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 SummaryManage the development, submission, and state approval process for insurance form filings. Key Responsibilities:<ul><li>Drafting and reviewing product filings:</li></ul>Draft Medicare Supplement and short-term limited duration health insurance products (policies, forms, brochures, etc.) to ensure compliance with all applicable laws, regulations, and guidelines.<ul><li>Compliance:</li></ul>Verify that the products meet specific requirements regarding benefits, premium structures, eligibility, and other relevant aspects.<ul><li>Regulatory Updates:</li></ul>Stay abreast of changes in state and federal regulations related to Medicare supplement insurance.<ul><li>Record Keeping:</li></ul>Maintain accurate records of product filings and related correspondence.<ul><li>Coordination:</li></ul>Collaborate with other business areas and stakeholders within the company throughout the product filing and approval process.<ul><li>Specialized Knowledge:</li></ul>Possess a strong understanding of Medicare supplement and short term, limited duration health insurance products including and their benefits. Required Qualifications<ul> <li>Minimum of five (5) years of work experience in insurance product development and a policy forms drafting capacity with a health insurance carrier.</li> <li>Minimum of five (5) years of work experience with, health insurance products, specifically including Medicare Supplement and short-term limited duration health insurance plans, products, applicable regulations, and industry practices.</li> <li>Familiarity with legal research and review of applicable statutes and regulations.</li> <li>Strong analytical skills with the ability to review and analyze complex data and documents.</li> <li>Experience with independently drafting complex health insurance policy documents, applications, policy riders, and outlines of coverage.</li> <li>Strong attention to detail, in particular accuracy and meticulousness in reviewing and processing filings via SERFF.</li> <li>Excellent ability to communicate effectively, both verbally and in writing to effectively coordinate and communicate with internal business partners and insurance departments.</li> <li>Problem-Solving Skills: Ability to identify and resolve issues related to product filings.</li> <li>Software Proficiency: Proficiency in relevant software and databases such as Microsoft Word, Microsoft Teams, Adobe, PowerPoint, and Workfront. </li> <li>Experience with responding to insurance department questions and objections in response to insurance product filings.</li> <li>Extensive knowledge of insurance department rules and regulations governing coverage forms, endorsements, rules, and policy language requirements.</li> <li>Maintains a high level of confidentiality and professional demeanor and approach in the performance of duties.</li> <li>Must possess initiative to work independently without frequent supervisory involvement.</li> <li>Ability to quickly understand new insurance products and product changes.</li> <li>Possess high organizational skills and ability to set and adjust priorities.</li> <li>Ability to make decisions within scope of authority.</li> </ul>Preferred Qualifications Education High School diplomaAnticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$46,988.00 - $122,400.00This 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: 05/05/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVSHealth

Senior Analyst, Product & Regulatory Approvals

Overview Are you looking for a rewarding career? If so, we invite you to join our team at Amedisys, one of the largest and most trusted home health and hospice companies in the U.S. Attractive pay <ul><li>$ 24 - $ 28 /H</li></ul> What's in it for you <ul> <li>A full benefits package with choice of affordable PPO or HSA medical plans.</li> <li>Paid time off.</li> <li>Up to $1,300 in free healthcare services paid by Amedisys yearly, when enrolled in an Amedisys HSA medical plan.</li> <li>Up to $500 in wellness rewards for completing activities during the year. Use these rewards to support your wellbeing with spa services, gym memberships, sports, hobbies, pets and more.*</li> <li>Mental health support, including up to five free counseling sessions per year through the Amedisys Employee Assistance program.</li> <li>401(k) with a company match.</li> <li>Family support with infertility treatment coverage*, adoption reimbursement, paid parental and family caregiver leave.</li> <li>And more.</li> </ul> Please note: Benefit eligibility can vary by position depending on shift status. *To participate, you must be enrolled in an Amedisys medical plan. Responsibilities <ul> <li>Receives and reviews patient assessments for assigned care centers.</li> <li>Reviews diagnosis coding patient status items compared to other related patient documentation to verify completeness and accuracy on non-OASIS required assessments.</li> <li>Reviews specified OASIS patient status items for specified payors compared to other related patient documentation to verify completeness and accuracy.</li> <li>Identifies needs for additional supportive documentation/information and communicates needs to care center leadership and supervisor.</li> <li>Communicates any delays in processing assessments to supervisor and care center.</li> <li>Performs other duties as assigned.</li> </ul> Qualifications <ul><li>HCSD or BCHH-C ICD-10 certification.</li></ul> Preferred <ul><li>One year home health ICD-10 coding experience.</li></ul> Our compensation reflects the cost of labor across several U.S. geographic markets and may vary depending on location, job-related knowledge, skills, and experience. Amedisys is an equal opportunity employer. All qualified employees and applicants will receive consideration for employment without regard to race, color, religion, sex, age, pregnancy, marital status, national origin, citizenship status, disability, military status, sexual orientation, genetic predisposition or carrier status or any other legally protected characteristic.

Amedisys

Medical Coding Specialist  FT

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position SummaryAs a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. You would be responsible for ensuring the member is receiving the appropriate care at the appropriate time and at the appropriate location, while adhering to federal and state regulated turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all encompassing): -Reviews services to assure medical necessity, applies clinical expertise to assure appropriate benefit utilization, facilitates safe and efficient discharge planning and works closely with facilities and providers to meet the complex needs of the member. -Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities.-Develops, implements and supports Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work.-Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members-Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members -Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure, and clinical judgment to render coverage determination/recommendation along the continuum of care -Communicates with providers and other parties to facilitate care/treatment -Identifies members for referral opportunities to integrate with other products, services and/or programs -Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization -Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function. Required Qualifications<ul> <li> RN with current unrestricted US licensure required </li> <li> 2+ years clinical practice experience as an RN required </li> <li>2+ Years Utilization Management</li> <li> Must be willing to travel to the local office as needed if living within approximately 45 minutes/miles.</li> </ul> Preferred Qualifications<ul> <li>Bilingual highly preferred (Korean, Arabic...)</li> <li> 1+ year(s) experience utilizing multiple computer systems and applications including Microsoft Word, Excel, Outlook, and web-based applications </li> </ul> Education<ul><li> -Associates Degree in Nursing is minimum required, BSN preferred</li></ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$26.01 - $56.14This 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: 04/26/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Utilization Management: Nurse Consultant

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.Requisition Job DescriptionAt Aetna, we are committed to helping people on their path to better health. By taking a total and connected approach to health, we guide and support our members so they can get more out of life, every day. We are looking for people like you who value excellence, integrity, caring and innovation. As an employee, you’ll join a team dedicated to improving the lives of Texas members. We value diversity and are dedicated to helping you achieve your career goals.In this Aetna Network Management Role individual contributor role the contract negotiator:<ul> <li>Negotiates competitive contracts with health care providers using pre-determined internal guidelines and financial standards.</li> <li>Negotiates contract language in accordance with Aetna standards, engaging other departments as needed for review and approval of contract terms outside the standards.</li> <li>Conducts competitive and financial analyses to achieve best in market discounts and financial results that are within pre-determined targets.</li> <li>Manages contract performance and works with various internal departments to address questions, issues, and activities related to execution, loading, and ongoing maintenance of provider contracts.</li> <li>Negotiates and supports the implementation of value-based contract relationships in support of business strategies.</li> <li>Manages relationships with key providers and ensures resolution of escalated issues related, but not limited to, claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information.</li> <li>Negotiates settlements as needed. May recruit providers as needed to ensure network adequacy and achievement of network expansion goals. Maintains accountability for specific medical cost initiatives.</li> <li>Candidates residing in Texas Preferred; however, not required. </li> </ul>Required Qualifications<ul> <li>3+ years of experience negotiating contracts with ancillary providers, physician groups, and IPAs, including contract language, development, and analysis of rate proposals, identifying operational and financial improvement opportunities, and collection and analysis of competitive data and key financial metrics. Uses competitive and financial data, as well as analysis detail, to negotiate favorable contracts.</li> <li>3+ years of working knowledge of complex contracting options, provider reimbursement methodologies and terms, and contract setup. Understanding of provider financial issues, industry standard payment policies, regulatory requirements, and competitor strategies. </li> <li>Must be proficient in Word, Excel, and Microsoft Office.</li> </ul> Preferred Qualifications<ul> <li>Professional and Ancillary contracting experience.</li> <li>Strong critical thinking, problem resolution, organization, communication, and interpersonal skills. </li> <li>Able to successfully manage multiple negotiations, issues, and other tasks to ensure completion and meet deadlines. </li> <li>Able to manage expectations and maintain strong relationships, both internally and externally.</li> <li>Experience negotiating and/or managing value-based contracts brings added value.</li> </ul> Education <ul><li>Bachelor’s Degree or equivalent combination of education and professional 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: 06/29/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Mgr,Contract Negotiation

<h3> Position Summary </h3> As a senior member of Records &amp; Contracts (R&amp;C), the R&amp;C Senior Manager: Compliance &amp; Reporting leads teams (within US and India), and is responsible for complex, highly visible, and transformative records and contracts compliance programs and initiatives for the Deloitte US Firm. The Senior Manager develops strategy, oversees the execution of all associated processes, and directs interactions with senior level cross-functional stakeholders resulting in the digitization, modernization, automation, and transformation of both R&amp;C as well as business processes. Activities are focused on records and contracts management programs that have an impact at all levels of the organization, resulting in improved records and contracts related outcomes, further risk mitigation and desired people-related outcomes, while maintaining and promoting process, information, and system performance, overall cost reduction or avoidance, and adherence to the organization’s records and contracts management and confidentiality, privacy, and information security policies. Responsibilities include: <ul> <li>As a member of the R&amp;C Leadership team, directs the development, execution, management, oversight, and enhancement of records and contracts compliance projects and processes with overall R&amp;C mission and Firm objectives. Drives integrated, cohesive decision-making across records and contracts programs</li> <li>Designs, develops, implements, and evaluates the effectiveness of highly innovative records and contracts compliance and reporting projects that provide business analytics and intelligence, supporting cross-functional transformation goals. Implements technology solutions, including generative AI solutions, to deliver insights that address business, regulatory and legal challenges</li> <li>Accountable and responsible for embedding records and contracts compliance into firm culture and establishing a roadmap for future compliance efforts, drives meaningful and actionable reporting to the highest levels of firm leadership</li> <li>Develops and executes records and contracts management strategies and programs of extensive scope, extraordinary complexity, and Firm-wide impact. Leads compliance and reporting team in the definition, planning, execution, and enhancement of compliance and reporting programs. Ensures alignment of R&amp;C programs with R&amp;C strategy, as well as overall Firm strategies</li> <li>Accountable and responsible for multi-year and multi-faceted projects including resources, governance, schedule, economics, risk mitigation, contingency planning, compliance with regulations and standards, as well as business continuity.</li> <li>Provides intellectual leadership and promotes awareness of emerging and current business trends, operating conditions, and internal processes and initiatives that may impact records and contracts compliance programs. Devises strategies for changes. Designs and implements innovative processes and procedures and adapts approaches to increase efficiencies, improve organization, and enhance services provided.</li> <li>Engages with key cross-functional stakeholders (Risk, OGC, ITS, business stakeholders, Enabling Areas stakeholders, and functional leadership) to understand their needs and forge highly productive relationships (based on a high degree of trust) that benefit the businesses and the R&amp;C programs. Leverages those associations to present innovative solutions and demonstrate the “art of the possible” leading to significant cultural and behavioral transformation.</li> <li>Leads cross-functional strategy sessions to support enterprise-wide decision-making, program development (functional and technical) and enhancements that align with business and Firm-wide priorities. Gains consensus and then drives change across all business areas and levels.</li> </ul> Recruiting for this role ends on March 16, 2025 The successful candidate will possess: <ul> <li>Experience and ability to effectively interact and work productively with business and enabling areas leadership and other stakeholders across all levels of Deloitte to make recommendations and resolve issues.</li> <li>Advanced program management and program planning; excellent team leadership skills.</li> <li>Ability to work with and maintain positive working relationships (while also conveying records and contracts management perspectives) with virtual and global business teams and internal clients.</li> <li>Experience with large complex transformations that require strategic thinking and the ability to see them through execution.</li> <li>Ability to manage multiple complex, multi-functional, multi-year projects simultaneously</li> <li>Proven ability to lead high visibility, substantial and high impact change management strategies/implementations.</li> <li>Demonstrated advanced proficiency with MS Office, SharePoint; ability to operate database software, including searching, using queries, and running reports.</li> <li>In-depth understanding of information/records/contracts management principles, processes and policies, design, systems/applications, and functions</li> <li>Demonstrated proficiency in data and analytics, and/or data management experience.</li> <li>Strong understanding of governance, risk, and compliance</li> <li>Ability to comprehend and correlate business objectives with records and/or contracts management solutions/projects; provides high-quality records and/or contracts management solutions to records/contracts related business problems.</li> <li>Superior organization, consultative, communication (written and verbal), negotiating, persuasion/influencing, consensus building, time management and presentation skills.</li> <li>Ability to author and deliver engaging presentations that produce and influence results; adept at adjusting communications and approach to various audiences.</li> <li>Ability to analyze data, determine root cause and provide and/or develop solutions; translates that data into actionable/informative presentations.</li> <li>Ability to drive to results; maintains constant awareness of projects and clients and keeps team focused on short- and long-term milestones.</li> </ul> Required: <ul> <li>Bachelor’s degree.</li> <li>Minimum of 10 years of relevant experience.</li> <li>Limited sponsorship may be available.</li> <li>Ability to travel 10-15%, on average, based on the work you do and the clients and industries/sectors you serve.</li> </ul> Preferred: <ul> <li>Professional experience or background in AI, machine learning, or natural language processing.</li> <li>Certified Records Manager (CRM) and/or Project Management Professional (PMP) or Contract Management-related certification.</li> </ul> The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $107,700 to $198,400. You may also be eligible to participate in a discretionary annual incentive program, subject to the rules governing the program, whereby an award, if any, depends on various factors, including, without limitation, individual and organizational performance. Information for applicants with a need for accommodation: <a href="https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html" target="_blank">https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html</a> EA_ExpHire Recruiting tips From developing a stand out resume to putting your best foot forward in the interview, we want you to feel prepared and confident as you explore opportunities at Deloitte. <a href="https://www2.deloitte.com/us/en/pages/careers/topics/recruiting-tips.html" target="_blank">Check out recruiting tips from Deloitte recruiters.</a> Benefits At Deloitte, we know that great people make a great organization. We value our people and offer employees a broad range of benefits. <a href="https://www2.deloitte.com/us/en/pages/careers/articles/life-at-deloitte-benefits-and-rewards.html" target="_blank">Learn more about what working at Deloitte can mean for you.</a> Our people and culture Our diverse, equitable, and inclusive culture empowers our people to be who they are, contribute their unique perspectives, and make a difference individually and collectively. It enables us to leverage different ideas and perspectives, and bring more creativity and innovation to help solve our client most complex challenges. This makes Deloitte one of the most rewarding places to work. <a href="https://www2.deloitte.com/us/en/pages/about-deloitte/articles/deloitte-inclusion.html" target="_blank">Learn more about our inclusive culture.</a> Our purpose Deloitte’s purpose is to make an impact that matters for our clients, our people, and in our communities. We are creating trust and confidence in a more equitable society. At Deloitte, purpose is synonymous with how we work every day. It defines who we are. We are focusing our collective efforts to advance sustainability, equity, and trust that come to life through our core commitments. <a href="https://www2.deloitte.com/us/en/pages/about-deloitte/articles/purpose-at-deloitte-us.html" target="_blank">Learn more about Deloitte's purpose, commitments, and impact.</a> Professional development From entry-level employees to senior leaders, we believe there’s always room to learn. We offer opportunities to build new skills, take on leadership opportunities and connect and grow through mentorship. From on-the-job learning experiences to formal development programs, our professionals have a variety of opportunities to continue to grow throughout their career.

Deloitte

Senior Manager: Records & Contracts Compliance & Reporting

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 Accountable for the strategic alignment, operational success and performance management of value based providers in one line of business, less complex Value Based Care models, and/or less sophisticated and smaller provider partnerships, practices, or systems. Ensures that assigned value based contract arrangements are functioning successfully and working to improve quality of care while reducing costs. Key Responsibilities: <ul> <li>Provider Relationship Management - Understands the terms of the value based contract arrangements to answer questions/address issues. Responsible for establishing and maintaining productive, professional relationships. </li> <li>Educates internal and external parties as needed to ensure compliance with contract terms and expectations.</li> <li>Coordinates and prepares for external provider meetings and ensures that the most impactful internal subject matter experts (clinical, pharmacy, financial, analytical, etc.) are utilized to optimize performance. (External meetings include JOCs, clinical meetings, Informatics discussions, contract reconciliation, etc.).</li> <li>Drives provider performance and partners with local market to ensure pathways to performance against business and team objectives.</li> <li>Assists with workflow development and strategies to integrate data and reporting.</li> <li>Drives improvement in deal performance.</li> <li>Leverages reporting/data to monitor contract performance against financial, clinical, cost and efficiency targets.</li> <li>Identifies areas where improvements need to be made.</li> <li>Provides strategy consultation on actions/tactics to make those improvements. </li> </ul> Required Qualifications<ul> <li>6+ years experience in a health plan, health system or provider organization, ACO-Value Based Contracting / managed-care experience preferred.</li> <li>Proven ability to interact with, influence and collaborate with internal and external stakeholders.</li> <li>Experience managing matrixed environment with ability to leverage internal business partners to complete tasks.</li> <li>Good interpersonal and communication skills.</li> <li>Knowledge of healthcare and insurance industry.</li> <li>Ability to form strong client relationships.</li> <li>Understanding of Provider Contracting, Plan Design and Product Offerings. </li> </ul> Preferred Qualifications<ul><li>Strong understanding of Value-Based Contracting &amp; Performance Management</li></ul> Education<ul><li>Bachelor's degree preferred or a combination of professional work experience and education.</li></ul>Pay RangeThe typical pay range for this role is:$67,900.00 - $182,549.00 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: 04/26/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Senior Provider Performance 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.Job Summary<ul> <li>Develops Network database tools that enable network management to work more efficiently and focus efforts effectively.</li> <li>Advises on provider performance, network adequacy, geographical coverage, and makes necessary network modifications or expansions.</li> <li>Implements improvement initiatives to ensure that network databases meet all applicable regulatory and quality standards.</li> <li>Conducts market analysis, assesses competitive positioning, and recommends strategies to maintain a competitive edge.</li> <li>Consults with internal teams, including medical directors, operations managers, and network development professionals, to align provider network performance goals and objectives.</li> <li>Provides continuous recommendations to senior leadership to guide decision-making and ensure close alignment with the organization's strategic goals and objectives.</li> </ul> Required Qualifications<ul> <li>A minimum of 5 years of SQL and QuickBase (developing and building of dashboards), Python, SAS, Access, Excel, Salesforce, and/or other large data management tools.</li> <li>Adept at machine learning and AI</li> <li>Adept at managing large amounts of data</li> <li>Adept at project management</li> <li>Adept at problem solving and decision-making skills</li> <li>Adept at collaboration and teamwork</li> <li>Adept at Growth Mindset with Mentorship Capability</li> <li>Adept at execution and delivery (planning, delivering, and supporting) skills</li> <li>Adept at business intelligence (data driven insights)</li> <li>Intrinsically Driven</li> <li>Proactive Initiator</li> </ul> Preferred Qualifications<ul> <li>Prior Relevant Work Experience with a health system or large payor.</li> <li>Adept at Google Cloud/Desktop</li> </ul> Education<ul><li>Bachelor's degree preferred or a combination of professional work experience and education.</li></ul>Pay RangeThe typical pay range for this role is:$67,900.00 - $199,144.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program. 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: 05/17/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Sr. Network Management Manager - QuickBase

<h3> Position Summary </h3> NetSuite Implementation Senior Consultant Digital Customer is collaborating with clients in ways never thought possible before. We are creating, developing, designing and implementing in ways that will change the digital landscape forever. Our Digital Customer strategy is to help clients define strategies, build brands, create experiences, and deliver platforms. Recruiting for this role ends on 10/19/24. Work you’ll do A Senior Consultant at Deloitte works within an engagement team and is responsible for identifying business requirements, requirements management, functional design, prototyping, process design (including scenario design, flow mapping), testing, training, defining support procedures, leading work streams and supporting implementations. Implement and deploy NetSuite solutions: <ul> <li>Working within an engagement team, a Senior NetSuite Consultant is responsible for identifying business requirements, requirements management, functional design, prototyping, process design (including scenario design, flow mapping), testing, training, defining support procedures, leading work streams and supporting implementations</li> <li>Provide NetSuite consulting expertise utilizing industry experience, business analysis, best practices and a pragmatic mindset to facilitate clients’ most complex requirements.</li> <li>Implement and deploy NetSuite solutions accommodating unique industry business and management processes, regulatory requirements and other business requirements.</li> <li>Create functional requirements as an input to application design.</li> <li>Build, develop and test detailed functional designs for business solution components and prototypes.</li> <li>Drive test planning, execution, and optimization support.</li> <li>Conduct business process mapping and requirements gathering sessions with new customers to determine configuration requirements both on-site and remote.</li> <li>Prepare Business Requirements and Technical Scoping Documents resulting from the above noted mapping sessions to provide proposed solutions for the requirements for customer approval.</li> <li>Build, develop and test detailed scripted customized solutions and prototypes.</li> <li>Troubleshoot issues that arise during configuration sessions.</li> <li>Provide on-going post implementation support to optimize user adoption and NetSuite configuration.</li> </ul> The team Digital Customer Our Digital Customer team focuses on designing and implementing sales and service experiences, capabilities, and architectures to bring customer strategies to life. Our ambition is to be the best in the world at driving customer transformation through the development of clever commercial strategies, distinctive experiences, and the application of digital technologies. We help make the “creative digital consultancy” real and in doing so, make new markets. Professionals will serve our clients through the following types of work: <ul> <li> Customer Operations | modernize, deploy, and operate office capabilities and business processes across sales operations, quote-to-cash, and revenue management team</li> <li> Sales Excellence &amp; Service Excellence | Integrate the latest technologies with leading-edge strategies, insights, experiences, and talent to enable outstanding customer service</li> <li> Salesforce | Deloitte unleashes the powerful Salesforce platform for our clients to drive the best possible outcomes and redefine engagement. We innovate like never before by creatively using technology to help enhance digital customer and employee experiences for our clients.</li> </ul> Qualifications Required <ul> <li>Bachelor's Degree or equivalent experience</li> <li>3+ years of relevant consulting or industry experience</li> <li>2+ years of experience with NetSuite ERP implementations</li> <li>Ability to travel up to 50% on average, based on the work you do and the clients and industries/sectors you serve</li> <li>Limited immigration sponsorship may be available </li> </ul> Preferred <ul> <li>Experience with NetSuite integrations and customizations</li> <li>A Certified NetSuite Professional</li> <li>Experience with full life cycle NetSuite implementations</li> <li>Bachelor's or Advanced degree in accounting, business, finance or other business-related field, computer science, information systems, or other technology-related field</li> </ul> Information for applicants with a need for accommodation: <a href="https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html" target="_blank">https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html</a> The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $131,175 to $218,625. You may also be eligible to participate in a discretionary annual incentive program, subject to the rules governing the program, whereby an award, if any, depends on various factors, including, without limitation, individual and organizational performance. #Customer_US #SS_US Requisition code: 182569 Recruiting tips From developing a stand out resume to putting your best foot forward in the interview, we want you to feel prepared and confident as you explore opportunities at Deloitte. <a href="https://www2.deloitte.com/us/en/pages/careers/topics/recruiting-tips.html" target="_blank">Check out recruiting tips from Deloitte recruiters.</a> Benefits At Deloitte, we know that great people make a great organization. We value our people and offer employees a broad range of benefits. <a href="https://www2.deloitte.com/us/en/pages/careers/articles/life-at-deloitte-benefits-and-rewards.html" target="_blank">Learn more about what working at Deloitte can mean for you.</a> Our people and culture Our diverse, equitable, and inclusive culture empowers our people to be who they are, contribute their unique perspectives, and make a difference individually and collectively. It enables us to leverage different ideas and perspectives, and bring more creativity and innovation to help solve our client most complex challenges. This makes Deloitte one of the most rewarding places to work. <a href="https://www2.deloitte.com/us/en/pages/about-deloitte/articles/deloitte-inclusion.html" target="_blank">Learn more about our inclusive culture.</a> Our purpose Deloitte’s purpose is to make an impact that matters for our clients, our people, and in our communities. We are creating trust and confidence in a more equitable society. At Deloitte, purpose is synonymous with how we work every day. It defines who we are. We are focusing our collective efforts to advance sustainability, equity, and trust that come to life through our core commitments. <a href="https://www2.deloitte.com/us/en/pages/about-deloitte/articles/purpose-at-deloitte-us.html" target="_blank">Learn more about Deloitte's purpose, commitments, and impact.</a> Professional development From entry-level employees to senior leaders, we believe there’s always room to learn. We offer opportunities to build new skills, take on leadership opportunities and connect and grow through mentorship. From on-the-job learning experiences to formal development programs, our professionals have a variety of opportunities to continue to grow throughout their career.

NetSuite Implementation Senior Consultant

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 SummaryReporting to the Lead Director of Medicaid Revenue Integrity, the Senior Manager will work closely with various Revenue Integrity Lead Directors and subject matter experts across the Medicaid business to establish and champion market level revenue integrity excellence. This position is responsible for supporting all assigned market level risk adjustment activities and processes related to complete and accurate diagnosis capture through provider and member engagement. In support of the Revenue Integrity Medicaid Performance Management Office (PMO) this position will lead the work and deliverables of multiple complex projects, focusing on process improvement, production, and data analysis. This individual should have proven project management of multiple complex projects simultaneously and demonstrate understanding of root cause analysis. This position may act as a liaison with other key business areas, internally and externally. The Medicaid Revenue Integrity Senior Manager will play a critical role in extracting, analyzing, and interpreting healthcare and financial data from multiple sources to address business opportunities regarding population health management, health and economic outcomes, and other business needs. Required Qualifications<ul> <li>5+ years of data analytics experience in healthcare environment or equivalent work environment</li> <li>5+ years of Project Management experience managing multiple projects simultaneously and meeting deadlines.</li> <li>2+ years of leadership experience</li> <li>Strong analytical and problem-solving skills</li> <li>Proficiency in Microsoft suite and data visualization tools (i.e. Excel, PowerPoint, Tableau etc)</li> <li>Excellent communication, presentation/creating presentations, and writing skills.</li> <li>Highly organized with excellent attention to detail</li> </ul> Preferred Qualifications<ul> <li>Knowledge of Risk Adjustment, preferably Medicaid</li> <li>Detail-oriented with a disposition to probe into technical details for accuracy and completeness</li> <li>Design and code efficiently in SQL, SAS, or similar programming language</li> </ul> Education Bachelor's Degree or equivalent work experience Pay RangeThe typical pay range for this role is:$67,900.00 - $182,549.00 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: 05/16/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Senior Manager, Medicaid Revenue Integrity

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.We are seeking an experienced WorkBrain Techno-Functional Manager to join our team. This is an exciting opportunity to contribute to a growing team and help optimize timekeeping processes within the organization. In this role, you will be responsible for ensuring accurate tracking of employee hours, scheduling, attendance, and supporting HR and payroll processes. The WorkBrain Techno-Functional Manager will bridge business needs with technical solutions, have strong experience with WorkBrain, and familiarity with Kronos and other systems is a plus. If you have a passion for data analysis and systems management, we encourage you to apply!Key Responsibilities:<ul> <li>Administer and manage time and attendance systems (primarily WorkBrain) for accurate timekeeping and scheduling.</li> <li>Perform system configuration and maintenance of the WorkBrain time and attendance platform.</li> <li>Troubleshoot and resolve issues related to time entries, scheduling, and system performance in WorkBrain.</li> <li>Test WorkBrain configurations and custom solutions, identifying and resolving issues or defects.</li> <li>Collaborate with HR, payroll, and other departments to ensure smooth data flow and compliance with labor laws.</li> <li>Generate regular reports and data analysis for business leaders to assess attendance trends and labor costs.</li> <li>Provide support and training to employees and managers on timekeeping procedures and WorkBrain system use.</li> <li>Ensure that employee work hours are compliant with organizational policies and government regulations.</li> <li>Handle escalations and work on continuous improvements to streamline processes.</li> <li>Perform data audits to ensure accuracy and integrity in time tracking.</li> <li>Support any time and attendance-related projects and system upgrades.</li> </ul>Required Qualifications<ul> <li>5+ years' experience with WorkBrain Workforce Management Software</li> <li>5+ years' experience working in time and attendance management field</li> <li>4+ years' experience with labor laws, union rules, and organizational timekeeping policies</li> <li>4+ years' experience working with large datasets and perform data analysis using SQL</li> <li>3+ years' experience Managing Project using Agile Methodology in a large, matrixed organization</li> </ul>Preferred Qualifications<ul> <li>Experience with system implementation or upgrades</li> <li>Strong understanding of HRIS systems and integrations</li> <li>Familiarity with Kronos or similar large scale enterprise workforce management systems</li> <li>Experience in managing outsourced technology and governance</li> <li>Detail-oriented with a focus on accuracy and compliance</li> <li>Experience training and mentoring junior analysts and team members</li> <li>Strong communication and interpersonal skills, able to work effectively with stakeholders at all levels</li> <li>Ability to translate technical information into business terms</li> <li>Ability to handle sensitive employee data with confidentiality.</li> </ul>Education<ul><li>Bachelor’s degree in Business, HR, or related field</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: 05/03/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

71 Other Jobs in Timonium, MD 21093, USA