field_remote_option

field_job_occupational_field_parents_all

job_organization_name

job_upgrade_is_featured

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 SummaryMeritain Health is ranked as one of the nation’s largest Third-Party Administrators. Meritain Health’s Manager of Business Compliance will be responsible for the following: • Independently collecting facts and utilizing strong analytical capabilities to provide guidance on complex settlement matters and effectively communicates status and results in a concise and timely manner • Researching and responding to inquiries from regulatory agencies • Respond to Mental Health Parity intake requests • Responding to complex requests for information within area of responsibility from internal and external partners • Monitor compliance activities to identify and report trends • Monthly KPI reporting • Assume other duties/responsibilities as assigned The ideal candidate should possess the following skills: • Attention to detail • Analytical and problem-solving skills • Superior critical thinking skills • Effective time management, organizational and prioritization skills • Quickly grasp business concepts, objectives, and strategies • Collaborate effectively and professionally with internal and external partners Required Qualifications3+ years of healthcare insurance industry experience 3+ years of compliance, quality and/or regulatory experience Demonstrated excellent and effective verbal and written communication skills with the ability to convey information to internal and external clients in a clear, accurate, and concise manner. Experience managing simultaneous projects with multiple deliverables. Strong MS Office skills. Preferred Qualifications Knowledge of self-funded health plans and Third-Party Administrators. Understanding of legal requirements. Experience with or understanding of Mental Health Parity EducationBachelor’s degree or equivalent experience. 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: 04/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVSHealth

Regulatory Compliance Manager

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.

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

Enterprise Systems QE EngineerWhat you can expectZoom offers Zoom Phone, Rooms, Webinars, Apps, and OnZoom for video conferencing. They prioritize customer and user needs when creating solutions. The Data Science team needs assistance with campaign marketing and eCommerce analytics. The ideal candidate is motivated, communicative, innovative, and skilled at problem-solving. The position requires collaboration with various teams on crucial company projects.About the TeamZoom's Information Technology team is dedicated to delivering customer happiness, enhancing business efficiency, and fostering agility through innovation, data insights, and automation. Our impact is evident in seamless user experiences, streamlining processes, and supporting Zoom's growth in communication and collaboration.What we’re looking for<ul> <li>Have a Bachelor's in Computer Science/Computer Engineering or equivalent</li> <li>8+ years of overall quality assurance experience including Functional &amp; Automation in long-term enterprise level roles</li> <li>Have sound expertise in Selenium ,Cypress,Playwright or any other test automation tool.</li> <li>Be proficient in Java,Python,Javascript for test Automation</li> <li>Have hands-on experience with source control,Test Management and bug tracking tools ( JIRA, Zephyr, Github, Gitlab, Jenkins etc)</li> <li>Have good knowledge of cloud-based testing solutions (BrowserStack, SauceLabs).</li> <li>Have experience in AI-driven test automation tools</li> <li>Have experience in Performance testing (JMeter, Gatling).</li> </ul>Ways of Working Our structured hybrid approach is centered around our offices and remote work environments. The work style of each role, Hybrid, Remote, or In-Person is indicated in the job description/posting.Benefits As part of our award-winning workplace culture and commitment to delivering happiness, our benefits program offers a variety of perks, benefits, and options to help employees maintain their physical, mental, emotional, and financial health; support work-life balance; and contribute to their community in meaningful ways. Click <a href="https://careers.zoom.us/benefits" target="_blank">Learn</a><a href="http://careers.zoom.us/benefits" target="_blank"> </a>for more information.About Us Zoomies help people stay connected so they can get more done together. We set out to build the best collaboration platform for the enterprise, and today help people communicate better with products like Zoom Contact Center, Zoom Phone, Zoom Events, Zoom Apps, Zoom Rooms, and Zoom Webinars. We’re problem-solvers, working at a fast pace to design solutions with our customers and users in mind. Here, you’ll work across teams to deliver impactful projects that are changing the way people communicate and enjoy opportunities to advance your career in a diverse, inclusive environment. Our Commitment​ We believe that the unique contributions of all Zoomies is the driver of our success. To make sure that our products and culture continue to incorporate everyone's perspectives and experience we never discriminate on the basis of race, religion, national origin, gender identity or expression, sexual orientation, age, or marital, veteran, or disability status. Zoom is proud to be an equal opportunity workplace and is an affirmative action employer. All your information will be kept confidential according to EEO guidelines.We welcome people of different backgrounds, experiences, abilities and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.If you need assistance navigating the interview process due to a medical disability, please submit an <a href="https://form.asana.com/?k=OIuqpO5Tv9XQTWp1bNYd8w&amp;d=1127274756253361" target="_blank">Accommodations Request Form</a> and someone from our team will reach out soon. This form is solely for applicants who require an accommodation due to a qualifying medical disability. Non-accommodation-related requests, such as application follow-ups or technical issues, will not be addressed.#LI-Remote

Zoom

Enterprise Systems QE Engineer

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.Position Summary *Must Live/ work in PST*The Care Management Associate (CMA) supports comprehensive coordination of medical services that include intake and outgoing calls for medical services. We work closely with both case management team and utilization management team. • The Care Management Associate will review eligibility and benefits and open pre-certification cases and either approve or send to nursing staff for review. • The Care Management Associate role include: • Responsible for initial review and triage of Care Team tasks. • Identifies principal reason for admission, facility, and member product to correctly apply intervention assessment tools. • Screen patients using targeted intervention business rules and processes to identify needed medical services, make appropriate referrals to medical services staff and coordinate the required services in accordance with the benefit plan. • Monitors non-targeted cases for entry of appropriate discharge date and disposition. • Identifies and refers outlier cases (e.g., Length of Stay) to clinical staff. • Identifies triggers for referral into Aetna’s Case Management, Disease Management, Mixed Services, and other Specialty Programs. • Utilizes Aetna systems to build, research and enter member information, as needed. • Support the Development and Implementation of Care Plans. • Coordinates and arranges for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense by identifying opportunities for the patient to utilize participating providers and services • Promotes communication, both internally and externally to enhance effectiveness of medical management services (e.g., health care providers, and health care team members respectively) • Performs non-medical research pertinent to the establishment, maintenance, and closure of open cases • Provides support services to team members by answering telephone calls, taking messages, researching information, and assisting in solving problems. • Adheres to Compliance with PM Policies and Regulatory Standards. • 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. • May assist in the research and resolution of claims payment issues. • Supports the administration of the hospital care, case management and quality management processes in compliance with various laws and regulations, URAQ and/or NCQA standards, Case Management Society of America (CMSA) standards where applicable, while adhering to company policy and procedures. Required Qualifications Minimum of 6 months of call center experience required. Must live/work in PST Preferred Qualifications • Effective communication, telephonic and organization skills. • Familiarity with basic medical terminology and concepts used in care management. • 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 to navigate through Internal/external computer systems, including Excel and Microsoft Word. EducationHigh School Diploma or equivalent experienceAnticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$18.50 - $31.72This 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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">Benefits | CVS Health</a>We anticipate the application window for this opening will close on: 02/28/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Care Management 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

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. <h1>Position Summary</h1> Provide comprehensive healthcare management to facilitate delivery of appropriate quality healthcare, promote cost effective outcomes and improve program/operational efficiency involving clinical issues. Supports comprehensive coordination of medical services including intake, screening and referrals to Aetna Medical Services Programs. Promotes/supports quality effectiveness of Healthcare Services Training Schedule: Monday -Friday 8:00am – 5:00pm (11 weeks, 100% attendance required)Schedule: Monday - Friday Anytime between 8am – 6:00pm ESTRequired Qualifications - 2+ years of previous Customer Service experience (Call center experience)- 2+ Data Entry- 1+ year experience with Microsoft office applications Preferred Qualifications - Medical Assisting, Medical office experience.- Familiarity with medical terminology and concepts used in care management.- Effective communicator, strong customer service skills, computer literacy in order to navigate through internal/external computer systems.- The ability to effectively communicate in a multi-disciplinary team. 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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">Benefits | CVS Health</a>We anticipate the application window for this opening will close on: 03/15/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Inbound/Outbound Queue Associate

Solutions Engineer (Mid-Market) What you can expect The Zoom Virtual Engineering (ZVE) Solutions Engineer serves as the trusted advisor. Zoom Virtual Engineering (ZVE) leverages a digital platform to scale and accelerate pre-sales coverage in the markets we serve. You will articulate Zoom's architectural advantages to our customers and support the Account Executive to propose and design solutions. About the Team Our Zoom Virtual Engineering team is passionate about our people and making a positive impact on our customers, the team, and the world. We encourage individual growth and development with the ability to specialize from entry to expert level across multiple products/solutions within the Zoom Platform. Our team culture is embracing our global diversity and extreme collaboration which enables a cohesive and connected family in Zoom Virtual Engineering. Our clear goals, guiding principles, and shared purpose empower every member to leverage their strengths and have a great sense of achievement. Responsibilities<ul> <li>Designing next generation communication solutions for Zoom customers</li> <li>Conducting demos and POCs (proofs of concept) for prospective and existing Zoom customers</li> <li>Conducting solution and architectural design and selling</li> <li>Building competitive intelligence</li> <li>Doing RFQ/RFP response and preparation</li> <li>Working Across Multiple Boundaries</li> </ul> What we’re looking for <ul> <li>Have Bachelor of Science (BS) / Bachelor of Engineering (BE) or equivalent</li> <li>2-4 years of technical experience in Collaboration technologies</li> <li>Have SaaS Collaboration sales, success or tech support experience (i.e. web conferencing, cloud voice, UCaaS)</li> <li>Be able to clearly present topics to different audiences in Spanish and converse conversational in English</li> <li>Be able to present topics in a clear and concise manner to many levels of technical skill sets and audience sizes</li> <li>Be flexible and able to function in a high-growth environment</li> <li>Have basic understanding of DevOps with basic programming knowledge</li> </ul>Ways of Working Our structured hybrid approach is centered around our offices and remote work environments. The work style of each role, Hybrid, Remote, or In-Person is indicated in the job description/posting.Benefits As part of our award-winning workplace culture and commitment to delivering happiness, our benefits program offers a variety of perks, benefits, and options to help employees maintain their physical, mental, emotional, and financial health; support work-life balance; and contribute to their community in meaningful ways. Click <a href="https://careers.zoom.us/benefits" target="_blank">Learn</a><a href="http://careers.zoom.us/benefits" target="_blank"> </a>for more information.About Us Zoomies help people stay connected so they can get more done together. We set out to build the best collaboration platform for the enterprise, and today help people communicate better with products like Zoom Contact Center, Zoom Phone, Zoom Events, Zoom Apps, Zoom Rooms, and Zoom Webinars. We’re problem-solvers, working at a fast pace to design solutions with our customers and users in mind. Here, you’ll work across teams to deliver impactful projects that are changing the way people communicate and enjoy opportunities to advance your career in a diverse, inclusive environment. Our Commitment​ We believe that the unique contributions of all Zoomies is the driver of our success. To make sure that our products and culture continue to incorporate everyone's perspectives and experience we never discriminate on the basis of race, religion, national origin, gender identity or expression, sexual orientation, age, or marital, veteran, or disability status. Zoom is proud to be an equal opportunity workplace and is an affirmative action employer. All your information will be kept confidential according to EEO guidelines.We welcome people of different backgrounds, experiences, abilities and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.If you need assistance navigating the interview process due to a medical disability, please submit an <a href="https://form.asana.com/?k=OIuqpO5Tv9XQTWp1bNYd8w&amp;d=1127274756253361" target="_blank">Accommodations Request Form</a> and someone from our team will reach out soon. This form is solely for applicants who require an accommodation due to a qualifying medical disability. Non-accommodation-related requests, such as application follow-ups or technical issues, will not be addressed.#LI-Remote

Solution Engineer (Mid-Market) - Mexico

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

What you can expectIn this role, you contribute to Workvivo’s success by understanding our Enterprise customers’ needs and requirements. You are a storyteller at heart, delivering a compelling, well-researched and targeted “Demo” of our product for the desired future state of the business. As we scale activities across EMEA, you will leverage the tools and resources available to you, to accelerate sales opportunities and pipeline creation for Enterprise clients. You will lead responses to Request for Information (RFI) &amp; Request for Proposals (RFP), and deliver Evaluations (Eval) &amp; Proof of Concept (POC).About the TeamWorkvivo is an employee experience platform designed to amplify workplace culture and foster employee engagement, regardless of location. Committed to customer satisfaction, Workvivo focuses on enhancing employees' working lives across diverse industries globally. As part of Zoom, Workvivo aligns with Zoom's mission to prioritize people, enabling meaningful connections, modern collaboration, and driving innovation in businesses and individual interactions.What we’re looking for<ul> <li>5+ years experience as a Solutions Engineer, with exposure and experience with Enterprise clients</li> <li>Bachelor's degree in computer science, Information Technology, or related field experience.</li> <li>Have drive, ambition, and a positive attitude.</li> <li>Demonstrate trusted advisor status by demonstrating a solid understanding of the Customers business objectives.</li> <li>Able to take responsibility for the problem statement and work collaboratively to resolve issues in a timely manner.</li> <li>Have ownership and responsibility, proactively make suggestions and is comfortable leading internal projects, ability to function effectively in ambiguous circumstances.</li> <li>Able to work to deadlines and be comfortable with juggling various tasks of a different nature.</li> <li>Willingness to travel as needed to meet with customers, trade-shows, corporate events globally and participate in sales engagements.</li> <li>Propose solutions that integrate Workvivo’s platform with customers' existing technology stacks, ensuring seamless operation and optimisation of their Employee Engagement &amp; Communication strategies.</li> <li>Respond to technical queries and concerns during the sales process, ensuring customers' and prospects' technical requirements are addressed effectively.</li> <li>Strong understanding of cloud computing architectures and the SAAS model specifically. </li> <li>Strong understanding of Enterprise IT architectures and platforms, including in particular Active Directory AD, SCIM API based automated user provisioning, SAML based SSO, Intranet, Content Management Systems CMS, Document Management Systems DMS</li> </ul>Ways of Working Our structured hybrid approach is centered around our offices and remote work environments. The work style of each role, Hybrid, Remote, or In-Person is indicated in the job description/posting.Benefits As part of our award-winning workplace culture and commitment to delivering happiness, our benefits program offers a variety of perks, benefits, and options to help employees maintain their physical, mental, emotional, and financial health; support work-life balance; and contribute to their community in meaningful ways. Click <a href="https://careers.zoom.us/benefits" target="_blank">Learn</a><a href="http://careers.zoom.us/benefits" target="_blank"> </a>for more information.About Us Zoomies help people stay connected so they can get more done together. We set out to build the best collaboration platform for the enterprise, and today help people communicate better with products like Zoom Contact Center, Zoom Phone, Zoom Events, Zoom Apps, Zoom Rooms, and Zoom Webinars. We’re problem-solvers, working at a fast pace to design solutions with our customers and users in mind. Here, you’ll work across teams to deliver impactful projects that are changing the way people communicate and enjoy opportunities to advance your career in a diverse, inclusive environment. Our Commitment​ We believe that the unique contributions of all Zoomies is the driver of our success. To make sure that our products and culture continue to incorporate everyone's perspectives and experience we never discriminate on the basis of race, religion, national origin, gender identity or expression, sexual orientation, age, or marital, veteran, or disability status. Zoom is proud to be an equal opportunity workplace and is an affirmative action employer. All your information will be kept confidential according to EEO guidelines.We welcome people of different backgrounds, experiences, abilities and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.If you need assistance navigating the interview process due to a medical disability, please submit an <a href="https://form.asana.com/?k=OIuqpO5Tv9XQTWp1bNYd8w&amp;d=1127274756253361" target="_blank">Accommodations Request Form</a> and someone from our team will reach out soon. This form is solely for applicants who require an accommodation due to a qualifying medical disability. Non-accommodation-related requests, such as application follow-ups or technical issues, will not be addressed.#LI-Remote

108 Other Jobs in Richmond, VA, USA