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At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary Leverages technology and data to improve healthcare outcomes by designing, implementing, and maintaining health information systems, analyzing healthcare data, and utilizing technology to support clinical workflows and decision-making. Applies expertise in healthcare and information technology to ensure efficient data management, promote data-driven insights, and enhance the delivery of healthcare services.What you will do<ul><li>Produces customized reports of varied healthcare data to assist in the assessment of health and economic outcomes.</li></ul><ul> <li>Collects, organizes, and analyzes healthcare data from various sources, such as relational databases and claims data.</li> <li>Employs statistical methods and data visualization techniques to identify trends, patterns and gaps in care that can support sales and operations.</li> <li>Creates interactive dashboards and reports utilizing Tableau desktop and Tableau Server</li> <li>Collaborates with business partners to identify data requirements, extract data from multiple sources and present findings.</li> <li>Verifies accuracy of data using multiple methods, including SQL queries; motivated to explore multiple avenues of data irregularities and identify the cause.</li> <li>Documents methods, specifications, and findings clearly.</li> <li>Identifies opportunities for process improvement by leveraging data analysis to identify bottlenecks, inefficiencies, and areas for automation.</li> <li>Juggles multiple deliverables and timelines and completes assigned projects accurately and on-time.</li> <li>Makes positive contributions to a motivated work environment by working collaboratively and efficiently with other team members to achieve common goals.</li> </ul> Required Qualifications<ul> <li>5+ years of data analysis experience and expert with Tableau.</li> <li>5+ years of computer skills and knowledge of Microsoft Word, Excel, PowerPoint, Access.</li> </ul> Preferred Qualifications<ul> <li>5+ years of SQL experience</li> <li>3+ year(s) of managed care experience</li> <li>Strong analytic skills with ability to interpret trends and outliers and translate insights into recommendations.</li> <li>Adept at probing into granular details of big data and complex technical processes.</li> <li>Strong written and verbal communications skills to convey complex data insights to a diverse audience.</li> <li>Ability to perform root-cause analysis.</li> <li>Strong collaboration and communication skills within and across teams.</li> <li>Ability to work in a fast-paced environment and meet tight deadlines.</li> <li>Strong team player with ability to encourage teamwork and a positive environment.</li> <li>Ability to be resourceful and quickly adapt to changing business requirements.</li> <li>Attention to detail.</li> </ul> Education<ul><li>Bachelor’s degree in a related field (e.g., Analytics, Informatics) and/or equivalent work experience.</li></ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$54,300.00 - $159,120.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 05/25/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVSHealth

Mgr, Informatics

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.Job Description Primary Job Duties &amp; Responsibilities: Follows management-established procedures to execute routine business support tasks for core Inbound and Outbound communications functions, under general supervision. Develops effective relationships with all team members to effectively progress daily communications to resolve issues and prevent delays in service or responses. Handles Inbound and Outbound tasks in a manner that operates in full compliance with patient confidentiality policies and regulations. Maintains accurate and complete documentation of member health information to minimize risk management, while adhering to all regulatory, and accreditation requirements. Reviews requests for appropriate referral to medical services staff and approves services that do not require a medical review. Escalates more complex customer/member inbound inquiries to management for more thorough follow-up and resolution. Takes management direction to properly execute techniques, processes, and responsibilities according to established work area policies and procedures. Documents all Inbound and Outbound phone details into the company database to ensure full collection of customer/patient needs and requirements. Demonstrates active listening skills while handling customer/patient calls, also exerting compassion and understanding to gain customer/patient trust and loyalty. Education: -High school diploma or up to 1 year equivalent experience.-Prior Relevant Work Experience -0-1 yearEssential Qualifications: -Working knowledge of problem solving and decision making skills Available Shift: -Shift Available: Sunday- Thursday- 6:30am- 2:30pm EST -Training: 10:00 AM - 6:30 PM EST for first 8 weeks *Some Holidays required*Position Summary Inbound Queue Associate - Behavioral Health role is responsible for accepting inbound calls from facilities, providers, and members regarding pre-certification process within Medicare and Commercial Insurance. Responsibilities to include but limited to the following: • Performs intake of calls from members or providers regarding services via telephone, fax, EDI. • Screens requests for appropriate referral to medical services staff. • Approve services that do not require a medical review in accordance with the benefit plan. • Performs non-medical research including eligibility verification, COB, and benefits verification. • Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements. • Protects the confidentiality of member information and adheres to company policies regarding confidentiality • Communicate with Aetna Case Managers, when processing transactions for members active in this program • Other duties and responsibilities as required.Required Qualifications • 2 plus years of Customer Service Background • 2 plus years of Call Center experience Preferred Qualifications • Familiarity with basic medical terminology and concepts used in care management. • 2-4 years experience as a medical assistant, office assistant or other clinical experience. • Effective communication, telephonic and organization skills. • Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members. • Computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word. • Ability to effectively participate in a multi-disciplinary team including internal and external participants Education High School Diploma or equivalent GEDAnticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$17.00 - $25.65This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 04/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Behavioral Health Inbound/Outbound Que Associate

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.The Medical Economics Unit (MEU) is responsible for identifying and mitigating medical cost trends for the Aetna business unit. We are hiring for a position to assist in the analysis and compliance of the Mental Health Parity and Addiction Equity Act (MHPAEA) regulatory requirements. As a Manager of Medical Economics, you will work closely with compliance, network and other MEU teams to assist with data requests, analytics, documentation and rate setting.Responsibilities you would manages, lead, or participates in (e.g. Medical Cost Savings Initiatives):<ul> <li>Project Management accountabilities include project oversight including initiation, identification and completion of key deliverables to ensure all business objectives are met.</li> <li>Responsible for the development and implementation of key medical economics business efforts e.g. medical cost initiatives, policies/programs and analytical models.</li> <li>Accountable for all financial projections associated with project.</li> </ul>In this role you will be able to demonstrate:<ul> <li>Ability to analyze data and information and summarize findings for a variety of stakeholders.</li> <li>Lead and own all financial projections within the projects</li> <li>Ability to communicate effectively</li> <li>Ability to quickly grasp business concepts, objectives, and strategies and summarize them</li> <li>Proven experience leading cross-functional, matrixed projects and programs</li> <li>Strong attention to detail, organizational skills, and the ability to manage multiple tasks while meeting deadlines</li> </ul>Qualifications:<ul> <li>5-7 years work experience</li> <li>3 + years experience collaborating across the enterprise business segments to understand business needs and requirements</li> <li>Experience developing and implementing new ideas that support the program work and team, while helping the company achieve compliance with regulatory requirements</li> <li>Experience influencing change to improve processes, organization effectiveness and systems</li> <li>Assist others to identify solutions to issues that negatively impact the program and/or project goals</li> </ul>Preferred Qualifications<ul> <li>Knowledge of managed care and how provider reimbursement policies relate to the control of medical claims costs.</li> <li>Comprehension of provider contracts and the potential impact the regulatory/legislative environment has on reimbursement strategies.</li> <li>Understanding of internal and external database applications.</li> </ul>Education<ul><li>Bachelor's Degree or equivalent work experience required</li></ul>**This is a hybrid role located at a CVS hub or remote*****The role does not offer sponsorship***Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$54,300.00 - $159,120.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 04/21/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Manager, Medical Economics

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary:Aetna Duals Center of Excellence is seeking a dedicated and experienced Behavioral Health Medical Director. The ideal candidate will be a board-certified psychiatrist with a current, unencumbered state license, and at least four (4) years of training in a medical specialty. The Behavioral Health Medical Director will ensure timely medical decisions, including after-hours consultation, and will share responsibility for managing the behavioral health services delivery system.This is a Work from Home Remote Position with travel as needed but most likely less than 10% Travel.Preferences for NY, NJ, VA, OH, MI and IL licenses. Able to get additional licenses in key states, where required.Responsibilities: <ul> <li>Directs the utilization review process and oversee the quality of utilization determinations.</li> <li>Responsible for overall medical policies to ensure the appropriate and most cost-effective medical care is received, and for the day-to-day management of Behavioral Health Medical Director Staff.</li> <li>Responsible for recommending changes and enhancements to current member management, review guidelines, and clinical criteria based on extensive knowledge of health care delivery systems, utilization methods, reimbursement methods, and treatment protocols.</li> <li>Ensuring consistency in the application of utilization management standards, including those implemented by subcontracted entities for BH services.</li> <li>Review and resolution of quality-of-care concerns.</li> <li>Participation in clinical staff recruitment and ongoing performance improvement.</li> <li>Responsible for predetermination reviews and reviews of claim determinations, providing clinical, coding, and reimbursement expertise.</li> <li>Support submission and completion of Potential Quality of Care Determinations (PQOC) and complete reviews as needed.</li> <li>Participate in BH transition of care (TOC) rounds and care management activities as needed.</li> <li>Will serve as a collaborator with Duals Center of Excellence in designated markets to ensure compliance with UM and quality programs and support initiatives, programs, and solutions.</li> <li>Support duties as required regarding utilization management of the service benefit and pharmacy benefit within the state health plan and additional duties as assigned.</li> <li>Actively participate in continuous improvement activities, other activities that support quality of care and total cost of care oversight.</li> </ul>Required Qualifications / Licenses:<ul> <li>Three (3) or more years of experience in post-residency training clinical practice.</li> <li>Three (3) or more years administrative experience in the health care industry or managed care.</li> <li>Independently motivated and capable of researching and adjudicating Medicare and Medicaid benefit and coverage decisions.</li> <li>Strong communication skills both written and verbal.</li> <li>Board Certification in ABMS recognized specialty of Adult Psychiatry</li> <li>Current and Active State Medical License without encumbrances.</li> <li>Able to get additional licenses in key states, where required.</li> <li>Ability to attend in-person meetings and manage after-hours/ on-call consultations when needed.</li> </ul>Preferred Experience:<ul> <li>Previous UM experience with a Health Plan or Health / Hospital System.</li> <li>Previous experience with CMS and / or MCG guidelines as well as state specific Medicaid contracts.</li> <li>Previous Medicare and Medicaid experience.</li> <li>Experience in managing behavioral health services.</li> </ul> Education<ul><li> M.D. or D.O.</li></ul>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. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 04/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Behavioral Health Medical Director

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 SummaryFully remote position. Work from home anywhere in the U.S.A. Shift: Monday through Friday 11:30am to 8pm EST Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. Applies critical thinking and is knowledgeable in clinically appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health.Utilizes clinical experience and skills in a collaborative process to assess appropriateness of treatment plans across levels of care, apply evidence based standards and practice guidelines to treatment where appropriate.<ul> <li>Coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.</li> <li>Provides triage and crisis support.</li> <li>Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation.</li> <li>Coordinates with providers and other parties to facilitate optimal care/treatment.</li> <li>Identifies members at risk for poor outcomes and facilitates referral opportunities to integrate with other products, services and/or programs.</li> <li>Identifies opportunities to promote quality effectiveness of healthcare services and benefit utilization.</li> </ul>Required Qualifications<ul> <li>Must have active current and unrestricted Independent clinical behavioral health license in the state of residence (LPC, LCSW, LMFT, LMHC, etc) </li> <li> 3+ years of behavioral health experience </li> <li>Must be able to talk on the telephone and type at the same time as this is a queue based position.</li> <li>Must be able to work Monday through Friday 11:30am to 8pm EST</li> </ul>​Preferred Qualifications<ul> <li>3+ years of direct clinical practice experience post master's degree, including hospital setting or alternative care setting such as ambulatory care or outpatient program</li> <li>Managed care and utilization review experience preferred.</li> <li>Crisis intervention skills preferred.</li> </ul>Education<ul><li>Master's degree required if social worker, LPC, LCSW, LMFT, LMHC, </li></ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$60,522.00 - $129,615.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 04/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Utilization management Clinician Behavioral Health

<h3> Position Summary </h3> Position Summary As a Sr. GenAI Engineer, you will actively engage in your engineering craft, taking a hands-on approach to multiple high-visibility projects. 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 extensive GenAI &amp; engineering craftsmanship and advanced proficiency across multiple programming languages and modern frameworks, consistently demonstrating your exemplary track record in delivering high-quality, outcome-focused solutions. Recruiting for this role ends on 4.1.25 Work you’ll do <ul> <li> Outcome-Driven Accountability: Embrace and drive a culture of accountability for customer and business outcomes. Develop engineering solutions that solve complex problems with valuable outcomes, ensuring high-quality, lean designs and implementations.</li> <li> Technical Leadership and Advocacy: Serve as the technical advocate for products, ensuring code integrity, feasibility, and alignment with business and customer goals. Lead requirement analysis, contributing to low-level architecture and component design, development, unit testing, integrations, and support.</li> <li> Engineering Craftsmanship: Maintain accountability for the integrity of code design, implementation, quality, data, and ongoing maintenance and operations. Stay hands-on, self-driven, and continuously learn new approaches, languages, and frameworks with significant focus on infusing AI/ML/GenAI where possible/appropriate. Create technical specifications, and write high-quality, supportable, scalable code and review code of other engineers, mentoring them, to ensure all quality KPIs are met or exceeded. Demonstrate collaborative skills to work effectively with diverse teams.</li> <li> Customer-Centric Engineering: Develop lean engineering 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, 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 software engineering practices and principles, including AI/ML/GenAI, Agile methodologies and DevSecOps to deliver daily product deployments using full automation from code check-in to production with all quality checks through SDLC lifecycle. Strive to be a role model, leveraging these techniques to optimize solutioning and product delivery. Demonstrate strong 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 product. Translate business/user needs, architectures, and UX/UI designs into technical specifications and code. 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: 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: The ideal candidate will be a dependable team player and mentor, collaborating with cross-functional teams to design, develop, and deploy advanced software solutions. <ul> <li>Understanding and experience in managing big data of various forms to generate insights and create intelligence.</li> <li>Understanding of methodologies &amp; tools like, XP, Lean, SAFe, DevSecOps, SRE, ADO, GitHub, SonarQube, etc. to deliver high quality products rapidly.</li> <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>Bachelor's degree in computer science, software engineering, or related field.</li> <li>6+ years of engineering experience focused in AI/ML</li> <li>2+ years of recent experience in GenAI utilizing technologies such as: OpenAI, Claude, Gemini, LangChain, Agents, Vector databases and approaches like Prompt Engineering, fine-tuning, etc.</li> <li>Limited immigration sponsorship may be available</li> </ul> Preferred: <ul> <li>8+ years of engineering experience focused in AI/ML</li> <li>Prior experience in Python, R, TensorFlow, PyTorch, Keras, Julia, ML libraries, NLP.</li> <li>Prior experience with Angular, React, NodeJS, Python, Streamlit, C#, .NET Core, Golang, SQL/NoSQL.</li> <li>Prior experience with experience with cloud-native engineering, using FaaS/PaaS/micro-services on cloud hyper-scalers like Azure, AWS, and GCP.</li> <li>Prior experience and familiarity with XP, Lean, SAFe, DevSecOps, SRE, ADO, GitHub, SonarQube.</li> <li>Advanced degree (e.g., MS) in computer science, software engineering, or related field.</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 $102,500 to $ 210,600. 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. Information for applicants with a need for accommodation: Hyperlink: <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_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

Manager, GenAI Engineering

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 is recruiting for a Senior Manager, National Value Based Care (VBC) Development who will support innovative and strategic provider relationships as part of the VBC Business Development team. You will work collaboratively across the Network organization to ensure speed to market and to support segment leaders with growing our value-based care portfolio.You will make an impact by:<ul> <li>Support efforts focused on growing and maintaining strategic relationships with national provider partners with a focus on executing enterprise-wide initiatives.</li> <li>Support contracting efforts including negotiating contract deal terms and support the development and implementation of value-based contract relationships, serving as SME in support of business strategies across multiple lines of business, including Medicare Advantage, Medicaid, ACA, and Commercial.</li> <li>Develops relationships with providers and executes on go-to-market strategies and tactics around VBC risk deals to ensure attainment of network expansion and adequacy targets.</li> <li>Collaborates cross-functionally with various stakeholders internally and/or externally to scope/define projects, documentation of contractual information, and review/analysis of reports as part of VBC risk arrangement activities.</li> <li>Partners with cross functional teams, business areas, business segments to ensure all workflow processes and interdependences are identified and addressed.</li> <li>Provides network development/expansion, provider relationships, and refinement activities in support of cross-market network management.</li> <li>Support design, development, management, and/or implementation of strategic network configurations and integration activities as related to value-based care risk deals.</li> </ul>Required Qualifications<ul> <li>8-10 years of experience in Payer and Provider Value based care.</li> <li>Experience in Value Based Care financial models and value-based care contracting/negotiations</li> <li>Experience in Risk-based arrangements and Value-Based care in government services (Medicare Advantage, Medicaid, ACA)</li> <li>Proven negotiation skills including extensive experience leading Medicare advantage percent of premium/delegation deals.</li> <li>Ability to manage multiple priorities, and leading multiple complex negotiations at a time.</li> <li>Adept at execution and delivery (planning, delivering, and supporting) skills.</li> <li>Experience working in a highly matrixed environment.</li> </ul>Preferred Qualifications<ul> <li>Healthcare Industry experience with either a payer or provider</li> <li>Strong communication, critical thinking, problem resolution and interpersonal skills.</li> <li>Internal Aetna system knowledge a plus</li> <li>Proven working knowledge of provider financial issues and competitor strategies, complex contracting options, value-based agreements, financial/contracting arrangements, and regulatory requirements.</li> </ul>Education<ul><li>Bachelor's degree or or a combination of education and professional work experience.</li></ul>Pay RangeThe typical pay range for this role is:$67,900.00 - $199,144.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program. 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: 04/19/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Network Development and Contracting, Primary Care

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.

Medical Director - (Cardiology)

Summary:&nbsp;Responsible for installing hot tubs, swim spas and assembling game roof products by performing the following duties. Duties and Responsibilities&nbsp;include the following. Other duties may be assigned. <ul> <li>Ability to learn and comprehend instructions*</li> <li>Ability to lift a hot tub*</li> <li>Ability to follow instructions from lead*</li> <li>Ability to stay on task and complete tasks in a reasonable time*</li> <li>Availability to work long hours if needed*</li> <li>Ability to use hand tools such as drills sockets screwdrivers etc.*</li> <li>Ability to identifying product*</li> <li>Ability to problem solve in field*</li> <li>Ability to drive a box truck or truck and trailer*</li> <li>Building product on site *</li> <li>Essential Function</li> </ul> Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Language Ability: Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization. Math Ability: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs. Reasoning Ability: Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations. Certificates and Licenses: Valid Drivers’ License Knowledge, Skills, and Other Abilities: <ul> <li>Professionalism</li> <li>Ability to learn</li> <li>Ability to use hand tools</li> <li>Professionalism and communication with customers</li> </ul> 				 					You have applied too many times. Please try again later.

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