field_remote_option

job_industry

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 Summary The Customer Service Supervisor (Meritain Health) typically:<ul> <li>Develops, motivates, evaluates, and coaches staff on work procedures, proper call handling, and teamwork to deliver excellent customer service.</li> <li>Maintains a visible presence and is available to staff to answer questions, monitor calls, and give ongoing feedback.</li> <li>Utilizes available incentive programs to reward, recognize, and celebrate team and individual successes.</li> <li>Assesses individual and team performance on a regular basis, and provides candid and timely feedback regarding developmental training needs; includes completion of monthly and annual scorecards.</li> <li>Monitors all performance metrics, such as daily stats and schedule adherence; allocates resources to meet volume and performance demands.</li> <li>Develops and maintains strong collaborative relationships with constituents and internal business partners to maintain excellent lines of communication and share resources to meet common service center objectives.</li> <li>Removes barriers to job performance and ensures regulatory compliance.</li> <li>Attracts, selects, and retains high caliber, diverse talent, able to successfully achieve or exceed business goals. Builds a cohesive team that works well together.</li> <li>Acts as liaison between staff and other areas, including management, communicating workflow results, ideas, and solutions.</li> <li>Proactively analyzes constituent data, identifying trends and issues. Recognizes and acts on the needs to improve the development and delivery of products and services. Clearly identifies what must be accomplished for successful completion of business objectives.</li> <li>Effectively applies and enforces Aetna HR (Human Resources) policies and practices, i.e., FML (Family Medical Leave)/EML (Extended Medical Leave), Attendance, Code of Conduct, Disciplinary Guidelines, etc.</li> <li>All other duties as deemed necessary to the job function.</li> </ul>Required Qualifications<ul> <li>2 years of experience supporting a claim and/or customer service team in a production-based environment.</li> <li>Working knowledge of Microsoft Office products (Word, Excel, PowerPoint, Outlook).</li> <li>Ability to work five 8-hour shifts from Monday-Friday between 8am-7:30pm EST. </li> </ul>Preferred Qualifications<ul> <li>Acutely organized and able to effectively prioritize daily workload.</li> <li>Previous experience in the healthcare industry.</li> <li>Previous experience with self-funded or fully insured health care, sales, account management, or TPA (Third-Party Administrator) experience. </li> </ul>Education High school diploma or GED.Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$43,888.00 - $102,081.00This 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: 05/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVSHealth

Customer Service Supervisor (Meritain Health)

Senior Manager, SEO - Capital One Shopping (Remote)This is your opportunity to join the Digital Marketing Growth team on Capital One’s fast-growing consumer app, Capital One Shopping. We’re focused on scaling our products to millions of customers and refining the experience to create a product that customers can’t live without. We are looking for a Senior Manager, SEO to join our Capital One Shopping Digital Marketing team and help advance our Search Engine Optimization (SEO) marketing strategy. You will have the opportunity to help formulate industry-leading strategies and drive an agenda across the evolving landscape of search marketing to help create explosive growth in an ascending business of Capital One.Responsibilities<ul> <li>Design and execute a growth agenda within search engine optimization (SEO)</li> <li>Understand the landscape of search engine optimization (SEO) and formulate a perspective on where it is headed to keep the team on the forefront of the space</li> <li>Be a fungible teammate who can tackle on a variety of projects outside of their direct sphere of ownership where needed</li> <li>Partner with internal and external teams to develop product and creative roadmaps to enhance reach and conversion </li> </ul>Who We’re Looking For<ul> <li>You have experience leading a search engine optimization (SEO) program, ideally for a consumer-facing product</li> <li>You have an affinity for fast-paced environments, a positive attitude, and a get stuff done attitude</li> <li>You love to ideate, test, build and scale new strategies, and tackle problems with multiple lenses in mind</li> <li>You enjoy interacting across various part of the organization to collaborate and advance your strategy</li> <li>You have a passion for the present and future of digital marketing </li> <li>You are continuously looking for ways to sharpen your technical skills and subject matter knowledge </li> <li>You have a passion for being a part of a team and playing your part in creating winning outcomes for the organization</li> </ul>General Responsibilities:<ul> <li>Strategic leadership: Develop business strategies that will drive growth, profitability, and competitive success for Capital One in the face of shifting consumer and regulatory behavior</li> <li>Business ownership: Have an ownership mindset, and potentially P&amp;L accountability for a business segment. Strategic planning with a 1-6 month horizon</li> <li>Leadership: May manage and develop a team. Coaching and mentoring associates throughout the organization with a goal of developing and retaining talent at Capital One</li> <li>Product: Develop and implement new product and pricing strategies for various lending products; lead product level modeling/analytics</li> <li>Marketing: Lead direct to consumer marketing efforts for select products, and strategic intent for products distributed through various channels. Build targeted insights to inform the design and development of new customer experiences, as well as breakthrough technology and concepts designed to deliver on new go-to-market strategies</li> <li>Credit Risk: Drive step-change improvements in credit performance by connecting drivers of future consumer credit trends to historical behavior, creating risk models, and testing hypotheses using rigorous monitoring and analysis</li> <li>Execution: Coordinate across the line of business to manage and sequence delivery of business intent, build business requirements and execute against the product strategy. Oversee multiple projects and programs concurrently</li> <li>Partnership: Work closely with colleagues across Capital One including: IT, Sales, Operations, Finance and others to drive improvement in quality, volume, service, and profitability</li> <li>Strategic &amp; analytic orientation: A proven track record of decision making and problem solving based on analytics. Conceptual thinking skills must be complemented by a strong quantitative orientation, given that a large part of the business is based on rigorous analytic marketing &amp; credit risk management</li> <li>Strong business judgment, leadership and integrity: He/she should be a tenacious decision maker, able to bring a healthy, aggressive, yet responsible approach to business</li> <li>Solid people leadership experience: Ability to build and leverage the capabilities of a high-performing team, as well as business partners across the enterprise. He/she should foster innovation, drive critical decisions, hold business partners accountable, and be able to consistently deliver results</li> <li>Strong executive communication skills: Impeccable written and oral communication credentials, coupled with strategic influencing skills and the ability to drive agreement through intellect, interpersonal and negotiation skills</li> <li>Clear results orientation: display an intense focus on achieving both short and long term goals. He/she should be able to drive and execute an agenda in an uncertain and fluid environment</li> <li>Successful track record of thriving in a fast paced, entrepreneurial and dynamic environment. Previous consulting experience is a plus</li> </ul>Basic Qualifications:<ul> <li>Bachelor’s Degree or Military experience</li> <li>At least 3 years of experience in Search Engine Optimization (SEO) </li> </ul>Preferred Qualifications:<ul> <li>Master’s Degree</li> <li>4+ years of experience in Search Engine Optimization (SEO)</li> <li>2+ years of experience in project management</li> <li>1+ year of experience in product development</li> </ul>At this time, Capital One will not sponsor a new applicant for employment authorization for this position.The minimum and maximum full-time annual salaries for this role are listed below, by location. Please note that this salary information is solely for candidates hired to perform work within one of these locations, and refers to the amount Capital One is willing to pay at the time of this posting. Salaries for part-time roles will be prorated based upon the agreed upon number of hours to be regularly worked.Remote (Regardless of Location): $155,300 - $177,200 for Sr. Manager, Marketing Richmond, VA: $155,300 - $177,200 for Sr. Manager, Marketing Candidates hired to work in other locations will be subject to the pay range associated with that location, and the actual annualized salary amount offered to any candidate at the time of hire will be reflected solely in the candidate’s offer letter.This role is also eligible to earn performance based incentive compensation, which may include cash bonus(es) and/or long term incentives (LTI). Incentives could be discretionary or non discretionary depending on the plan.Capital One offers a comprehensive, competitive, and inclusive set of health, financial and other benefits that support your total well-being. Learn more at the <a href="https://www.capitalonecareers.com/benefits" target="_blank">Capital One Careers website</a>. Eligibility varies based on full or part-time status, exempt or non-exempt status, and management level.This role is expected to accept applications for a minimum of 5 business days.No agencies please. Capital One is an equal opportunity employer committed to diversity and inclusion in the workplace. All qualified applicants will receive consideration for employment without regard to sex (including pregnancy, childbirth or related medical conditions), race, color, age, national origin, religion, disability, genetic information, marital status, sexual orientation, gender identity, gender reassignment, citizenship, immigration status, protected veteran status, or any other basis prohibited under applicable federal, state or local law. Capital One promotes a drug-free workplace. Capital One will consider for employment qualified applicants with a criminal history in a manner consistent with the requirements of applicable laws regarding criminal background inquiries, including, to the extent applicable, Article 23-A of the New York Correction Law; San Francisco, California Police Code Article 49, Sections 4901-4920; New York City’s Fair Chance Act; Philadelphia’s Fair Criminal Records Screening Act; and other applicable federal, state, and local laws and regulations regarding criminal background inquiries.If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation, please contact Capital One Recruiting at 1-800-304-9102 or via email at <a href="#">RecruitingAccommodation@capitalone.com</a>. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodations.For technical support or questions about Capital One's recruiting process, please send an email to <a href="#">Careers@capitalone.com</a>Capital One does not provide, endorse nor guarantee and is not liable for third-party products, services, educational tools or other information available through this site.Capital One Financial is made up of several different entities. Please note that any position posted in Canada is for Capital One Canada, any position posted in the United Kingdom is for Capital One Europe and any position posted in the Philippines is for Capital One Philippines Service Corp. (COPSSC).

Capital One

Senior Manager, SEO - Capital One Shopping (Remote)

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 $125,000.00 - $150,000.00 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. What's in it for you A full benefits package with choice of affordable PPO or HSA medical plans. Paid time off. Up to $1,000 in free healthcare services paid by Amedisys yearly, when enrolled in an Amedisys HSA medical plan. 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.* Mental health support, including up to five free counseling sessions per year through the Amedisys Employee Assistance program. 401(k) with a company match. Family support with infertility treatment coverage*, adoption reimbursement, paid parental and family caregiver leave. And more. Please note: Benefit eligibility can vary by position depending on shift status. *To participate, you must be enrolled in an Amedisys medical plan. **For full-time caregivers meeting certain requirements. Why Amedisys Amedisys is a leading provider of home health, hospice, and high-acuity care, dedicated to helping patients and families navigate the complex healthcare system. With a focus on compassionate, patient-centered care, you would be joining a team of professionals committed to improving the lives of those they serve. Responsibilities Responsible for initiating, planning and executing various types of strategic initiatives, including business process improvements and technical components. This role will have a specific focus on programs related to automation and Robotics Process Automation (RPA), aligning these efforts with organizational strategy, optimizing processes, and ensuring successful implementation and operationalization. <ul> <li>Aligns with key functional areas within corporate departments, serving as a liaison between process and technology, providing advice on potential solutions to existing gaps and opportunities, and ensuring those solutions fit within the defined/approved architecture.</li> <li>Evaluates current industry standards (process and technology) for project/program delivery in healthcare setting, specifically related to automation.</li> <li>Leverages deep understanding of AI/ML lifecycle, including data collection, model training, evaluation, deployment, and monitoring, to successfully lead automation initiatives as well as support solution design.</li> <li>Uses analytics and gaps analysis to discover opportunities for optimization and automation of key areas in the organization and works with leadership to align, implement and measure properly.</li> <li>Works with department leaders to define and manage value-driven initiatives that are aligned with enterprise strategies.</li> <li>Ensures proper accountability for budgets and success of all projects/programs.</li> <li>Creates a model for succession management by mentoring fellow project managers on project management best practices.</li> <li>May supervise or lead Business System Analyst or Project Manager on multiple projects.</li> <li>Complies with policies, procedures and regulatory mandates including but not limited to abiding to the terms of the Amedisys Compliance Program.</li> <li>Performs other duties as assigned.</li> </ul> Qualifications Required: <ul> <li>Six (6+) years' experience in project management, including two (2+) years directly managing AI/ML, RPA initiatives.</li> <li>Demonstrated project management experience managing end-to-end delivery of AI and Robotics Process Automation (RPA) products.</li> <li>Hands on experience managing project teams including monitoring and reporting status and project risk.</li> <li>Experience with Microsoft Project or other project management applications.</li> <li>Experience with implementing/interfacing with third party software.</li> <li>PMP, PMI-ACP or SAFe certified.</li> </ul> Preferred: <ul> <li>Bachelor's degree in business administration, computers science, healthcare management or related field.</li> <li>Experience with UiPath and PowerAutomate.</li> <li>Previous experience in healthcare or other regulated industry.</li> <li>Six Sigma Black Belt</li> </ul> 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

Automation Program Manager - PMO

What you can expectAs a Software Engineer, you will be responsible for designing and implement scalable, high-performance backend systems using Node.js, TypeScript, and Fastify. You will collaborate with cross-functional teams to analyze user needs, create technical specifications, and write clean, efficient, and well-documented code. Your goal is to deliver high-quality software products that meet customer requirements and enhance user experience.About the TeamThe Workforce Management development team is focused on building, enhancing, and adding new features to our contact center solution. This is an AI powered tool for supervisors of contact centers to manage their Agents. This tool is used to create, schedule and monitor in a bulk model. This is an exciting product area filled with potential for people looking to make an impact!Responsibility:<ul> <li>Design and implement scalable, high-performance backend systems using Node.js, TypeScript, and Fastify.</li> <li>Build and maintain robust GraphQL APIs to power flexible, real-time client interactions.</li> <li>Work with SQL databases (PostgreSQL/MySQL) and caching solutions (Redis) to manage and access data efficiently.</li> <li>Partner with product and design teams to deliver feature-rich, high-quality applications that meet business goals.</li> <li>Take ownership of full stack features from planning through execution, including testing, deployment, and monitoring.</li> <li>Troubleshoot, debug, and optimize systems for performance, scalability, and resilience.</li> <li>Write maintainable, well-documented, and thoroughly tested code</li> <li>We require experience with CI/CD tools, with Jenkins, GitLab etc</li> </ul>What we’re looking for:<ul> <li>4- 5 years of recent development experience.</li> <li>Strong in Node.js and TypeScript.</li> <li>Solid knowledge of Fastify, or other comparable Node.js frameworks (Express, NestJS).</li> <li>Expertise in GraphQL API design and implementation</li> <li>Proficiency in relational databases (PostgreSQL/MySQL) and caching tools like Redis.</li> <li>Familiarity with REST, JWT/Auth mechanisms, and secure coding practices.</li> <li>Experience writing unit/integration tests and using CI/CD pipelines.</li> <li>Clear understanding of clean code principles, scalable architecture, and performance best practices.</li> <li>Frontend experience with React.</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. Find room to grow with opportunities to stretch your skills and advance your career in a collaborative, growth-focused environment. Our Commitment​At Zoom, we believe great work happens when people feel supported and empowered. We’re committed to fair hiring practices that ensure every candidate is evaluated based on skills, experience, and potential. If you require an accommodation during the hiring process, let us know—we’re here to support you at every step.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

Software Engineer

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.As a Senior Product Manager at CVS Health, in our "Analytics &amp; Behavior Change" group, you will be on the front line of driving innovation and directly impacting business decisions. This role is part of a team that works across the Pharmacy Benefits Management ecosystem building analytical cloud-based products, supporting pharmaceutical forecasting and pricing. You will have a chance to modernize legacy systems using cutting edge technology, to bring in accuracy and efficiency by using data science and AI. You will work with teammates from our business groups, data science, data engineering, and application development, as well as with your peers from partner product owners. you will be developing components of a software product that serves financial users from our Pharmacy Benefit Manager (PBM) business unit. You will work on multiple components of Data and Forecast Mart (DFM) and Computation Engine (CE) application, where data resides on GCP thru multiple sources and egressed to Azure for forecasting and modeling. The products we are building have a strong forecasting, what-if scenario, and financial component to them.What is your role:<ul> <li>Leading a team responsible for digital product development by defining strategy, vision, product roadmaps, prioritizing feature development, collaborating with stakeholders, and ensuring successful product launches.</li> <li>Overseeing the entire product lifecycle, including user research and interview, requirements gathering from various stakeholders/SMEs, end to end architecture/design, development, testing, integration, and iteration.</li> <li>Working across the organization to align product strategies with business goals, manage stakeholders, and facilitate effective collaboration between product teams and other departments to drive product success and customer satisfaction.</li> </ul>What you will be doing:<ul> <li>Identifying new opportunities, assessing the company’s product performance, and helping develop its long-term strategic plans for future product lines.</li> <li>Establishing the efficient user research, requirement management, prioritization, and delivery of the digital product roadmap to successfully enhance the company's brand recognition and competitive advantage in the industry.</li> <li>Developing technology and product roadmaps to provide visibility of risk and improvement options to maintain a proactive attitude among the digital product team.</li> <li>Analyzing qualitative and quantitative data to influence product features and prioritization to successfully deliver value to the users and company.</li> <li>Facilitating continuous and cross-communication across functional units and stakeholder groups, establishing relationships with collaborators at every organizational level.</li> <li>Defining strategy for product iterations, schedules, releases, and roadmaps to maintain speed to market and differentiation.</li> <li>Discovering, designing, and documenting business requirements and make sure that data scientists, data engineers, QA Engineers, BI engineers, and application developers have enough information to deliver high-value software code.</li> <li>Working with users, business product owners (BPO), release managers and other stakeholders towards requirements and prioritizing features along with synchronizing the release plans across multiple products.</li> <li>Organizing/leading meetings for collaboration and process implementations, status reporting and presentations, supporting resource and budget management.</li> </ul>Required Qualifications :<ul> <li>10+ years of work experience in Software Development projects.</li> <li>5+ years of Product Management experience.</li> <li>5+ years of Agile development methodology.</li> <li> 4+ years' experience working cross-functionally with Engineering or Data Science teams and familiarity with Data Science concepts.</li> <li>1+ year of hands-on experience with any programming language.</li> <li> Proven track record of managing all aspects of a successful analytics product throughout its lifecycle </li> <li>Exceptional communication skills to ensure all stakeholders understand and are aligned with the product plan.</li> <li>Adept at collaboration and teamwork</li> <li>Mastery of problem solving and decision-making skills</li> <li>Ability to thrive in a highly collaborative, fast-paced environment where the nature of the work can be varied</li> </ul>Preferred Qualifications :<ul> <li>History of providing data-based experiences to customers that make the complex understandable.</li> <li> Deep knowledge of various types of Healthcare data, including strong grasp of data nuances, common use cases, and limitations, with experience in common analytics tools </li> <li>experience with forecasting, what-if scenario planning, and financial analysis.</li> <li>Technical hands-on experience with SQL, Cloud based Architecture, PySpark, Python.</li> <li>Any data analytics experience is big plus.</li> </ul>Education :<ul><li>Bachelors degree required</li></ul>Pay RangeThe typical pay range for this role is:$106,605.00 - $284,280.00 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: 04/22/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Senior Analytics Product Manager - Remote

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 Research and process grievances and appeals for Dual eligible members and providers. Perform outreach to obtain additional information. Interact with Medical Directors and Nurses as well as Leadership. Required Qualifications<ul><li>1 year of experience processing health insurance grievance and appeal cases.</li></ul> Preferred Qualifications<ul><li>6+ years of experience Medicare and Medicaid appeal and grievance preferred</li></ul> Education<ul><li>High School Diploma or GED required</li></ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$21.10 - $44.99This 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: 06/04/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Complaint and Appeals Analyst - Fully Remote

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 SummaryWe are seeking a highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit within a leading health insurance organization. This role is ideal for a data professional with strong skills in SQL and Python who can transform complex healthcare data into actionable insights to support fraud, waste, and abuse (FWA) detection and Medicaid regulatory &amp; compliance reporting. This is an individual contributor role. Job responsibilities include:<ul> <li>Write robust, efficient code in SQL and Python to extract, manipulate, and analyze large healthcare datasets.</li> <li>Design, develop, and maintain complex data analyses to support investigations of potential fraud, waste, and abuse in Medicaid claims and provider activity.</li> <li>Prepare timely and accurate Medicaid regulatory &amp; compliance reports in accordance with prescribed guidelines and standards.</li> <li>Communicate messages based on data analyses, including preparing easy-to-understand visualizations and other related documents for diverse audiences </li> <li>Collaborate with SIU investigators, Program Integrity Manager, and Compliance to understand business processes and translate them into actionable data requirements.</li> <li>Develop and participate in presentation and consultation with business partners on data, capabilities and performance results</li> <li>Identify data quality issues, perform root cause analysis, and recommend improvements to enhance reporting accuracy and data integrity.</li> <li>Document data logic and methodology used in analyses and ensure reproducibility and transparency of results.</li> <li>Stay informed about changes in Medicaid policy, regulatory requirements, and FWA detection techniques to ensure ongoing compliance.</li> </ul>This is a work-from-home position in the US. supporting standard east coast business hours. Required Qualifications<ul> <li>3+ years of experience in data analytics or data science, preferably in healthcare, health insurance, or Medicaid programs</li> <li>Ability to distill complex data into meaningful insights and present findings to non-technical audiences.</li> <li>Solid understanding and experience interpreting medical claim data</li> <li>Advanced experience in SQL coding sourcing from a data warehouse</li> <li>3+ years of data interpretation and analysis experience</li> <li>3+ years of project leadership experience</li> <li>Strong business as well as systems knowledge</li> <li>Excellent problem-solving, critical thinking, and written communication skills</li> <li>Advanced experience in Excel </li> </ul> Preferred Qualifications<ul> <li>Experience in healthcare fraud, waste and abuse </li> <li>Proficiency in Python coding</li> <li>Knowledge of Medicaid healthcare claims adjudication (QNXT) &amp; regulatory reporting</li> <li>Experience with data visualization tools (e.g., Tableau, Power BI</li> <li>Familiarity with Big Query &amp; Jupyter Notebook</li> </ul> Education<ul><li>Bachelor’s degree or equivalent experience</li></ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$54,300.00 - $145,860.00This 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: 06/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Manager, SIU Data Analysis (SQL/Python)

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<ul> <li>Network implementation manager.</li> <li>Configure custom, domestic, and direct-to-employer networks. </li> <li>Subject matter expert for network files, network IDs, and PPO codes.</li> <li>User Acceptance Testing for new implementations and issue resolution.</li> <li>Performs research for network issues and partners with EDI IT on resolution.</li> <li>Coordinates custom online provider directories.</li> </ul> Required Qualifications<ul> <li>2+ years healthcare industry experience.</li> <li>1+ year network operations or provider relations experience.</li> <li>Proficiency in Microsoft Office Suite (Word, Excel, Outlook, etc.).</li> </ul>Preferred Qualifications<ul> <li>1+ year of implementation management experience</li> <li>1+ year of vendor management experience</li> </ul> Education<ul><li> High School Diploma or GED</li></ul>Anticipated 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: 05/23/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Senior Network Analyst

Your work days are brighter here.At Workday, it all began with a conversation over breakfast. When our founders met at a sunny California diner, they came up with an idea to revolutionize the enterprise software market. And when we began to rise, one thing that really set us apart was our culture. A culture which was driven by our value of putting our people first. And ever since, the happiness, development, and contribution of every Workmate is central to who we are. Our Workmates believe a healthy employee-centric, collaborative culture is the essential mix of ingredients for success in business. That’s why we look after our people, communities and the planet while still being profitable. Feel encouraged to shine, however that manifests: you don’t need to hide who you are. You can feel the energy and the passion, it's what makes us unique. Inspired to make a brighter work day for all and transform with us to the next stage of our growth journey? Bring your brightest version of you and have a brighter work day here.At Workday, we value our candidates’ privacy and data security. Workday will never ask candidates to apply to jobs through websites that are not Workday Careers. Please be aware of sites that may ask for you to input your data in connection with a job posting that appears to be from Workday but is not.In addition, Workday will never ask candidates to pay a recruiting fee, or pay for consulting or coaching services, in order to apply for a job at Workday.About the TeamAs a member of our diverse and skilled North America Solution Consulting team, you will have the opportunity to communicate and demonstrate the power of Workday's applications to prospects and customers alike. It is this team's job to bring the value of Workday solutions to life and showcase how the world of work can be transformed. Along with working closely with our sales counterparts, this team also sits at the exciting intersection of our Product Management, Consulting Services, Marketing, and Value Management teams, providing exposure to various areas of the business.About the RoleThis is your chance to guide a world class Solution Consulting Team focused on Financials and responsible for selling to prospects and customers in State and Local government. You will be aided and surrounded by some of the first-rate and brightest people in the industry; people who care about our customers and care about assisting them accomplish the results they seek. You will oversee the performance and delivery in support to the sales organization within the region while contributing to the growth of the region and department. Open to traveling 30%About YouBasic Qualifications:<ul><li> Manager, Solution Consultant <ul> <li>5+ years in a sales-related role (sales, presales, value management, customer success, etc.) selling enterprise software</li> <li>2+ years of experience leading people and/or mentoring colleagues on sales opportunity strategy</li> <li>3+ years of working in or selling to Human Resources organizations or have practical HCM experience like Workforce Management, Benefit, comp etc.</li> </ul> Sr. Manager, Solution Consultant <ul> <li>7+ years in a sales-related role (sales, presales, value management, customer success, etc.) selling enterprise software</li> <li>4+ years of experience leading people and/or mentoring colleagues on sales opportunity strategy</li> <li>5+ years of working in or selling to Human Resources organizations or have practical HCM experience like Workforce Management, Benefit, comp etc.</li> </ul> </li></ul>Other Qualifications:<ul> <li>Excellent verbal and written communication skills</li> <li>Experience in a fast-paced work environment</li> <li>Strong problem-solving and critical thinking skills</li> <li>A track record of hiring and retaining innovative employees</li> <li>Consistent achievement or overachievement of assigned goals and targets</li> <li>Success in mentoring coworkers in ways that allowed them to learn new skills and achieve career goals</li> <li>Collaborative with those in other roles to work towards shared goals</li> <li>A history of using data to support your decision-making process</li> </ul> Workday Pay Transparency StatementThe annualized base salary ranges for the primary location and any additional locations are listed below. Workday pay ranges vary based on work location. As a part of the total compensation package, this role may be eligible for the Workday Bonus Plan or a role-specific commission/bonus, as well as annual refresh stock grants. Recruiters can share more detail during the hiring process. Each candidate’s compensation offer will be based on multiple factors including, but not limited to, geography, experience, skills, job duties, and business need, among other things. For more information regarding Workday’s comprehensive benefits, please <a href="https://workdaybenefits.com/us/welcome-to-workday-benefits/prospective-workmates" target="_blank">click here</a>.Primary Location: USA.VA.McLean (Tyson's Corner) Primary Location Base Pay Range: $142,800 USD - $214,200 USD Additional US Location(s) Base Pay Range: $142,800 USD - $214,200 USDIf performed in Colorado, the pay range for this job is $ - $ USD based on min and max pay range for that role if performed in CO.The application deadline for this role is the same as the posting end date stated as below: 06/09/2025 Our Approach to Flexible Work With Flex Work, we’re combining the best of both worlds: in-person time and remote. Our approach enables our teams to deepen connections, maintain a strong community, and do their best work. We know that flexibility can take shape in many ways, so rather than a number of required days in-office each week, we simply spend at least half (50%) of our time each quarter in the office or in the field with our customers, prospects, and partners (depending on role). This means you'll have the freedom to create a flexible schedule that caters to your business, team, and personal needs, while being intentional to make the most of time spent together. Those in our remote "home office" roles also have the opportunity to come together in our offices for important moments that matter.Pursuant to applicable Fair Chance law, Workday will consider for employment qualified applicants with arrest and conviction records.Workday is an Equal Opportunity Employer including individuals with disabilities and protected veterans.Are you being referred to one of our roles? If so, ask your connection at Workday about our Employee Referral process!

188 Jobs in Richmond, VA, USA