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Job Description: At Bank of America, we are guided by a common purpose to help make financial lives better through the power of every connection. Responsible Growth is how we run our company and how we deliver for our clients, teammates, communities and shareholders every day. One of the keys to driving Responsible Growth is being a great place to work for our teammates around the world. We’re devoted to being a diverse and inclusive workplace for everyone. We hire individuals with a broad range of backgrounds and experiences and invest heavily in our teammates and their families by offering competitive benefits to support their physical, emotional, and financial well-being. Bank of America believes both in the importance of working together and offering flexibility to our employees. We use a multi-faceted approach for flexibility, depending on the various roles in our organization. Working at Bank of America will give you a great career with opportunities to learn, grow and make an impact, along with the power to make a difference. Join us! Job Description: This job is responsible for resolving research and adjustment inquiries within the bank's practices and procedures. Key responsibilities include maintaining internal operational and financial controls and ensuring that they are observed for all assigned cases. Job expectations include ensuring that all cases are resolved in compliance with industry regulations and bank procedures, integrity levels of the department's case management system, and financial controls, and escalating matters or issues to leadership to ensure minimum risk occurs. The Research and Adjustments Representative II role is an in office position that is responsible for receiving and sorting incoming mail, scanning mail and getting it the appropriate team, processing payments, extensive account research and completing maintenance on delinquent and/or charged off Business Lending, Deposit and Consumer Vehicle Lending products. This role requires advanced account review and problem solving skills. Primary responsibilities include loss mitigation of delinquent or charged accounts. Navigates a computerized data entry system and other relevant applications. They understand account terms, regulatory and compliance requirements that apply to the process and are able to work within these guidelines. Also, must adhere to internal operational and financial controls and ensures that they are observed for all assigned cases. May provide support to and training to other researchers within the department. Schedule: Monday – Friday, 7:30 – 4:00pm Responsibilities: <ul> <li>Works on daily incoming exceptions and maintains aged exceptions to a minimum</li> <li>Enters daily entries through internet based applications</li> <li>Performs routine or complex account maintenance depending on client account type</li> <li>Maintains high-volume portfolios</li> <li>Investigates and resolves issues and requests</li> </ul> Required Qualifications: <ul> <li>Self-motivated and goal oriented</li> <li>Ability to adapt quickly to changes in the environment</li> <li>Must be detail oriented, an independent thinker, and able to handle multiple tasks concurrently</li> <li>Must be able to work in a team environment</li> <li>Ability to navigate multiple computer systems</li> <li>Ability to think critically and use sound judgement in decision making</li> <li>Analytical and problem resolution skills</li> </ul> Desired Qualifications: <ul> <li>Previous Collections or Recovery experience</li> <li>College degree or commensurate work experience preferred</li> <li>Knowledge of Deposit and Card/Loan systems</li> </ul> Skills: <ul> <li>Attention to Detail</li> <li>Customer and Client Focus</li> <li>Pipeline Management</li> <li>Research</li> <li>Critical Thinking</li> <li>Decision Making</li> <li>Problem Solving</li> <li>Written Communications</li> <li>Adaptability</li> <li>Collaboration</li> <li>Risk Management</li> </ul> Shift:1st shift (United States of America) Hours Per Week: 40

Bank of America

Research & Adjustments Representative II - Offset

Job Description: At Bank of America, we are guided by a common purpose to help make financial lives better through the power of every connection. We do this by driving Responsible Growth and delivering for our clients, teammates, communities and shareholders every day. Being a Great Place to Work is core to how we drive Responsible Growth. This includes our commitment to being an inclusive workplace, attracting and developing exceptional talent, supporting our teammates’ physical, emotional, and financial wellness, recognizing and rewarding performance, and how we make an impact in the communities we serve. Bank of America is committed to an in-office culture with specific requirements for office-based attendance and which allows for an appropriate level of flexibility for our teammates and businesses based on role-specific considerations. At Bank of America, you can build a successful career with opportunities to learn, grow, and make an impact. Join us! Job Description: The PCLS team is primarily responsible for the tracking and clearing of documentation related to collateral supporting GWIM Credit. The team reviews and is involved with various processes related to the supported collateral. In addition, the PCLS will work closely with Client and Credit Teams to clear document exceptions. Job Responsible for : <ul> <li>Collaborating with our business partners with Credit and Operations to ensure proper engagements.</li> <li>Monitors collateral/documentation exceptions reports for the receipt of trailing loan documentation.</li> <li>Actively research various internal and external applications/websites for various collateral jurisdictional documents</li> <li>Prepares Secured Based Lending documents for the addition and deletion of investment accounts.</li> <li>Partners with Credit Managers and Client Teams to resolve outstanding exceptions.</li> </ul> Required Skills: <ul> <li>Solid understanding of loan documentation required to perfect the Bank’s security possession.</li> <li>Thorough attention to detail, ability to multi-task, and ability to function independently.</li> <li>Ability to multitask and meet deadlines in a fast-paced environment.</li> <li>Strong verbal and written communication skills.</li> <li>Work effectively with business partners and clients toward a common goal.</li> <li>Strong PC skills including WORD and EXCEL</li> </ul> Minimum Education Requirement: High School Diploma / GED / Secondary School or equivalent Shift:1st shift (United States of America) Hours Per Week: 40

Post Closing Loan Specialist

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary:The Clinical Pharmacist is an operation-based role that conducts criteria based &amp; clinical review of medical data collected to perform prior authorization as per policy and procedure. The Pharmacist/Clinician will apply clinical knowledge to plan approved criteria for reviews of cases. This role will work from CVS Caremark supported systems and take inbound calls from physicians or members regarding their pending, approved, or denied prior authorizations, internally support the Prior Auth team and member services department, as well as provide on-call after hours availability for urgent PA request as needed.This position is responsible for assisting front-line colleagues (i.e. Staff Pharmacists, LPN's and Pharmacy Technicians) with oncology process/procedural support by acting as a subject matter expert (SME) and performing any other complex tasks or addressing any escalation cases assigned by leadership. This includes providing on-the-job (OJT) training, answering questions from front-line colleagues, production support, and providing recommendations/solutions to effectively streamline systems and processes. The Pharmacist will be responsible for maintaining the most current oncology therapy knowledge through self-education.Responsibilities:1.) Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and plan design. Includes verifying insurance coverage and eligibility, interpreting clinical guideline criteria, consulting physicians and other healthcare providers, and appropriately utilizing clinical knowledge and resources while complying with department protocols. One of the crucial responsibilities is to guarantee that the decisions regarding cases are conveyed promptly and efficiently to all the healthcare providers, health plans/employers, patients, and other healthcare professionals following agreed-upon approval &amp; denial management processes. 2.) Collaborates with the technicians and prior authorization team members to process referrals, including answering clinical questions and collecting appropriate clinical/medical data needed to perform clinical assessments and reviews as per the health plan/employer-agreed criteria within the designated service level agreements. Performs and handles inbound and outbound phone calls with technicians, prior authorization team members, physicians, healthcare providers, and/or patients to facilitate prior authorization requests, answer inquiries, and/or resolve escalations.3.) Responsible for assisting front-line colleagues (i.e. Staff Pharmacists, LPN's and Pharmacy Technicians) with oncology process/procedural support by acting as a subject matter expert (SME) and performing any other complex tasks or addressing any escalation cases assigned by leadership.4.) Assist with standard or client specific oncology review process changes as needed. 5.) Assist with writing Work Instructions when needed.6.) Works collaboratively with internal and external business partners to provide solutions for customers, colleagues, and clients.7.) Provide feedback of trends pertinent to oncology reviews.8.) Maintains professional and technical knowledge of drug and disease states for the Specialty and Non-Specialty Pharmacy programs administered within the Commercial Prior Authorization and Case Review Unit (CRU) line of business.9.) Performs other related projects and duties as assigned, including attending training sessions and development meetings, and providing on-call and after-hours pharmacist availability as needed.This is a remote role, open to qualified candidates within the United States.Essential Functions: 1. Regular and predictable attendance2. Colleague may be required to work mandatory overtime/extended work week when needed3. Colleague may be required to travel when needed4. Comply with departmental, company, state, and federal requirements when processing all information to ensure accuracy of information being provided to internal and external customers.5. Adhere to all policies and procedures6. Attend on going training and development meetingsPhysical Requirements:1. Sits at desk for long periods of time (up to 100%)2. Talking on phone for extended periods of time (up to 100%)3. Computer use for extended periods of time (100%)4. Reading a computer screen (up to 100%)5. Light lifting of less than 10 lbsWork EnvironmentColleague is responsible for maintaining a HIPAA-compliant remote workspace. Must be able to provide a quiet, uninterrupted work environment. Must have a workstation that is not accessible to common traffic and is secure from unintentional access. Must have stable personal high-speed internet and ability to hard-wire into company computer (cannot use wireless internet)Education: BS in Pharmacy or PharmD requiredBoard Certified Oncology Pharmacist (BCOP) requiredActive, unrestricted pharmacist licensure in state of residence requiredRequired Skills &amp; Other Minimum Required Qualifications: <ul> <li>Licensed Registered Pharmacist</li> <li>Board Certified Oncology Pharmacist (BCOP) required</li> <li>2+ years clinical pharmacist experience, inclusive of prior authorization experience</li> <li>Knowledge of Microsoft Office Suite: Excel and Word required; Access, Outlook, PowerPoint, Visio preferable. Keyboard skills essential.</li> <li>Must be able to multitask and utilize multiple system applications simultaneously.</li> <li>Must be able to utilize available resources independently and provide high quality work.</li> <li>Must demonstrate problem solving ability and attention to detail.</li> <li>Ability to adapt and change with workflow and shifting priorities.</li> <li>Ability to work effectively in a team environment and provide mentorship to non-clinical staff on the PA team.</li> <li>Must possess excellent written, verbal, grammar, and listening communication skills.</li> <li>Must be able to effectively communicate with a diverse customer base (internal and external) in a friendly and confident manner.</li> <li>Ability to maintain confidentiality of PHI (Protected Healthcare Information).</li> </ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$45.43 - $101.54This 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: 05/12/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVSHealth

Clinical Pharmacist - Prior Authorization/Oncology (BCOP Required)

Job TitleDirector, Portfolio AdministrationJob Description SummaryPosition operates as a part of the North American Portfolio Administration Leadership team. Responsible to serve as point of contact for the client ensuring the highest level of customer service and to ensure Portfolio Lease Administration are sold, executed, and performed to the highest industry standards.Job Description<ul><li>Maintain track record of value creation and contribute to profitable/cost effective operations</li></ul><ul><li>Ensure financial performance of designated account(s) within the Portfolio Lease Administration Service Line</li></ul><ul><li>Develop and recommend department operations policy; provide strategic leadership within the department</li></ul><ul><li>Assist with the development of proposals and presentations for prospective projects</li></ul><ul><li>Coordinate and/or prepare reports, annual budgets, or needed financial documents</li></ul><ul><li>Deliver budgeted financial targets and other standards set forth in approved business plans for the combined businesses/accounts within the region</li></ul><ul><li>Provide strategic and tactical decisions of the business unit, including the identification of product line expansion/diversification opportunities and playing a key role in marketing for new business</li></ul><ul><li>Develop and cultivate customer relationships for long-term business opportunities</li></ul><ul><li>Manage a group if direct reports between 3-10 people.</li></ul><ul><li>Performs other related duties as required or requested.</li></ul> Cushman &amp; Wakefield is an Equal Opportunity employer to all protected groups, including protected veterans and individuals with disabilities. Discrimination of any type will not be tolerated.In compliance with the Americans with Disabilities Act Amendments Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a position at Cushman &amp; Wakefield, please call the ADA line at 1-888-365-5406 or email <a href="#">HRServices@cushwake.com</a>. Please refer to the job title and job location when you contact us.INCO: “Cushman &amp; Wakefield”

Cushman & Wakefield

Director, Portfolio Administration

Job TitleSenior Manager, Transformation Americas ServicesJob Description SummaryOverall responsible to identify and drive transformation opportunities to meet business needs across Investors Services. Requires independent business interactions across cross functional teams with ability to gather and evaluate requirements, quantify business value of opportunities, design efficient and effective processes, and pilot and implement robust solutions.Job DescriptionResponsibilities:<ul> <li>Manage teams and projects, lead business interactions and assist with transformation proposals within the organization</li> <li>Identify transformation opportunities and business needs; maintain and utilize relationships as well as communication of value proposition</li> <li>Prepare and / or coordinate complex written presentation materials</li> <li>Lead, coach and develop Analysts, providing day to day leadership</li> <li>Perform accurate analysis and design effective solutions to a variety or organizational issues.</li> <li>Strong ability to develop, create, and analyze key metrics.</li> <li>Organize and communicate data in a meaningful way.</li> <li>Ability to evaluation, prioritize and build automations to maximize efficiencies.</li> </ul>Qualifications: <ul> <li>Bachelor’s degree in Finance or Accounting a plus</li> <li>7+ years of related professional work experience </li> <li>Prior people management experience of a small team</li> <li>Ability to assess granular level details to facilitate strategic high-level decision making</li> <li>Effective and efficient time management skills and ability to multi-task</li> <li>Detail oriented, organized, and thorough</li> <li>Proven record of providing excellent internal and external customer service and relationship development</li> <li>Excellent oral and written communications skills, including presentation skills</li> </ul> Cushman &amp; Wakefield also provides eligible employees with an opportunity to enroll in a variety of benefit programs, generally including health, vision, and dental insurance, flexible spending accounts, health savings accounts, retirement savings plans, life, and disability insurance programs, and paid and unpaid time away from work. In addition to a comprehensive benefits package, Cushman and Wakefield provide eligible employees with competitive pay, which may vary depending on eligibility factors such as geographic location, date of hire, total hours worked, job type, business line, and applicability of collective bargaining agreements. The compensation that will be offered to the successful candidate will depend on factors such as whether the position is covered by a collective bargaining agreement, the geographic area in which the work will be performed, market pay rates in that area, and the candidate’s experience and qualifications. The company will not pay less than minimum wage for this role. The compensation for the position is: $106,250.00 - $125,000.00Cushman &amp; Wakefield is an Equal Opportunity employer to all protected groups, including protected veterans and individuals with disabilities. Discrimination of any type will not be tolerated.In compliance with the Americans with Disabilities Act Amendments Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a position at Cushman &amp; Wakefield, please call the ADA line at 1-888-365-5406 or email <a href="#">HRServices@cushwake.com</a>. Please refer to the job title and job location when you contact us.INCO: “Cushman &amp; Wakefield”

Senior Manager, Transformation Americas Services

Job TitleSpatial Data StrategistJob Description SummaryThe Spatial Data Strategist on a Space Management team is to help solve business problems by building standard and ad hoc dashboards. Provide strategic space and occupancy planning expertise in support of long-term supply and demand planning, real estate strategy, workplace design, space analysis and space efficiency within a Client’s real estate portfolio data.Job DescriptionPrinciple Responsibilities<ul> <li>Building standard and ad hoc BI dashboards</li> <li>Utilization and allocation reporting analysis</li> <li>Work with Spatial data team to create scenarios and long-term strategic planning related to space</li> <li>Contribute to workplace trends/strategies and future ways of working.</li> <li>Work with various levels of the organization to capture project goals, objectives, and the associated requirements.</li> <li>Work with business key stakeholders to determine various KPIs and data reporting needs for various levels</li> <li>Gather requirements for building external and internal data dashboards. Work with vendors and customer to understand data needs</li> <li>Understand various roles and responsibilities in business group for better data governance and data security</li> <li>Cross functional collaboration with other service lines and SME Functions to ensure consistency of data across platforms and processes.</li> <li>Continual focus on innovation, constantly striving to improve delivery of services. This will include actively obtaining feedback from stakeholders and responding to the same, bringing in industry knowledge, innovation and best practice.</li> <li>Show strong verbal presentation skills and ability to communicate to executive level</li> <li>Process work quickly, accurately, and with changing priorities</li> </ul>Targeted Competencies<ul> <li>Advanced skills in Business Intelligence tools (i.e.: Tableau and Power BI)</li> <li>Advanced/Expert skills in Excel</li> <li>Advanced skills in Adobe and Microsoft application suites</li> <li>Strong written and verbal presentation skills, ability to communicate to executive level and internal teams</li> <li>Solid business acumen; ability to understand and anticipate business needs to provide appropriate solutions</li> <li>Strong team player who is adaptable and capable of driving change / change management</li> <li>Possess analytical, organizational and problem-solving skills with a focus on the long term, strategic vision.</li> <li>Advanced understanding of CAFM\IWMS (Serraview preferred) for Space Management preferred</li> <li>Basic understanding of Corporate Real Estate and Financial concepts</li> <li>Bachelor’s degree (BA/BS) in a related discipline or field of study (i.e. Data and Analytics, Computer Science, Information Systems, Architecture, Interior Design, Corporate Real Estate &amp; Facilities Management Planning/Coordination, Facilities, Project or Construction Management, etc.) preferred</li> <li>Seven+ year’s experience in a corporate real estate environment preferred</li> <li>Ability to process work quickly, accurately and with changing priorities</li> <li>Ability to effectively interpret and apply policy and procedure</li> </ul> Cushman &amp; Wakefield also provides eligible employees with an opportunity to enroll in a variety of benefit programs, generally including health, vision, and dental insurance, flexible spending accounts, health savings accounts, retirement savings plans, life, and disability insurance programs, and paid and unpaid time away from work. In addition to a comprehensive benefits package, Cushman and Wakefield provide eligible employees with competitive pay, which may vary depending on eligibility factors such as geographic location, date of hire, total hours worked, job type, business line, and applicability of collective bargaining agreements. The compensation that will be offered to the successful candidate will depend on factors such as whether the position is covered by a collective bargaining agreement, the geographic area in which the work will be performed, market pay rates in that area, and the candidate’s experience and qualifications. The company will not pay less than minimum wage for this role. The compensation for the position is: $84,915.00 - $99,900.00Cushman &amp; Wakefield is an Equal Opportunity employer to all protected groups, including protected veterans and individuals with disabilities. Discrimination of any type will not be tolerated.In compliance with the Americans with Disabilities Act Amendments Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a position at Cushman &amp; Wakefield, please call the ADA line at 1-888-365-5406 or email <a href="#">HRServices@cushwake.com</a>. Please refer to the job title and job location when you contact us.INCO: “Cushman &amp; Wakefield”

Spatial Data Strategist

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position SummaryThe Behavioral Health Medical Director is responsible for behavioral health medical leadership providing their subject matter expertise to the health plan. They will have key roles in utilization management and case management programs for mental health and substance use disorder services. They will collaborate with health plan leadership to oversee the behavioral health benefit and work collaboratively with state agency leaders and other stakeholders as it relates to behavioral health needs. Responsibilities include ∙ Participation in the development of clinical practice standards, policies, and procedures ∙ Behavioral health care management performance and coordination with physical health care management ∙ Participation in state agency/stakeholder meetings when requested ∙ Oversight and implementation of the utilization management program for behavioral health services, including preventing contraindicated care ∙ Ensuring consistency in the application of utilization management standards, including those implemented by subcontracted entities ∙ Overseeing the complaint and grievance process for behavioral health denials, ∙ Review and resolution of quality-of-care concerns ∙ Participation in clinical staff recruitment and ongoing performance improvement. ∙ Provide strategic oversight and leadership for all behavioral health activities within the health plan. ∙ Serve as the subject matter expert on behavioral health for ABHKY, ensuring compliance and alignment with state regulations and expectations. ∙ Lead and coordinate efforts with the state and other health plan colleagues to promote integrated care models. ∙ Oversee coordination activities with the state, ensuring effective collaboration and adherence to regulatory requirements. ∙ Work closely with health plan leadership, the Chief Medical Officer, other Medical Leadership, Pharmacy Director, clinical staff (including those in utilization management, care management, quality management), and colleagues within network and provider relations, to enhance the delivery of holistic and integrated care. ∙ Contribute to the development and implementation of policies and procedures that support the health plan's objectives and comply with state guidelines. ∙ Advocate for and implement innovative approaches to behavioral health care, promoting evidence-based practices that enhance patient outcomes. ∙ Support duties as required regarding utilization management of the service benefit and pharmacy benefit within the state health plan and additional duties as assigned. ∙ Actively participate in continuous improvement activities, development and monitoring of SAI initiatives, and other activities that support quality of care and total cost of care oversight. ∙ Serve as a key health plan external facing liaison, regarding behavioral health initiatives, programs, and projects with state regulators, providers, vendors, and community organizations. ∙ Provides guidance and/or represents the Health Plan in all state fair hearings for services that are behavioral health related. Required Qualifications ∙ Board-certified Psychiatrist licensed in the State of Kentucky. ∙ Clinical experience in the treatment of substance use disorders, including utilization of ASAM criteria, and an understanding of the Kentucky system of care. ∙ At least five years combined experience in mental health and substance use services and at least two (2) years of BH leadership experience in a government, health management, or managed care organization, and/or at least two (2) years of experience as a Medical Director in clinical practice, and/or at least three (3) years of clinical BH experience (excluding psychiatric residency). Preferred Qualifications ∙ Experience with KY Medicaid behavioral health benefits and service ∙ Ability to effectively interact with providers, advocacy groups and State partners ∙ Excellent organization and time management skills ∙ Experience navigating a matrixed organization. ∙ KY Medicaid regulatory experienceEducationMD or DOPay RangeThe typical pay range for this role is:$174,070.00 - $374,920.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 07/25/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Behavioral Health Medical Director - ABH KY

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. Medical Director - SIU (Special Investigations Unit) CVS Health - Special Investigations Unit (SIU) Join our mission to safeguard healthcare integrity and protect patient well-being. As the Medical Director of Healthcare Fraud Investigations, you'll lead our efforts to detect, prevent, and combat fraudulent activities in the healthcare system. **This is a remote based, work from home role.** Key Responsibilities: The Special Investigations Unit (SIU) Medical Director will be responsible for performing reviews of medical records in support of healthcare fraud investigations. Serving as a clinical liaison supporting SIU activities across all lines of business the SIU Medical Director will be responsible for making both pre and post-payment claim payment determinations based on Aetna Clinical Policy and/or state and federal regulations. Additional responsibilities include: <ul><li>Serves as a clinical liaison supporting SIU Investigators, Managers, and Directors in matters pertaining to the investigation of suspected healthcare fraud cases </li></ul> <ul><li>Develops and delivers presentations to internal and external customers regarding healthcare fraud matters and Aetna’s approach to fighting fraud. </li></ul> <ul><li>Provides clinical expertise and business direction in the creation of analytical solutions designed to identify potentially fraudulent scenarios </li></ul> <ul><li>Maintains open communication with constituents within and external to the organization </li></ul> <ul><li>Uses available resources and technology in developing evidence, supporting allegations of fraud, waste, or abuse </li></ul> <ul><li>Documents all appropriate information related to medical review determinations </li></ul> <ul><li>Proactively builds relationships with other internal MDs to obtain clinical guidance when required to ensure accurate decision making </li></ul> <ul><li>Represents Aetna as a witness in legal matters as required, and as approved by the Legal Department. Demonstrates high level of knowledge and acts confidently when providing testimony during civil or criminal proceedings. </li></ul> <ul><li>Responsible for peer to peer reviews of SIU related claims based on provider escalation or state/federal requirements </li></ul> <ul><li>Supports legal efforts by providing expert medical testimony and </li></ul> <ul><li>Conducts root cause analysis to identify potential control gaps in the organization’s existing clinical policy, procedures, claim editing etc., and proactively seeks out appropriate contacts to help implement solutions. </li></ul> <ul><li>Mentor and educate SIU team members on clinical aspects of fraud schemes </li></ul> Required Qualifications: <ul><li>MD or DO with active license, preferably in emergency medicine or primary care </li></ul> <ul><li>5+ years of clinical practice experience </li></ul> <ul><li>Strong analytical and problem-solving skills </li></ul> <ul><li> Excellent communication and leadership abilities </li></ul> Preferred Qualifications: <ul><li>3+ years supporting healthcare fraud investigations or related field </li></ul> <ul><li>Board Certification in Emergency Medicine</li></ul> Education: <ul> <li>Active and current state medical license without encumbrances</li> <li>M.D. or D.O., Board Certification in a recognized specialty including post-graduate direct patient care experience</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: 07/28/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Medical Director - SIU (Special Investigations Unit)

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 We are seeking a highly skilled and experienced Security Engineer to join our Secure Collaboration Team. The successful candidate will be responsible for maintaining and enforcing security policies for various collaboration platforms, including SharePoint, OneDrive, Teams, Slack, SFTP, eShare, and related capabilities. This role will play a critical part in ensuring the security and compliance of these platforms while supporting the organization's overall secure sharing strategy.Primary Job Duties &amp; Responsibilities<ul> <li>Develop, implement, and maintain security policies for collaboration platforms, like M365, Teams, Slack, and SFTP, ensuring alignment with corporate security standards and regulatory compliance requirements.</li> <li>Oversee user access controls, identity management, and permission policies for collaboration platforms to ensure the least privilege access model.</li> <li>Conduct regular risk assessments and vulnerability assessments for collaboration platforms and implement necessary risk mitigation controls.</li> <li>Work with internal teams to integrate collaboration platforms into the enterprise security infrastructure, ensuring secure configuration and setup.</li> <li>Educate employees on best practices for secure usage of collaboration platforms, promoting a culture of security awareness within the organization.</li> <li>Work closely with IT, compliance, and business teams to ensure security requirements are met and any security concerns are addressed promptly.</li> <li>Develop and maintain collaboration dashboards and KPI reports in PowerBI to continuously monitor usage and trends of various collaboration platforms.</li> <li>Track and report usage of unsanctioned file sharing tools and cloud storages, support documentation of security incidents, response actions, and lessons learned.</li> <li>Stay up to date with security features and tools available for platforms like M365, Teams, eShare, Slack, and SFTP, and leverage them to enhance platform security.</li> <li>Create and maintain Azure Runbooks using PowerShell scripts, and automation using PowerApps.</li> <li>Continuously drive a simplified, consistent user experience at points of service engagement.</li> </ul>Required Qualifications<ul> <li>5+ years of experience in a security engineering or administration of collaboration platforms such as SharePoint, OneDrive, Teams, Slack, and cloud sharing tools.</li> <li>3+ years of experience with data at rest and data in motion encryption and other data protection techniques in cloud environments.</li> <li>2+ year of experience with automation of apps utilizing PowerApp.</li> <li>2+ year of experience in cloud sharing security configuration of M365 services and Azure.</li> <li>2+ year of experience with PowerBI and Azure Runbooks using Powershell.</li> </ul> Preferred Qualifications<ul> <li>Experience with eShare collaboration platform.</li> <li>Experience with secure file access and transfer protocols (SFTP).</li> <li>Excellent problem-solving skills and ability to work independently and collaboratively in a fast-paced environment.</li> <li>Strong communication skills to articulate security risks, solutions, and best practices to non-technical stakeholders.</li> <li>Demonstrated experience working with a wide range of internal and external stakeholders at all levels on strategic and operational information security programs.</li> <li>Strong analytical skills and the ability to understand and solve complex problems</li> <li>Experience in documenting and implementing procedures and guidelines.</li> <li>Continuous learner well informed on technology trends, tools, methodologies, and models.</li> <li>Ability to manage a high degree of complexity and distill information that provides clear direction.</li> <li>Comfortable operating within areas of ambiguity to iterate and make progress in a consistent manner.</li> <li>Agility to deal with a constantly changing business environments.</li> </ul> Education<ul><li>Bachelor’s degree or equivalent experience (High School Diploma and 4 years relevant experience)</li></ul>BUSINESS OVERVIEWBring 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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunitiesAnticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$101,970.00 - $203,940.00This 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: 07/31/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Senior Security Engineer - Secure Collaboration

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 CVS Health, a Fortune 6 company, has an outstanding opportunity for a Medical Director (Medical Affairs).This is a remote based, work from home opportunity. The Medical Affairs department provides clinical business support to the entire enterprise and provides clinical oversight and mentorship for CVS Health clinical programs, PBM Clinical Quality activities, consultative support to the P&amp;T process, formulary development, drug information services and pipeline activities, and provision of clinical leadership to various internal departments (e.g., specialty pharmacy services, clinical product development, Enterprise Analytics, Compliance, Legal, Accreditation) and clients. The Medical Director (Medical Affairs) will report into the Medical Affairs Department and is responsible for clinical support and consultative activities across the PBM. In this role you may provide consultative clinical support to Account Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and appeals) and responds to prescriber inquiries related to UM transactions and more generally related to CVS Health coverage policies. Medical Directors at CVS Health are encouraged to model the highest levels of clinical integrity, knowledge and cross functional thinking and decision making. Medical Directors represent the clinical decision making and professional thought process of the prescriber as a partner across the enterprise’s decisions and planning. – Each Director is responsible for providing oversight of a portion of CVS Health's clinical programs and commercial client program support. Will share in reviews of utilization management (PA) criteria and clinical policy revisions/reviews. – Directors will spend a portion of most days completing assigned medication utilization reviews (PA) and/or medical necessity appeals for commercial clients, governmental (Medicare/Medicaid) programs and individual client requested coverage determinations or appeals when appropriate. – Medical Directors will participate in inter-rater review activities and other quality oversight processes for internal Director UM decisions. If specifically assigned to one business segment (i.e., Medicare clients), each director will become sufficiently skilled in various UM programs to support other segments (including commercial and Medicaid) on evening and weekend coverage. –In this role you'll perform a share of special clinical investigations and research as requested by the Senior Medical Director, Medical Affairs. These projects can include brief reviews of published literature around specific pharmaceutical questions or more in-depth projects requiring collaboration with pharmacists within Medical Affairs and in business units outside of the Department. CVS Health, a Fortune 4 company, has an outstanding opportunity for a Medical Director (Medical Affairs). Required Qualifications * Family Medicine or Internal Medicine Board Certification.* Minimum of 5 years clinical experience in direct patient care. * 2 or more years proven experience in clinical outcomes, with a solid understanding of medical statistics, regulatory agencies, and analytic programs * Unrestricted license to practice medicine in the state in which the candidate is located. Preferred Qualifications * Combination of five years of management and/or clinical experience in a managed care environment and health administration, including adequate clinical experience in direct patient care and working with professionals at different levels as a teammate (e.g., RNs, PharmDs, etc.). * ABMS or AOA Board Certified in a recognized medical specialty, preferably in a Primary Care field (Internal medicine, Family Medicine) * Master’s Degree in Public Health Administration or MBA preferred, UM/QA certification desired * Proficiency in MS Office Suite Education * Must be graduate of an accredited Medical School and Residency Program * Possess an unrestricted active license to practice medicine in a State, Territory, Commonwealth of the United States, or the District of Columbia * Required annual Continuing Medical Education (CME) up to date and must remain current in medical and management areas during employmentPay 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: 06/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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