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<h3> Position Summary </h3> Technology | PxE HXM | SuccessFactors Functional Engineer Position summary As a SuccessFactors Functional Engineer, you will play an important role in implementing and optimizing SuccessFactors solutions, with a particular focus on the Employee Central module. Your expertise will be pivotal in delivering solutions that delight customers and users, while also driving tangible value for Deloitte's business investments. You will leverage your expertise in SuccessFactors to design, configure, and deploy high-quality, outcome-focused solutions, consistently demonstrating your strong track record. The ideal candidate will be a dependable team player, collaborating with cross-functional teams to ensure the successful implementation and optimization of SuccessFactors solutions. Recruiting for this role ends on March 17, 2025 Work you’ll do <ul> <li> Outcome-Driven Accountability: Embrace and drive a culture of accountability for customer and business outcomes. Develop solutions that solve complex HR problems with valuable outcomes, ensuring high-quality, lean designs and implementations.</li> <li> Technical Leadership and Advocacy: Serve as the technical advocate for SuccessFactors solutions, ensuring module configuration integrity, feasibility, and alignment with business and customer goals. Lead requirement analysis, design, configuration, unit testing, integrations, and support.</li> <li> Engineering Craftsmanship: Maintain accountability for the integrity of the configuration design, implementation, quality, data, and ongoing maintenance and operations. Be hands-on, self-driven, and continuously learn new approaches and frameworks. Create functional/technical specifications, and implement high-quality, supportable, scalable configurations ensuring all quality KPIs are met or exceeded. Demonstrate collaborative skills to work effectively with diverse teams.</li> <li> Customer-Centric Engineering: Develop lean solutions through rapid, inexpensive experimentation to solve customer needs. Engage with customers and product teams before, during, and after delivery to ensure the right solution is delivered at the right time.</li> <li> Incremental and Iterative Delivery: Adopt a mindset that favors action and evidence over extensive planning. Utilize a leaning-forward approach to navigate complexity and uncertainty, delivering lean, supportable, and maintainable solutions.</li> <li> Cross-Functional Collaboration and Integration: Work collaboratively with empowered, cross-functional teams including product management, experience, engineering, and delivery. Integrate diverse perspectives to make well-informed decisions that balance feasibility, viability, usability, and value. Foster a collaborative environment that enhances team synergy and innovation.</li> <li> Advanced Technical Proficiency: Possess deep expertise in modern product engineering practices and principles, including Agile methodologies and DevSecOps to deliver daily product deployments using full automation, if available, documenting changes, tracking versions, performing regular backups, and deploying configuration bundles into production via Instance Sync with all quality checks through SDLC lifecycle. Strive to be a role model, leveraging these techniques to optimize solutioning and product delivery. Demonstrate understanding of the full lifecycle product development, focusing on continuous improvement and learning.</li> <li> Domain Expertise: Quickly acquire domain-specific knowledge relevant to the business or implemented SuccessFactors modules. Translate business/user needs, architectures, and UX/UI designs into functional/technical specifications. Be a valuable, flexible, and dedicated team member, supportive of teammates, and focused on quality and tech debt payoff.</li> <li> Effective Communication and Influence: Exhibit exceptional communication skills, capable of articulating complex technical concepts clearly and compellingly. Inspire and influence teammates and product teams through well-structured arguments and trade-offs supported by evidence. Create coherent narratives that align technical solutions with business objectives.</li> <li> Engagement and Collaborative Co-Creation: Engage and collaborate with product engineering teams at all organizational levels, including customers as needed. Build and maintain constructive relationships, fostering a culture of co-creation and shared momentum towards achieving product goals. Align diverse perspectives and drive consensus to create feasible solutions.</li> </ul> The successful candidate will have and/or be able to: <ul> <li>Strong SAP SuccessFactors platform foundation with the understanding of OOPs, data structures, algorithms, configuration, user permissions, etc. </li> </ul> <ul> <li>Advanced knowledge is required in creating and maintaining foundation and generic objects, workflows, configuring business rules, event reasons, Metadata Framework (MDF), Role-Based Permissions (RBP), leveraging SAP Cloud Platform Integration (CPI) or Boomi/MuleSoft, and data exchange formats (XML/JSON).</li> <li>Experience in AI/ML and GenAI.</li> </ul> <ul> <li>Excellent interpersonal and organizational skills, with the ability to handle diverse situations, complex projects, and changing priorities, behaving with passion, empathy, and care.</li> </ul> The team US Deloitte Technology Product Engineering has modernized software and product delivery, creating a scalable, cost-effective model that focuses on value/outcomes that leverages a progressive and responsive talent structure. As Deloitte’s primary internal development team, Product Engineering delivers innovative digital solutions to businesses, service lines, and internal operations with proven bottom-line results and outcomes. It helps power Deloitte’s success. It is the engine that drives Deloitte, serving many of the world’s largest, most respected companies. We develop and deploy cutting-edge internal and go-to-market solutions that help Deloitte operate effectively and lead in the market. Our reputation is built on a tradition of delivering with excellence. Qualifications Required: <ul> <li>5+ years proven experience with SuccessFactors, specifically in implementing and optimizing the Employee Central module. SAP SuccessFactors Employee Central Certification is required.</li> <li>Limited immigration sponsorship may be available</li> <li>Ability to travel 0-10%, on average, based on the work you do and the clients and industries/sectors you serve</li> </ul> Preferred: <ul> <li> A bachelor’s degree in computer science, software engineering, or a related discipline and/or advanced degree (e.g., MS)</li> <li> Previous experience using methodologies &amp; tools like, XP, Lean, SAFe, DevSecOps, SRE, ADO, GitHub, SonarQube, etc. to deliver high quality products rapidly.</li> <li>Previous experience with JavaScript, Groovy, Python, SQL, and planning and configuring architectural layouts for various BizX suite modules.</li> </ul> Information for applicants with a need for accommodation: <a href="https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html" target="_blank">https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html</a> The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $93,000 - $191,000. You may also be eligible to participate in a discretionary annual incentive program, subject to the rules governing the program, whereby an award, if any, depends on various factors, including, without limitation, individual and organizational performance. EA_ExpHire EA_ITS_ExpHire Recruiting tips From developing a stand out resume to putting your best foot forward in the interview, we want you to feel prepared and confident as you explore opportunities at Deloitte. <a href="https://www2.deloitte.com/us/en/pages/careers/topics/recruiting-tips.html" target="_blank">Check out recruiting tips from Deloitte recruiters.</a> Benefits At Deloitte, we know that great people make a great organization. We value our people and offer employees a broad range of benefits. <a href="https://www2.deloitte.com/us/en/pages/careers/articles/life-at-deloitte-benefits-and-rewards.html" target="_blank">Learn more about what working at Deloitte can mean for you.</a> Our people and culture Our inclusive culture empowers our people to be who they are, contribute their unique perspectives, and make a difference individually and collectively. It enables us to leverage different ideas and perspectives, and bring more creativity and innovation to help solve our client most complex challenges. This makes Deloitte one of the most rewarding places to work. Our purpose Deloitte’s purpose is to make an impact that matters for our clients, our people, and in our communities. We are creating trust and confidence in a more equitable society. At Deloitte, purpose is synonymous with how we work every day. It defines who we are. We are focusing our collective efforts to advance sustainability, equity, and trust that come to life through our core commitments. <a href="https://www2.deloitte.com/us/en/pages/about-deloitte/articles/purpose-at-deloitte-us.html" target="_blank">Learn more about Deloitte's purpose, commitments, and impact.</a> Professional development From entry-level employees to senior leaders, we believe there’s always room to learn. We offer opportunities to build new skills, take on leadership opportunities and connect and grow through mentorship. From on-the-job learning experiences to formal development programs, our professionals have a variety of opportunities to continue to grow throughout their career.

Deloitte

Technology | PxE HXM | SuccessFactors Functional Engineer

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: Oversee the overall client satisfaction for all accounts <ul> <li>Manage account renewal and retention processes and assist sales team in generating new client referrals</li> <li>Identify new services and profit enhancement opportunities within existing clients</li> <li>Collaborate with internal departments regarding client needs and requests, including understanding and interpreting contractual obligations to meet business needs</li> <li>Oversee the identification of client complaints and resolution of issues related to internal processes and systems</li> <li>Implement client specific corrective action plans and ensure timely submissions of complaints process</li> <li>Oversee the reporting and client documentation within Salesforce.com</li> <li>Research competitive intelligence and relevant market information to enhance client experience</li> <li>Facilitate development of custom proposals for new and existing clients</li> <li>Ability to travel</li> </ul>Education/Experience: Bachelor’s degree in Healthcare or Business Administration, Marketing, related field or equivalent experience. 7+ years of account management experience, preferably in specialty pharmacy, pharmacy benefit management, and/or a managed care environment. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.Pay Range: $110,900.00 - $205,000.00 per yearCentene 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

Centene Corporation

Director, Account Management

<h3> Position Summary </h3> Learning and Development (L&amp;D) Project Lead Specialist The Talent Innovation and Solutions Digital &amp; Analytics team implements and supports core, firmwide Talent applications leveraged to support key Talent strategies and processes. As Talent identifies opportunities to transform the way we deliver services, technology solutions will need to be implemented or updated to provide an enhanced experience to our professionals and to drive operational efficiency and effectiveness improvements across Talent. We are seeking a motivated and organized team member to join our team, focusing on Talent project activities and systems that are part of the Growth &amp; Development portfolio. As a Lead Specialist, you will directly support and manage various aspects of planning and deploying technical programs and projects across multiple client projects/engagements. You will ensure the successful implementation of vendor and/or custom solutions, adhering to project timelines and budget constraints. Additionally, you will provide strategic direction and business guidance to Talent stakeholders and technical teams, while supervising and coordinating team efforts to execute project plans throughout the program or project lifecycle. Recruiting for this role ends on March 14th, 2025. Work you’ll do As the our Lead Specialist, you will: <ul> <li> Project Management: <ul> <li>Lead up to two concurrent project implementations while supporting up to three live systems/projects in post-deployment activities.</li> <li>Plan, schedule, estimate, forecast, coordinate, and manage the delivery of all project deliverables and related initiatives.</li> <li>Define technical requirements for new initiatives/projects, ensuring compliance with firm standards and security protocols.</li> <li>Understand, assess, and review business issues, translating them into technical terminology for discussions with Deloitte Technology and support teams.</li> <li>Monitor and report on the status of project efforts, lead project status activities, and proactively manage project issues and risks (RAID log). Propose recommendations and solutions to resolve potential conflicts and risks.</li> </ul> </li> <li> Training and Documentation: Conduct training sessions on system/project-related topics and collaborate with stakeholders and support teams to update current documentation.</li> <li> PMO Support: Support the Talent Innovation and Solutions Digital &amp; Analytics Manager as the PMO Lead for various operations activities and technology projects as applicable.</li> <li> Resource Management: Utilize shared project team sites, OneNote notebooks, Smartsheet, and mailboxes to ensure structured communication and access to materials and documents for all project team members.</li> </ul> Required Qualifications <ul> <li>Bachelor’s Degree</li> <li>Minimum of 6 years of relevant experience with project management support to implement new Talent systems and processes, from ideation thru deployment</li> <li>Proficient Microsoft Office skills (e.g., PowerPoint, Excel, OneNote, Word, Teams); Knowledge of relevant applications and development life cycles</li> <li>Ability to travel 5%, based on the work you do and the clients and industries/sectors you serve</li> <li>Limited immigration sponsorship may be available</li> </ul> Preferred Qualifications <ul> <li>Knowledge of Learning and Development (L&amp;D) technologies</li> <li>Knowledge of the professional services industry</li> <li>PMP certification</li> </ul> The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $88,600- $163,100. Information for applicants with a need for accommodation: <a href="https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html" target="_blank">https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html</a> EA_ExpHire Recruiting tips From developing a stand out resume to putting your best foot forward in the interview, we want you to feel prepared and confident as you explore opportunities at Deloitte. <a href="https://www2.deloitte.com/us/en/pages/careers/topics/recruiting-tips.html" target="_blank">Check out recruiting tips from Deloitte recruiters.</a> Benefits At Deloitte, we know that great people make a great organization. We value our people and offer employees a broad range of benefits. <a href="https://www2.deloitte.com/us/en/pages/careers/articles/life-at-deloitte-benefits-and-rewards.html" target="_blank">Learn more about what working at Deloitte can mean for you.</a> Our people and culture Our inclusive culture empowers our people to be who they are, contribute their unique perspectives, and make a difference individually and collectively. It enables us to leverage different ideas and perspectives, and bring more creativity and innovation to help solve our client most complex challenges. This makes Deloitte one of the most rewarding places to work. Our purpose Deloitte’s purpose is to make an impact that matters for our clients, our people, and in our communities. We are creating trust and confidence in a more equitable society. At Deloitte, purpose is synonymous with how we work every day. It defines who we are. We are focusing our collective efforts to advance sustainability, equity, and trust that come to life through our core commitments. <a href="https://www2.deloitte.com/us/en/pages/about-deloitte/articles/purpose-at-deloitte-us.html" target="_blank">Learn more about Deloitte's purpose, commitments, and impact.</a> Professional development From entry-level employees to senior leaders, we believe there’s always room to learn. We offer opportunities to build new skills, take on leadership opportunities and connect and grow through mentorship. From on-the-job learning experiences to formal development programs, our professionals have a variety of opportunities to continue to grow throughout their career.

Learning and Development Project Lead Specialist

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: Analyze integrated and extensive datasets to extract value, which directly impacts and influences business decisions. Work collaboratively with key business stakeholders to identify areas of value, develop solutions, and deliver insights to reduce overall cost of care for members and improve their clinical outcomes.<ul> <li>Interpret and analyze data from multiple sources including healthcare provider, member/patient, and third-party data</li> <li>Support execution of large-scale projects with limited direction from leadership</li> <li>Identify and perform root-cause analysis of data irregularities and present findings and proposed solutions to leadership and/or customers</li> <li>Manage multiple, variable tasks and data review processes with limited supervision within targeted timelines</li> <li>Support the design, testing, and implementation of process enhancements and identify opportunities for automation</li> <li>Apply expertise in quantitative analysis, data mining, and the presentation of data to see beyond the numbers and understand how customers interact with analytic products</li> <li>Support multiple functions and levels of the organization and effectively, both verbally and visually, communicate findings and insights to non-technical business partners</li> <li>Independently engage with customers and business partners to gather requirements and validate results</li> <li>Communicate and present data-driven insights and recommendations to both internal and external stakeholders, soliciting and incorporating feedback when required</li> <li>Performs other duties as assigned</li> <li>Complies with all policies and standards</li> </ul>Education/Experience: Bachelor’s degree in business, economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance or related field or equivalent experience. 2+ years of experience working with large databases, data verification, and data management, or 1+ years IT experience. Healthcare analytics experience preferred. Working knowledge of SQL/query languages. Preferred knowledge of programmatic coding languages such as Python and R. Knowledge of statistical, analytical, or data mining techniques including basic data modeling, trend analysis, and root-cause analysis preferred. Preferred knowledge of modern business intelligence and visualization tools. Experience in provider contracting, claims pricing, financial reporting/analysis, data modeling, statistical modeling, data science, or geospatial/reimbursement analysis preferred.Pay Range: $55,100.00 - $99,000.00 per yearCentene 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

Data Analyst II Healthcare Analytics

Company Description Northwestern Mutual has been helping families and businesses achieve financial security for over 160 years. With a focus on personalized, holistic financial solutions, including insurance and investments, we aim to empower people to make the most of life today and in the future. Trusted by over 4.5 million individuals, we manage substantial assets and provide various financial services. Our commitment to diversity and growth drives us to shape a stronger financial future for all. Role Description If you are outgoing, have high energy, and love new challenges everyday then this is something you want to explore. This is an excellent opportunity for individuals with an entrepreneur mindset, who desire to run their own business, be their own boss, flexibility to make their own schedule, and still have the luxury to be backed by a Fortune 100 Company. While 2 years of management experience is preferred, it is not needed. What is a MUST, is someone who strives in a fast pace environment with new challenges daily. Responsibilities for Year 1: -Learn to build your own Financial Planning Practice by guiding and coaching clients toward their financials goals -Learn to be a multiplier and lead by example -Learn how to attract and build a team -Pass Exams: Life, Health, SIE, Series 6/7, Series 63/66 Responsibilities for Year 2: -Have an official Leadership Role, and mentor new advisors to build what you have built in Year 1 -Continue to run your own Financial Planning Practice Responsibilities for Year 3 through Retirement: we will discuss in our interview, as that is something that is very unique but that you control. You are in the driver seat. You decide where this goes long term. We are building entrepreneurs and leaders to grow a business and a team. There are multiple forms of compensation, bonuses, and benefits. Job Type: Full-time Pay: $90,000.00 - $250,000.00 per year Benefits: <ul> <li>401(k)</li> <li>401(k) matching</li> <li>Dental insurance</li> <li>Employee assistance program</li> <li>Flexible schedule</li> <li>Health insurance</li> <li>Health savings account</li> <li>Life insurance</li> <li>Parental leave</li> <li>Professional development assistance</li> <li>Referral program</li> <li>Retirement plan</li> <li>Tuition reimbursement</li> <li>Vision insurance</li> </ul> Compensation Package: <ul> <li>Bonus opportunities</li> <li>Commission pay</li> <li>Signing bonus</li> </ul> Application Question(s): <ul><li>Do you know someone that works at Northwestern Mutual? If so, what is their name?</li></ul> Ability to Commute: <ul><li>Kansas City, MO 64108 (Required)</li></ul> Work Location: In person

Northwestern Mutual

Planning Specialist

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Provides in-depth business knowledge and advanced technical support to one or more business areas through developed and ad hoc analysis/reporting , as well as designing and programming complex, new processes/reports. Acts as subject matter expert for department or business unit on business systems/applications. Analyzes company functions, processes, and activities to improve computer-based business applications for the most effective use of money, materials, equipment, and people. Performs application/system design and implementation. Documents development requirements. Consults with end users to test and debug applications to meet client needs.<ul><li>Develops ad-hoc reports to conduct data analysis and validation.</li></ul><ul><li>Confers with area/department to analyze current operational procedures and trends and identify problems.</li></ul><ul><li>Conducts business analysis and recommends technical alternative solutions to management as to course of action that best meets the organization's goals.</li></ul><ul><li>Research, evaluate and assess the financial impact of issues identified in data/processes.</li></ul><ul><li>Analyzes requirements, procedures, and problems to automate processing or to improve existing business systems.</li></ul><ul><li>Creates multiuser, real-time, robust database solutions.</li></ul><ul><li>Acts as subject matter expert to provide business and technical expertise in requirements solicitation, system analysis, technical design, programming and documentation of business applications/systems.</li></ul><ul><li>May be responsible for monitoring and reporting to management on the status of departmental projects: Anticipates and identifies issues that could inhibit achieving the project goals and objectives, and implementing corrective actions and mitigation strategies.</li></ul><ul><li>Provides oversight and resolves complex issues, optimizing performance, resolving problems, and providing timely follow-up on identified issues.</li></ul><ul><li>Provides guidance and training to staff on process, procedures and issue resolution.</li></ul><ul> <li>Performs other duties as assigned.</li> <li>Complies with all policies and standards</li> </ul>Education/Experience: Required A Bachelor's Degree in a related field: Required or equivalent work experience in technical data analysis, conducting system analysis meetings, developing system design documents, developing project plans with achievable milestones and deadlines, and mediating different department demands to gain approvals on system scope and design. Preferred Other a Master's degree in a related field, i.e., Mathematics, Computer Science, etc may be considered in lieu of some of the required experience (not to exceed 2 years) Candidate Experience: Preferred 1+ year of experience in Healthcare Required 4+ years of experience in relevant programming to include SAS, SQL, VB.NET, or Oracle (or similar depending upon departmental requirements) Required 3+ years of experience in related business analysisPreferred 1+ year of experience in ASP/ASP.NETPreferred experience with HEDISPreferred experience working within a healthplan Pay Range: $86,000.00 - $154,700.00 per yearCentene 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

Senior Vendor Business Technical Analyst

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 SummaryAetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Cardiology) that can be remote based, work from home.This role can be remote based anywhere in the US.The Medical Director (Cardiology) will be a Subject Matter Expert (SME) with a background in Cardiology specialty, including post-graduate direct patient care experience specifically. This role expands Aetna's medical management programs to address member needs across the continuum of care. In this role you'll support the Medical Management staff ensuring timely and consistent responses to members and providers. You will lead all aspects of utilization review/quality assurance, directing case management. In this role you will provide clinical expertise and business direction in support of medical management programs through participation in clinical team activities You'll 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 In addition, you will be responsible for predetermination reviews ad reviews of claim determinations, providing clinical, coding, and reimbursement expertise. Required Qualifications* 2 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 Cardiology specialty including post-graduate direct patient care experience specifically Preferred Qualifications * Previous healthcare insurance experience. Education * M.D. or D.O.,Board Certification in a Cardiology specialty.Pay 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. 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: 05/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVSHealth

Medical Director - (Cardiology)

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. Applicants for this job have the flexibility to work remote from home anywhere in the Continental United States.Position Purpose: Plan, organize, monitor, and oversee programs utilizing cross functional teams to deliver defined requirements and meet business needs and strategic objectives.<ul> <li>Support business department initiatives that promote, quality, safety and cost of care opportunity.</li> <li>Responsible for gathering requirements, creating plans and schedules, managing resources, and facilitate project execution and deployment.</li> <li>Utilize corporate and industry standard tools and techniques to effectively oversee programs according to department procedures.</li> <li>Maintain detailed business process documentation including meeting minutes, action items, issues lists and risk management plans as applicable.</li> <li>Create and monitor all department deliverables to ensure adherence to quality standards including clinical reporting documents, related reference materials, and policy and procedure documentation.</li> <li>Communicate program status to management and key stakeholders.</li> <li>Identify resources, resolve issues, and mitigate risks.</li> <li>Identify requirements, procedures and problems to improve existing processes.</li> <li>Coordinate cross-functional meetings with various functional areas to meet overall stakeholder expectations and business objectives.</li> <li>Manage projects through the full project life cycle.</li> <li>Provide leadership and effectively communicate project status to all stakeholders.</li> <li>Negotiate with project stakeholders to identify and secure resources, resolve issues and mitigate risks.</li> <li>Performs other duties as assigned.</li> <li>Complies with all policies and standards.</li> </ul>Education/Experience:<ul> <li>Bachelor’s degree in related field or equivalent experience.</li> <li>3+ years of project management.</li> <li>Health care experience preferred. </li> </ul>Pay Range: $68,700.00 - $123,700.00 per yearCentene 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

Program Manager II - Provider Delegation

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. Applicants for this role will have the flexibility to work remotely anywhere in the Continental United States.Position Purpose: Responsible for the strategic and operational oversight across business segment to drive visibility on operating model performance and implement strategic initiatives to ensure optimal efficiency and effectiveness. Support implementation of short and long-term strategic priorities, business objectives through strategic planning, project management, and operational execution, and business and market development opportunities.<ul><li>Develop, prioritize and execute business process excellence initiatives to identify opportunities for operational efficiencies across the segment.</li></ul><ul><li>Support business development strategy and initiatives across the segment.</li></ul><ul><li>Translate strategic objectives from business transformation initiatives into actionable plans and ensure flawless execution of those plans.</li></ul><ul><li>Lead efforts to identify barriers to operational success of the segment and drive solutions to address business needs and ensure operational excellence.</li></ul><ul><li>Lead efforts to partner with leadership team and stakeholders to define and deploy key performance indicators to monitor past, current and future performance of business processes.</li></ul><ul><li>Develop and oversee data analysis efforts to produce accurate, efficient, and timely data reporting models, including federal and state deliverables, contract deliverables, ad hoc reports, and internal reports for all functional areas within the segment.</li></ul><ul><li>Partner with operational leadership teams to resolve complex technology, data, and process-based issues, gaps, and risks.</li></ul><ul> <li>Partner with operational leadership teams to design and implement workflow optimization and automation processes.</li> <li>Performs other duties as assigned</li> </ul><ul><li>Complies with all policies and standards</li></ul>Education/Experience:<ul> <li>Bachelor's degree in business, healthcare administration, related field, or equivalent experience.</li> <li>8+ years of relevant experience, including project management, implementations, systems, reporting and/or process improvement in the healthcare industry. </li> </ul>Licenses/Certifications: <ul><li>Project Management Professional Certificate (PMP), Health Care Certification, Six Sigma or similar certification preferred.</li></ul>Pay Range: $145,100.00 - $268,800.00 per yearCentene 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

Senior Director, Operational Strategy & Excellence

<h3> Position Summary </h3> 191538NetSuite Implementation Consultant Digital Customer is collaborating with clients in ways never thought possible before. We are creating, developing, designing and implementing in ways that will change the digital landscape forever. Our Digital Customer strategy is to help clients define strategies, build brands, create experiences, and deliver platforms. Work you’ll do A Consultant at Deloitte works within an engagement team and is responsible for identifying business requirements, requirements management, functional design, prototyping, process design (including scenario design, flow mapping), testing, training, defining support procedures, leading work streams and supporting implementations. Implement and deploy NetSuite solutions: <ul> <li>Working within an engagement team, a Senior NetSuite Consultant is responsible for identifying business requirements, requirements management, functional design, prototyping, process design (including scenario design, flow mapping), testing, training, defining support procedures, leading work streams and supporting implementations</li> <li>Provide NetSuite consulting expertise utilizing industry experience, business analysis, best practices and a pragmatic mindset to facilitate clients’ most complex requirements.</li> <li>Implement and deploy NetSuite solutions accommodating unique industry business and management processes, regulatory requirements and other business requirements.</li> <li>Create functional requirements as an input to application design.</li> <li>Build, develop and test detailed functional designs for business solution components and prototypes.</li> <li>Drive test planning, execution, and optimization support.</li> <li>Conduct business process mapping and requirements gathering sessions with new customers to determine configuration requirements both on-site and remote.</li> <li>Prepare Business Requirements and Technical Scoping Documents resulting from the above noted mapping sessions to provide proposed solutions for the requirements for customer approval.</li> <li>Build, develop and test detailed scripted customized solutions and prototypes.</li> <li>Troubleshoot issues that arise during configuration sessions.</li> <li>Provide on-going post implementation support to optimize user adoption and NetSuite configuration.</li> </ul> The team Digital Customer Our Digital Customer team focuses on designing and implementing sales and service experiences, capabilities, and architectures to bring customer strategies to life. Our ambition is to be the best in the world at driving customer transformation through the development of clever commercial strategies, distinctive experiences, and the application of digital technologies. We help make the “creative digital consultancy” real and in doing so, make new markets. Professionals will serve our clients through the following types of work: <ul> <li> Customer Operations | modernize, deploy, and operate office capabilities and business processes across sales operations, quote-to-cash, and revenue management team</li> <li> Sales Excellence &amp; Service Excellence | Integrate the latest technologies with leading-edge strategies, insights, experiences, and talent to enable outstanding customer service</li> <li> Salesforce | Deloitte unleashes the powerful Salesforce platform for our clients to drive the best possible outcomes and redefine engagement. We innovate like never before by creatively using technology to help enhance digital customer and employee experiences for our clients.</li> </ul> Qualifications Required <ul> <li>Bachelor's Degree or equivalent experience</li> <li>3+ years of relevant consulting or industry experience</li> <li>2+ years of experience with NetSuite ERP implementations</li> <li>Ability to travel up to 50% on average, based on the work you do and the clients and industries/sectors you serve </li> <li>Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future.</li> <li>Limited immigration sponsorship may be available </li> </ul> Preferred <ul> <li>Experience with NetSuite integrations and customizations</li> <li>A Certified NetSuite Professional</li> <li>Experience with full life cycle NetSuite implementations</li> <li>Bachelor's or Advanced degree in accounting, business, finance or other business-related field, computer science, information systems, or other technology-related field</li> </ul> Information for applicants with a need for accommodation: <a href="https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html" target="_blank">https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html</a> The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $97,875 to $163,125. You may also be eligible to participate in a discretionary annual incentive program, subject to the rules governing the program, whereby an award, if any, depends on various factors, including, without limitation, individual and organizational performance. #Customer_US #SS_US Requisition code: 191538 Recruiting tips From developing a stand out resume to putting your best foot forward in the interview, we want you to feel prepared and confident as you explore opportunities at Deloitte. <a href="https://www2.deloitte.com/us/en/pages/careers/topics/recruiting-tips.html" target="_blank">Check out recruiting tips from Deloitte recruiters.</a> Benefits At Deloitte, we know that great people make a great organization. We value our people and offer employees a broad range of benefits. <a href="https://www2.deloitte.com/us/en/pages/careers/articles/life-at-deloitte-benefits-and-rewards.html" target="_blank">Learn more about what working at Deloitte can mean for you.</a> Our people and culture Our diverse, equitable, and inclusive culture empowers our people to be who they are, contribute their unique perspectives, and make a difference individually and collectively. It enables us to leverage different ideas and perspectives, and bring more creativity and innovation to help solve our client most complex challenges. This makes Deloitte one of the most rewarding places to work. <a href="https://www2.deloitte.com/us/en/pages/about-deloitte/articles/deloitte-inclusion.html" target="_blank">Learn more about our inclusive culture.</a> Our purpose Deloitte’s purpose is to make an impact that matters for our clients, our people, and in our communities. We are creating trust and confidence in a more equitable society. At Deloitte, purpose is synonymous with how we work every day. It defines who we are. We are focusing our collective efforts to advance sustainability, equity, and trust that come to life through our core commitments. <a href="https://www2.deloitte.com/us/en/pages/about-deloitte/articles/purpose-at-deloitte-us.html" target="_blank">Learn more about Deloitte's purpose, commitments, and impact.</a> Professional development From entry-level employees to senior leaders, we believe there’s always room to learn. We offer opportunities to build new skills, take on leadership opportunities and connect and grow through mentorship. From on-the-job learning experiences to formal development programs, our professionals have a variety of opportunities to continue to grow throughout their career.

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