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At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.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.

CVSHealth

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 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!

Workday

Manager, Solution Consultant - Workday Financials - State and Local Government

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.Effectively manages competitive and complex contractual relationships with TPAs and/or business partners in Europe, APAC, Africa and Middle East excluding Americas region in support of international network, medical cost management and overall claim/customer service strategies. Provide concierge level of service to our members via timely provision of required network access and proactive management of network relationships to ensure seamless direct settlement access. Job Responsibilities:<ul> <li>Manage TPA relationship with external vendors and own overall relationship with assigned TPAs in Europe, Africa, Middle East and APAC region.</li> <li>Oversee and manage contractual relationship with assigned TPA(s).</li> <li>Manage Third Party Risk Governance process for your assigned TPA(s).</li> <li>Manage ongoing Aetna compliance review process for your assigned TPA(s).</li> <li>Manage monthly billing / submission of TPA invoices for timely payment</li> <li>Ensure TPA networks are timely reviewed and uploaded on internal Aetna systems.</li> <li>Ensure TPA guides, country guides and other internal materials are timely updated and up to date.</li> <li>Ensuring streamline member experience at each country level. Evaluate network options, network efficacies and optimize network utilization to increase direct billing.</li> <li>End to end ownership of operational issues originating from assigned TPAs and work towards swift resolutions.</li> <li>Effectively negotiates and manages complex, competitive contractual relationships with providers/vendors according to prescribed guidelines in support of global and regional network strategies. Expand International provider network by contracting new direct pay providers and manage overall contracting process.</li> <li>Act as a Subject matter expert to assist internal sales, account management and sales support team on network and TPA questions / inquiries. Support sales as a subject matter expert on external broker / client calls.</li> <li>Oversee and manage any operational issues and queries regarding your assigned TPA(s).</li> <li>Manage day to day provider operations, either direct or through network business partners. Ensures operational efficiency for all network processes and infrastructure through proactive provider education and collaboration with Aetna International Service Operations</li> <li>Executes regional-specific strategies and tactics in response to market expectations</li> <li>Executes client-specific strategies and tactics for key expatriate clients.</li> <li>Responsible for understanding and managing medical cost issues and initiating appropriate action from the provider perspective</li> <li>Key contributor to enhanced provider service solution like provider portal and other digital solution, including development and/or management of process and technical support.</li> <li>Initiate legal reviews as needed; ensure all required reviews completed by appropriate functional areas</li> </ul>Required Qualifications:<ul> <li>Benefits Management/Interacting with Medical Professionals</li> <li>Strong project management skills</li> <li>Prior client facing experience.</li> <li>Managing vendor relationships</li> <li>General Business/Demonstrating Business and Industry Acumen</li> <li>Sales/Managing Competitive Networks</li> </ul>Preferred Qualification:<ul> <li>Leadership/Fostering a Global Perspective</li> <li>Health Insurance understanding / business negotiations</li> <li>Service/Demonstrating Service Discipline</li> </ul>Education<ul><li>Bachelors 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: 06/21/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Senior Network Vendor 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.Requisition Job DescriptionPosition SummaryLeads the work and deliverables of multiple marketing campaigns for Aetna Voluntary plan sponsors. Supports initial enrollment and ongoingenrollment communication needs, as well as works on special projects throughout the year. Works cross-functionally with sales,implementation and account management constituents, and externally with human resources and consultants.What you will do<ul> <li>Acts as a top-level specialist on project and program planning and develops comprehensive program plans that encompass objectives, deliverables, timelines, and resource allocation.</li> <li>Adapts project and program plans to ensure alignment with business objectives and reinforce organizational standards.</li> <li>Applies highly developed knowledge of financial management principles to manage cost estimation, tracking, and budget reporting for programs and projects.</li> <li>Coaches’ junior-level project and program managers on how to utilize key performance indicators (KPIs) to measure progress and analyze project and program outcomes.</li> <li>Coordinates knowledge sharing among project teams to highlight success stories and improve project and program management practices through insights.</li> <li>Creates a continuous improvement plan for the project and program department to enhance delivery processes and outcomes.</li> <li>Designs the change management protocol to effectively respond to obstacles that may arise during project and program lifecycles.</li> <li>Utilizes data visualization tools and techniques to present project and program data in a visually appealing easily understandable format.</li> <li>Participates in project/program team training and development activities to enhance project management skills and knowledge.</li> </ul>Required Qualifications<ul> <li>5 + years marketing experience</li> <li>3 to 5 years project management experience</li> <li>Proven communication skills, including writing, presentation, and negotiation skills.</li> <li>Proven track record in meeting project milestones.</li> </ul>Preferred Qualifications<ul> <li>8-10 years of experience related to marketing communications, enrollment technology, customer service and processes, including project consultation preferred.</li> <li>3 to 5 years healthcare experience</li> <li>Expert proficiency with Microsoft Office, inDesign and other marketing software.</li> </ul>Education<ul><li>Bachelor's degree or equivalent professional work experience.</li></ul>Pay RangeThe typical pay range for this role is:$67,900.00 - $199,144.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program. 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.

Senior Marketing Manager Project Program Management (IC)

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>Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. </li> <li>Acts as a subject matter expert by providing training, coaching, or responding to complex issues. </li> <li>May handle customer service inquiries and problems.</li> </ul>Additional Responsibilities <ul> <li>Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. </li> <li>Applies medical necessity guidelines, determines coverage, completes eligibility verification, identifies discrepancies, and applies all cost containment. measures to assist in the claim adjudication process.</li> <li>Handles phone and written inquiries related to requests for pre-approval/pre-authorization, reconsiderations, or appeals.</li> <li>Insures all compliance requirements are satisfied and all payments are made against company practices and procedures.</li> <li>Identifies and reports possible claim overpayments, underpayments and any other irregularities.</li> <li>Performs claim rework calculations.</li> <li>Distributes work assignment daily to junior staff.</li> <li>Trains and mentors claim benefit specialists.</li> <li>Makes outbound calls to obtain required information for claim or reconsideration.</li> </ul>Required Qualifications<ul> <li>2+ years medical claim processing experience.</li> <li>Experience in a production environment.</li> <li>Demonstrated ability to handle multiple assignments competently, accurately and efficiently.</li> </ul> Preferred Qualifications<ul> <li>Self funded medical claim processing experience.</li> <li>DG system knowledge.</li> </ul>Education<ul> <li>High School Diploma or GED required.</li> <li>Preferred Associates degree or equivalent work experience.</li> </ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$18.50 - $42.35This 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.

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