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Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members. Position Purpose: Oversee operations of the referral management, telephonic utilization review, prior authorization, and various related functions across Medicaid and Marketplace product lines at the enterprise level. Ensure compliance with contractual guidelines of the corporation and health plans impacted by numerous regulatory agencies with complex and often conflicting requirements.<ul> <li>Oversee the operations of utilization management, reconciliation coordination, concurrent review (telephonic and on-site), specialty therapy programs and other related functions across multiple product lines in both centralized and multi-site regional environments</li> <li>Oversee the development and implementation of centralized and multi-site regional clinical and non-clinical training programs</li> <li>Provide strategic and tactical leadership and support to provider relations issues related to utilization issues for hospitals and physician providers</li> <li>Oversee coordination efforts with member services and the connections departments to address concerns regarding compliance with medical management requirements</li> <li>Maintain compliance with National Committee for Quality Assurance (NCQA) standards for utilization management functions, prior authorization and concurrent review units</li> <li>Collaborate with upper management to implement and maintain policies and procedures regarding the prior authorization and concurrent review functions across multiple product lines and overseen by multiple regulatory agencies</li> <li>Oversee processes used to assess quality and risk management issues and facilitate the collection of information for quality improvement and reporting purposes</li> <li>Review various reports for statistical and financial tracking purposes to identify utilization trends and assist in financial forecasting</li> </ul>Education/Experience: Bachelor's degree in Nursing, related field or equivalent experience. 10+ years of nursing, utilization management, or case management experience in an acute care setting. Experience in managed care environment. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff. License/Certification: Current state’s nursing license.Pay Range: $182,100.00 - $345,600.00 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

Oklahoma Complete Health

VP, PHCO Utilization Management Medicaid  & Marketplace

<h3>Details </h3><ul> <li> Department: Operating Room</li> <li> Schedule: Part Time Day Shift, Monday through Friday, hours may vary</li> <li> Hospital: Ascension St. John Jenks</li> <li> Location: Jenks, OK</li> </ul><h3>Benefits </h3>Paid time off (PTO) Various health insurance options &amp; wellness plans Retirement benefits including employer match plans Long-term &amp; short-term disability Employee assistance programs (EAP) Parental leave &amp; adoption assistance Tuition reimbursement Ways to give back to your communityBenefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance and salary range at the time of the offer.<h3>Responsibilities </h3>Deliver professional nursing care in the operative setting to patients undergoing surgical or other invasive procedures.<ul> <li>Perform scrub functions including the selection and handling of instruments and supplies used during procedure.</li> <li>Perform circulating functions including monitoring, recording and communicating patient condition and managing overall nursing care of patient before, during and after procedure.</li> <li>Directly assist operating physician with surgical tasks including hemostasis, suturing and wound exposure as well as patient positioning.</li> <li>Prepare operating rooms and surgical instruments and equipment for use.</li> </ul><h3>Requirements </h3>Licensure / Certification / Registration:<ul> <li>Registered Nurse credentialed from the Oklahoma Board of Nursing obtained prior to hire date or job transfer date required.</li> <li>One or more of the following required: <ul> <li>Advanced Life Support obtained within 6 Months (180 days) of hire date or job transfer date. American Heart Association or American Red Cross accepted.</li> <li>BLS Provider obtained within 1 Month (30 days) of hire date or job transfer date. American Heart Association or American Red Cross accepted.</li> </ul> </li> </ul>Education:<ul><li>Diploma from an accredited school/college of nursing OR professional licensure at time of hire required.</li></ul><h3>Why Join Our Team </h3>Ascension St. John has been serving Northeast Oklahoma with compassionate, personalized care since 1926. Join more than 7,000 associates and find a rewarding healthcare career at one of our 6 hospitals and numerous other sites of care. When you join our care teams, you join a team dedicated to providing spiritually centered, holistic care which sustains and improves the health of the communities we serve.Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you.<h3>Equal Employment Opportunity Employer </h3>Ascension will provide equal employment opportunities (EEO) to all associates and applicants for employment regardless of race, color, religion, national origin, citizenship, gender, sexual orientation, gender identification or expression, age, disability, marital status, amnesty, genetic information, carrier status or any other legally protected status or status as a covered veteran in accordance with applicable federal, state and local laws.For further information, view the <a href="https://www.eeoc.gov/sites/default/files/2022-10/22-088_EEOC_KnowYourRights_10_20.pdf" target="_blank">EEO Know Your Rights (English)</a> poster or <a href="https://www.eeoc.gov/sites/default/files/2022-10/22-088_EEOC_KnowYourRightsSp_10_20.pdf" target="_blank">EEO Know Your Rights (Spanish)</a> poster.As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension.<a href="https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf" target="_blank">Pay Non-Discrimination Notice</a>Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.<h3>E-Verify Statement </h3>This employer participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information. <a href="https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf" target="_blank">E-Verify</a>

Ascension

RN Registered Nurse Circulator - Operating Room

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 SummaryDo you want to make a large impact in your next role? Work for a Fortune 5 company? Join our team as a Sr Analyst, where you will be developing and maintaining expert knowledge of the rapidly changing healthcare marketplace, pharmacy benefits management industry, CVS Health data warehouses and CVS sales/pricing strategies. Here, you will play an essential role in providing key insight to our Pricing partners as you analyze and forecast client data to ensure CVS health provides competitive, profitable, and attractive pricing offers.Using SAS, performs data analytics that adhere to the client set up and plan design. This includes scoping the request and working with Underwriting to ensure data projections represent what is required in the RFP.Communicate key takeaways and results to internal partners. Continuously adapt to changing requirements and updated assumptions and data projection methodologies.Collaborate with internal partners to work on ad-hoc projects as needed. You will be critical to how CVS Health is expanding in the healthcare and pharmacy benefits management (PBM) industry. The Sr. Analysts work in concert with our Strategic Proposals Management and Underwriting teams to provide our healthcare clients with enhanced pricing options and analytical insights to make more informed business decisions and meet the needs of the rapidly changing healthcare marketplace. Successful communication will be required as you will need to be able to communicate complex analytic findings and conclusions in an easy-to-understand way.In this position you will utilize your strong expertise in Excel and advanced knowledge of data modeling and statistical analysis. Your familiarity with healthcare claims data will also be key. To be successful in this role you will quickly learn the business and adapt to changing parameters throughout the year. You will also be able to speak to various internal partners of varying levels about your analytics and assumptions that were applied. Required Qualifications1-4 years of analytics experience analyzing, interpreting, and summarizing large data sets.Bachelor's degree required (Experience may be substituted at our discretion). Preferred Qualifications- Demonstrated experience using business analytics to problem solve data-driven questions. - Ability to communicate complex analytic findings and conclusions in an easy-to-understand way. - Ability to appropriately prioritize competing client requests to ensure focus on highest impact activities. - Ability to interact with others in a collegial and professional manner; leverage team resources to support assigned clients; help foster teamwork and knowledge sharing to complete key tasks. - Ability to work independently in a fast-paced environment and manage tight deadlines. - Knowledge of SAS or SQL is preferred. - Prior experience or knowledge of pharmaceuticals or health care industry is preferred.EducationBachelor's degree Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$46,988.00 - $102,000.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 03/31/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVSHealth

Underwriting Analytics - Senior Analyst

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: Responsible for developing, implementing, and conducting a variety of training programs. Manage the design, development and continuous improvement of a diverse set of learning programs and initiatives. Responsible for the ongoing education and training of the Population Health and Clinical Operations staff with Peach State health plan.***The Education Coordinator I is fully remote. Applicants within the state of Georgia will be considered for the position.***Responsibilities:<ul> <li>Perform orientation/training classes for all Operations staff new hires including didactic instruction on member management software.</li> <li>Assist with maintaining and updating training programs and manuals.</li> <li>Assist in monitoring the educational needs for the current staff.</li> <li>Perform competency evaluations and /or retraining as needed.</li> <li>Develop classes for all Clinical Operations staff.</li> <li>Assist with creating monthly self-study modules, weekly updates, and monthly staff in services provided by Medical Directors.</li> <li>Perform Quality calls on clinical staff.</li> <li>Assist Clinical Operations and Quality with external quality checks, including monitoring of external field staff visits and quality.</li> <li>Provide production support/participant calls as time permits.</li> </ul>Education/Experience: Associate’s or Bachelor’s degree in Nursing or equivalent experience. 3+ years of nursing. At least 1 year of learning and development experience, including adult learning principles, instructional design methodologies, and learning technologies. Licenses/Certifications: Registered Nurse (RN) or Licensed Practical Nurse (LPN) Location: Remote-GAPay 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

Education Coordinator I

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: Responsible for the design and direction on corporate Provider Communications. Lead and manage creative projects involving multiple stakeholders from corporate departments and health plans in a high-volume production environment .<ul> <li>Manage all aspects of design projects and lead team creative projects</li> <li>Provide vision, creative solutions and deliver high-quality designs for all assigned tasks</li> <li>Act as a consultant on best practices including maintaining brand standards</li> <li> Serve as a liaison to corporate and health plan creative teams, and work cross-functionally with other partners within department and across the organization to deliver design solutions and assets</li> <li>Assists with additional design projects</li> </ul>Education/Experience: Bachelor’s degree in Graphic Design, Marketing, Communications or related field or equivalent experience. 8+ years of related experience in marketing or advertising. Must be proficient with Adobe Creative Suite, especially InDesign, Photoshop and Adobe Express, as well as Microsoft PowerPoint or an equivalent application . Other design tools like Canva, Figma or Fondue a plus. Corporate, Leadership, and agency experience a plus. Experience in marketing for health care or other highly regulated industry a plus.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

Senior Graphic Designer

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 SummaryThrough complex negotiations and in-depth knowledge of Meritain Health products and services, the Account Executive will initiate actions which maximize revenue, retain, and grow client relationships, and effectively position our products and rate/fee levels with an emphasis on expanding the assigned book of business. The Account Executive will also provide guidance, support, and strategic leadership among the service teams assigned to their book of business. Responsibilities<ul> <li>Meets assigned sales, retention and profitability objectives and seeks opportunities for profitable growth.</li> <li>Acts as strategic business partner to customers and producers to optimize the positioning of Aetna’s products and services and to attain profitability and membership objectives.</li> <li>Draws from entire spectrum of product line and seeks opportunities to execute cross-sell strategies and add other lines of business.</li> <li>Retains and cultivates a profitable book of business by coordinating the renewal process.</li> <li>Works collaboratively within Aetna and across business functions to ensure customer needs are understood and key issues are addressed.</li> <li>Thoroughly analyzes and reviews reports and utilization to consult with customers, implement appropriate interventions and drive mutually beneficial outcomes for the customer and Aetna.</li> <li>Analyzes and reviews reports/data and utilization to assist the customers in understanding key drivers of benefits cost.</li> <li>Recommends solutions based on data.</li> <li>Coordinates resources to ensure a successful case installation of new products and services.</li> </ul>Required Qualifications - 3–5 years’ experience in Sales &amp; Service Account Management- Health Plan Benefit experience- Understanding of Self-insured/Stop loss products- Sales administration, support, reporting- Strategy development / Complex negotiations experience- Current Life, Accident &amp; Health License- Travel required (30%) Southeast Region- C-suite experience - Must be located in Eastern Standard Time Preferred Qualifications - Ideal candidate will have prior experience in a client management role, demonstrated examples of owning/managing complex customer relationships and an operations background. Ability to manage for profitable growth, anticipate and respond to marketplace trends; develop strategies that drive the business; demonstrate cross-cultural sensitivity; integrate financial, marketing, and strategic concepts EducationBachelor's degree or equivalent experience (HS diploma + 4 years relevant experience)Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$46,988.00 - $91,014.00This 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. 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: 04/14/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Account Executive (Meritain Health)

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: Perform internal audits, including the execution of strategic, operational, IT, and compliance risk-based audits for the company<ul> <li>Design, perform, and manage risk-based audits, evaluating controls and processes for scalability, effectiveness, efficiency, and risk mitigation strategies</li> <li>Perform audit planning, fieldwork, and wrap-up of engagements, including development and refinement of work programs</li> <li>Draft audit reports summarizing key findings and recommendations and consolidation of metrics and graphing</li> <li>Develop and communicate audit observations, recommendations, process improvement opportunities and best practices and obtain management responses</li> <li>Monitor and report on the status and findings of audits</li> <li>Serve as contact for corporate and external auditors regarding auditing, fraud matters, and projects</li> <li>Work with external professionals to complete audits/projects</li> </ul>Education/Experience:<ul> <li>Bachelor’s degree in Business, Accounting, Finance, Healthcare, related field or equivalent experience.</li> <li>2+ years of public accounting, internal audit, or related operational auditing or compliance experience required.</li> <li>Knowledge of Generally Accepted Accounting Principles required.</li> <li>Health Care industry experience preferred.</li> </ul> License/Certificates: CPA, CIA and/or CISA 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

Compliance Internal Auditor

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position SummaryAs a Manager, Business Analytics you will be part of the Medicare Grievance Team, responsible for managing business and system initiatives that focus on streamlining complaint processes and maintaining data integrity.In this role, you will manage system projects and initiatives with emphasis on data exchanges, technical enablement, data acquisition, and automation. Furthermore, this role will require collaboration and coordination with Information Technology (IT) teams, MHK, Medicare Complaint leadership team, and other business partners/stakeholders.Responsible for gathering technical and business requirements and drives the delivery of milestones to support organizational growth, value creation, and product portfolio. Constructs and analyzes business cases for new initiatives.Creates reports, dashboards, and visualizations to present data-driven insights in a clear and concise manner. Analyzes trends and patterns to identify areas of improvement, efficiency gains, and opportunities for value creation. Uses statistical techniques, data mining, and predictive modeling to uncover patterns, trends, and correlations within the data. Applies critical thinking and problem-solving skills to derive meaningful insights that drive business decision-making.Explores innovative tools and approaches to improve data analysis and drive continuous improvement within the organization. Plans and monitors internal projects from initiation through completion, ensuring on-time completion according to specifications and within budgeted costs. Designs cross-functional solutions to address business problems.Acts as a liaison between the IT development group and business units for the development and implementation of new systems and enhancement of existing systems.What you will do<ul> <li>Evaluates new applications and identifies systems requirements.</li> <li>Works with our CRM vendor, MHK, to ensure enhancements are made timely and accurately.</li> <li>Participates in audit data universe gathering and analyzing.</li> <li>Evaluates evolving business requirements and recommends appropriate systems alternatives and/or enhancements to current systems.</li> <li>Prepares communications and makes presentations on system enhancements and/or alternatives.</li> <li>Conducts quantitative and qualitative analyses to assess business performance and identify opportunities for improvement.</li> <li>Conducts MHK testing during each code enhancement rollout.</li> <li>Build and maintain business quickbase tools.</li> <li>Compiles clear and comprehensive documentation, such as business requirement documents and use cases.</li> <li>Collects and analyzes business data to identify trends, patterns, and insights.</li> <li>Develops basic process maps, flowcharts, and diagrams to document as-is and to-be processes.</li> <li>Conducts feasibility studies and cost-benefit analyses for proposed solutions and assesses potential solutions, technologies, or systems to address business needs.</li> <li>Assists in conducting impact assessments and addressing user concerns during implementation.</li> <li>Conducts meetings, workshops, and presentations to gather feedback and validate requirements.</li> <li>Actively contributes to team meetings, brainstorming sessions, and collaborative projects, including sharing ideas, providing feedback, and contributing to the overall goals and objectives of the team.</li> <li>Contributes to the development and maintenance of standardized templates, guidelines, and methodologies.</li> <li>Seeks opportunities to enhance their skills and knowledge through training and certifications.</li> </ul> Required Qualifications<ul> <li>4+ year of experience as a Data Analyst or in a similar role. </li> <li>Knowledge of statistical analysis techniques and tools </li> <li>Proficient using QuickBase; building, editing, and repairing existing databases.</li> <li>Excellent communication and presentation skills.</li> <li>Well-versed in data analysis and data transformation. </li> <li>Excellent problem-solving skills and critical thinking ability. </li> <li>Strong collaboration and communication skills (written/oral) with the ability to communicate analyses, technical ideas, and results to non-technical clients. </li> <li>Ability to work in a fast-paced environment across multiple teams. </li> <li>Excellent knowledge using Excel, Access, Visio, Word and/or PowerPoint. </li> <li>Willingness to understand business needs and to create strategies around them. </li> <li>Experience in working in a data warehouse environment as well as the ability to work with large data sets from multiple data sources. </li> <li>Ability to articulate business needs with IT partners and vice versa.</li> <li>Ability to prioritize work and perform independently</li> <li>Proven track record leading or managing large projects</li> <li>6+ years of experience with Medicare Advantage products</li> </ul> Preferred Qualifications<ul> <li>6+ year of experience as a Data Analyst or in a similar role.</li> <li>Proficiency using SAS/SQL/Python/R for data retrieval, manipulation, and transformation.</li> <li>Experience building, maintaining, and editing Tableau and Microsoft BI dashboards/reporting.</li> <li>8+ years of experience with Medicare Advantage products</li> <li>Advanced Excel modeling skills with experience owning complex models end-to-end</li> <li>Advanced degree in Business, Finance, Accounting, or Healthcare</li> <li>5+ years of experience with product management.</li> </ul> EducationBachelor's Degree or equivalent experience.Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$60,300.00 - $132,600.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 03/22/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Manager ,Business Analytics - Medicare Advantage

At Mitratech, we are a team of technocrats focused on building world-class products that simplify operations in the Legal, Risk, Compliance, and HR functions of Fortune 100 companies. We are a close-knit, globally dispersed team that thrives in an ecosystem that supports individual excellence and takes pride in its diverse and inclusive work culture centered around great people practices, learning opportunities, and having fun! Our culture is the ideal blend of entrepreneurial spirit and enterprise investment, enabling the chance to move at a rapid pace with some of the most complex, leading-edge technologies available. Given our continued growth, we always have room for more intellect, energy, and enthusiasm - join our global team and see why it's so special to be a part of Mitratech! Job Overview: The Senior Services Consultant is responsible for the successful completion of assigned client implementation project activities of Mitratech’s CLC suite. These implementation project activities include requirements analysis and definition, configuration of software, conference room pilots, testing, and go-live support for our clients. The Senior Services Consultant plans, researches, and analyzes the business requirements of the client; makes reasoned decisions after assessing the circumstances, and then provides recommendations along with the risks and issues involved with each alternative to the client. Essential Duties &amp; Responsibilities: <ul> <li>Be a sparring partner for our clients using our product portfolio</li> <li>Work together with Risk Experts and Executives in leading companies</li> <li>Lead requirements gathering sessions with our clients</li> <li> Execute on project deliverables such as: <ul> <li>Power user and end user training sessions on Mitratech’s product suite</li> <li>Providing functional and best practice knowledge on GRC topics</li> <li>Configure business intelligence reports using our BI tool (SQL knowledge preferable)</li> <li>Participate in UAT</li> </ul> </li> <li>Work as a member of a multidisciplinary team fostering teamwork and communication</li> </ul> Requirements &amp; Skills: <ul> <li> We are looking for a bright mind with solid GRC knowledge and/ or 2+ years experience in a consultancy with: <ul> <li>Bachelor’s degree</li> <li>Project management skills</li> <li>Experience in business solution implementation</li> <li>Experience or skills in business intelligence and analytics reporting/SQL (preferred)</li> <li>Strong verbal communication, networking and relationship building skills</li> <li>Ability to work independently in a fast-paced, changing environment</li> </ul> </li> <li>Experience working with virtual project teams</li> <li>Strong organizational skills</li> </ul> Mitratech is proud to be an EEOE, M/F/D/V, and we are committed to diversity both in practice and spirit at the corporate level. Mitratech participates in the Electronic Employment Verification Program. E-Verify is an Internet-based system that compares information from an employee’s I-9 to data from the U.S. Department of Homeland Security and Social Security Administration Records. To learn more, visit: <a href="http://everify.com/" target="_blank">everify.com</a> We are an equal-opportunity employer that values diversity at all levels. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity, disability, or veteran status.

Mitratech

Senior Consultant - Professional Services

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 Aetna is recruiting for a Sr. Manager, Strategic Planning, reporting to the Executive Director of Medicare Strategic Business Planning and Programming. This position supports the business unit's overall management process, leads cross functional efforts to ensure optimal communication and performance, assists in resource alignment and facilitates the development of organizational, unit, and cross-functional strategic program management.What you will do<ul> <li>Enabling alignment with business objectives and reinforce organizational standards through the Medicare management process</li> <li>Developing performance dashboards and managing, tracking and reporting results against performance guarantee activity of key Medicare initiatives</li> <li>Continuously building cross-functional relationships with business stakeholders to ensure business performance and key risks are discussed, evaluated, tracked and routinely reported out on (via monthly business reviews, etc.)</li> <li>Collaborating with teammates and business partners to drive process improvements and enhancements and implementing new ideas that support optimal business outcomes and improve overall efficiency in the management process</li> <li>Supporting the design and execution of overall communication strategy in support of business objectives and employee engagement in partnership with Communication, Human Resources, and Medicare business partners</li> <li>Performing additional cross-functional duties as needed to ensure departmental and business unit goals are met</li> </ul><h2>Required Qualifications</h2><ul> <li>7-10 years work experience</li> <li>Strong proficiency in translating complex business concepts into simple, compelling visual narratives that communicate business objectives and strategic goals</li> <li>Adept at execution and delivery (planning, delivering, and supporting) skills</li> <li>Adept at business intelligence with advanced quantitative skills</li> <li>Advanced Powerpoint presentation skills approriate for C-suite.</li> </ul> Preferred Qualifications<ul> <li>Prior experience in Medicare</li> <li>Adept at problem solving and decision making skills</li> <li>Adept at collaboration and teamwork</li> <li>Adept at growth mindset (agility and developing yourself and others) skills</li> </ul><h2>Education</h2>Bachelor's degree preferred/specialized training/relevant professional qualification. Pay RangeThe typical pay range for this role is:$67,900.00 - $149,328.00 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: 03/21/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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