means taking initiative with a project - anticipating the next steps and taking action before asked. You also know that it can mean leading from behind and stepping in with much needed support.</h3></li> <li><h3>You enjoy solving complex problems. If you don’t know how to do something, you work to find the answers. You don’t get frustrated easily when something doesn’t go the way you planned.</h3></li> <li><h3>You can take complicated concepts and communicate them effectively to a variety of audiences. You write well. You pay attention to the details. You can articulate your thoughts eloquently. You have a track record of successfully influencing senior leadership and clients.</h3></li> <li><h3>You are self-motivated. You take ownership of your work and your team’s work. You pay attention to the details. </h3></li> <li><h3>You enjoy spending your weekends reading the health section of the paper or listening to healthcare podcasts. You’re interested in tracking how the industry is evolving and like understanding the intricacies of it.</h3></li> <li><h3>You love numbers and can track a multitude of key operational and financial metrics with ease</h3></li> <li><h3>You “think big” and encourage others to take calculated risks in exploring unconventional ideas and challenging the status quo</h3></li> </ul> <h3> Required Qualifications </h3> <ul> <li><h3>7+ years of experience in healthcare in a role that involves strategic problem solving and/or new product development (e.g., consulting)</h3></li> <li><h3>7+ years of demonstrated organizational skills (e.g. project management experience or managing cross-team/department initiatives with demonstrated success)</h3></li> <li><h3>5+ years of data analytics experience working with large data sets and using Excel, SQL, Python, and/or other equivalent analytics tools</h3></li> <li><h3>5+ years leading cross-functional teams in a matrixed environment</h3></li> </ul> <h3> Preferred Qualifications </h3> <ul> <li><h3>Demonstrated relationship management skills at the senior level; capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously.</h3></li> <li><h3>Demonstrated leadership with relevant initiatives: Business process, enterprise business project strategic planning and analysis, risk management, public health, process improvement (e.g., Lean Six Sigma certification).management/consulting. </h3></li> <li><h3>Demonstrated superior business process, project management.</h3></li> <li><h3>Demonstrated experience successfully implementing change in complex organizations.</h3></li> <li><h3>Experience with enterprise-wide and/or cross-functional large scale initiatives with high degree of complexity.</h3></li> </ul> <h3>Education</h3> <ul><li><h3> Masters degree preferred, but not required. Bachelor's degree required or equivalent experience.</h3></li></ul> Pay RangeThe typical pay range for this role is:$82,940.00 - $182,549.00 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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">Benefits | CVS Health</a>We anticipate the application window for this opening will close on: 02/22/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Senior Manager Project Management

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 SummarySelected candidate will be required to work Central/Eastern time.We are seeking an experienced and dynamic Sr. Manager for our new Client Implementation Team at Meritain Health. This pivotal role will be responsible for leading the team in delivering exceptional client-facing services, ensuring a seamless onboarding experience for our clients and partnering with both internal and external partnersTeam Leadership: Lead, mentor, and develop a high-performing implementation team, fostering a collaborative environment that encourages innovation and continuous improvement. Project Management: Oversee the execution, and delivery of client implementation projects, utilizing best practices in project management to ensure timelines and quality standards are met. Reporting and Analysis: Analyze data to identify trends and areas for improvement, providing actionable insights to both the team and cross-functional onboarding teams. Stakeholder Collaboration: Work closely with cross-functional leaders, including sales, plan teams and support, to ensure alignment on client needs and successful onboarding experience. . Required Qualifications Proven track record of leading successful teams in project management or implementation in operational or healthcare settings.. Strong analytical skills with experience in reporting and data analysis. Excellent communication and interpersonal skills, with the ability to engage effectively with clients and team members. Proven ability to manage multiple projects simultaneously in a fast-paced environment. Preferred Qualifications Presentation Skills: Strong ability to create and deliver engaging presentations to diverse audiences.Excel Skills: Proficiency in Microsoft Excel, data analysis, and reporting. Salesforce Experience: Familiarity with Salesforce, including ability to create reports and maneuver through multiple objects easily. Education Bachelor’s degree in Business, Project Management, a related field or 3+ years related experience.Pay RangeThe typical pay range for this role is:$67,900.00 - $199,144.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 04/27/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Senior Manager New Group Implementation - Meritain Health

Your work days are brighter here.At Workday, it all began with a conversation over breakfast. When our founders met at a sunny California diner, they came up with an idea to revolutionize the enterprise software market. And when we began to rise, one thing that really set us apart was our culture. A culture which was driven by our value of putting our people first. And ever since, the happiness, development, and contribution of every Workmate is central to who we are. Our Workmates believe a healthy employee-centric, collaborative culture is the essential mix of ingredients for success in business. That’s why we look after our people, communities and the planet while still being profitable. Feel encouraged to shine, however that manifests: you don’t need to hide who you are. You can feel the energy and the passion, it's what makes us unique. Inspired to make a brighter work day for all and transform with us to the next stage of our growth journey? Bring your brightest version of you and have a brighter work day here.At Workday, we value our candidates’ privacy and data security. Workday will never ask candidates to apply to jobs through websites that are not Workday Careers. Please be aware of sites that may ask for you to input your data in connection with a job posting that appears to be from Workday but is not.In addition, Workday will never ask candidates to pay a recruiting fee, or pay for consulting or coaching services, in order to apply for a job at Workday.About the TeamAs a member of our diverse and skilled North America Solution Consulting team, you will have the opportunity to communicate and demonstrate the power of Workday's applications to prospects and customers alike. It is this team's job to bring the value of Workday solutions to life and showcase how the world of work can be transformed. Along with working closely with our sales counterparts, this team also sits at the exciting intersection of our Product Management, Consulting Services, Marketing, and Value Management teams, providing exposure to various areas of the business.About the RoleThis is your chance to guide a world class Solution Consulting Team focused on Financials and responsible for selling to prospects and customers in State and Local government. You will be aided and surrounded by some of the first-rate and brightest people in the industry; people who care about our customers and care about assisting them accomplish the results they seek. You will oversee the performance and delivery in support to the sales organization within the region while contributing to the growth of the region and department. Open to traveling 30%About YouBasic Qualifications:<ul><li> Manager, Solution Consultant <ul> <li>5+ years in a sales-related role (sales, presales, value management, customer success, etc.) selling enterprise software</li> <li>2+ years of experience leading people and/or mentoring colleagues on sales opportunity strategy</li> <li>3+ years of working in or selling to Human Resources organizations or have practical HCM experience like Workforce Management, Benefit, comp etc.</li> </ul> Sr. Manager, Solution Consultant <ul> <li>7+ years in a sales-related role (sales, presales, value management, customer success, etc.) selling enterprise software</li> <li>4+ years of experience leading people and/or mentoring colleagues on sales opportunity strategy</li> <li>5+ years of working in or selling to Human Resources organizations or have practical HCM experience like Workforce Management, Benefit, comp etc.</li> </ul> </li></ul>Other Qualifications:<ul> <li>Excellent verbal and written communication skills</li> <li>Experience in a fast-paced work environment</li> <li>Strong problem-solving and critical thinking skills</li> <li>A track record of hiring and retaining innovative employees</li> <li>Consistent achievement or overachievement of assigned goals and targets</li> <li>Success in mentoring coworkers in ways that allowed them to learn new skills and achieve career goals</li> <li>Collaborative with those in other roles to work towards shared goals</li> <li>A history of using data to support your decision-making process</li> </ul> Workday Pay Transparency StatementThe annualized base salary ranges for the primary location and any additional locations are listed below. Workday pay ranges vary based on work location. As a part of the total compensation package, this role may be eligible for the Workday Bonus Plan or a role-specific commission/bonus, as well as annual refresh stock grants. Recruiters can share more detail during the hiring process. 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. For more information regarding Workday’s comprehensive benefits, please <a href="https://workdaybenefits.com/us/welcome-to-workday-benefits/prospective-workmates" target="_blank">click here</a>.Primary Location: USA.VA.McLean (Tyson's Corner) Primary Location Base Pay Range: $142,800 USD - $214,200 USD Additional US Location(s) Base Pay Range: $142,800 USD - $214,200 USDIf performed in Colorado, the pay range for this job is $ - $ USD based on min and max pay range for that role if performed in CO.The application deadline for this role is the same as the posting end date stated as below: 06/09/2025 Our Approach to Flexible Work With Flex Work, we’re combining the best of both worlds: in-person time and remote. Our approach enables our teams to deepen connections, maintain a strong community, and do their best work. We know that flexibility can take shape in many ways, so rather than a number of required days in-office each week, we simply spend at least half (50%) of our time each quarter in the office or in the field with our customers, prospects, and partners (depending on role). This means you'll have the freedom to create a flexible schedule that caters to your business, team, and personal needs, while being intentional to make the most of time spent together. Those in our remote "home office" roles also have the opportunity to come together in our offices for important moments that matter.Pursuant to applicable Fair Chance law, Workday will consider for employment qualified applicants with arrest and conviction records.Workday is an Equal Opportunity Employer including individuals with disabilities and protected veterans.Are you being referred to one of our roles? If so, ask your connection at Workday about our Employee Referral process!

Workday

Manager, Solution Consultant - Workday Financials - State and Local Government

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position SummaryAetna International is looking for a motivated, energetic, team player to join the Large Group Account Management team. This individual will have overall responsibility of supporting a book of business that represents some of Aetna International's largest customers. The ideal candidate will be located in the Eastern Time Zone. They will need to foster strong relationships with customers and producers and they will play a key role in supporting the continued growth of Aetna International's brand in the marketplace.As an Associate Account Manager, the candidate will:<ul> <li>Provides proactive account service management in support of business objectives and to achieve customer satisfaction. </li> <li>Develops and executes customer service strategy. </li> <li>Meets with customers frequently via phone and video conferencing, leads calls, facilitates meetings, and meets customers in person on occasion. </li> <li>Engages in frequent email correspondence, discusses service levels and expectations, shared process improvements, discusses operation of benefit plans. </li> <li>Identifies gaps in service, determines root cause and develops an actionable solution. </li> <li>Engages with other Aetna departments in issue resolution and maintains a service log. </li> <li>The candidate will support client needs in multiple times zones. </li> <li>Responds to customers' requests for network analysis, benefit plan design changes, benefit questions, billing issues, member eligibility and claims. </li> <li>Collaborates with the Account Executive and the sales team to achieve growth/renewal activities including installation, plan set up, eligibility, billing and contract drafting by working proactively with support areas, signs off on ID Cards, Manages member communications strategies for each customer.</li> </ul> Required Qualifications<ul> <li>2+ years of industry or customer service experience preferably with complex accounts.</li> <li>An active resident insurance producer license, as required by state law or obtain an insurance producer license within 60 days of start date.</li> <li>Must be located in Eastern Time Zone.</li> <li>Insurance industry experience</li> </ul> Preferred Qualifications<ul><li>Background in international health insurance</li></ul> Education<ul><li>Bachelor's Degree or equivalent work experience (HS diploma + 4 years relevant experience).</li></ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$43,888.00 - $93,574.00This 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: 05/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Associate Account Manager (Aetna International) EST

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.

80 Jobs in Home, PA 15747, USA