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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.***This position is classified as remote OR hybrid in the Hartford, CT office location***Position Summary<ul><li>Our team leads Aetna’s Commercial Federal Medical Loss Ratio (MLR) financial reporting effort, which requires gathering, analyzing, and validating large data sets from various financial sources. We’re looking for this role to lead in enhancing our data infrastructure and analytics, turn data into actionable information, and lead cross-functional projects within MLR, Actuarial, and the business, including regulatory audits.</li></ul><ul><li> What you will do<ul> <li>Manage projects and processes to meet filing deadlines and internal goals in a self-directed manner</li> <li>Lead activities necessary to ensure a complete and accurate MLR (Medical Loss Ratio) filing, including: reviewing and approving data reconciliations, utilizing and maintaining internally developed tools to complete reasonability analysis, enhancing reporting and reconciliation capabilities through technical tool expansion or process improvements</li> <li>Automate, maintain, and develop internal reports and analysis tools in support of the filing review process by leveraging coding, data management background, and department best practices</li> <li>Help supervise staff and unit priorities to ensure consistent, timely and accurate completion of job responsibilities</li> <li>Manage audit requests by coordinating responses, becoming a subject matter expert in MLR processes, working cross-functionally with other business areas to gather detailed data and craft regulatory audit responses</li> <li>Ability to engage immediately and willingness to lead high profile projects with minimal supervision</li> <li>Fast paced, multi-tasking environment with fixed deadlines and limited project plan flexibility</li> <li>Participate in the execution, enhancement and monitoring of internal controls</li> </ul> </li></ul> Required Qualifications<ul> <li>Minimum 7 years relevant experience</li> <li>Strong project management, organizational, and communication skills required</li> <li>Experience in accounting, finance or relevant positions required</li> <li>Strong technical skills related to MS Access and Excel required, SQL and Python knowledge a plus</li> </ul> Preferred Qualifications<ul> <li>Statutory Reporting experience</li> <li>Prior experience leading a project team</li> </ul> Education<ul><li>Bachelor degree OR equivalent experience.</li></ul>Pay RangeThe typical pay range for this role is:$82,940.00 - $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: 04/18/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVSHealth

Sr Manager Project Management

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 SummaryCarries out and facilitates Scrum events, removing impediments, promoting collaboration, supporting the Product Owner, and driving continuous improvement. Ensures the effective implementation of the Scrum framework, creating a conducive environment for the team's success, and fostering a culture of collaboration and continuous learning. Job Description Carries out and facilitates Scrum events, removing impediments, promoting collaboration, supporting the Product Owner, and driving continuous improvement. Ensures the effective implementation of the Scrum framework, creating a conducive environment for the team's success, and fostering a culture of collaboration and continuous learning. What you will do<ul> <li>Coach scrum masters and product owners on agile principles, values, and best practices for project/product management.</li> <li>Develop the budgets and resource planning strategy with consideration for team velocity, historical data, and limitations.</li> <li>Determine the amount of work that can be completed within proposed projects timelines.</li> <li>Ensure that risk assessments include risks identification, mitigation strategies, and contingency plans for scrum projects.</li> <li>Establish scrum processes and procedures for backlog management, prioritization techniques, and user story refinement.</li> <li>Forecast team capacity and delivery potential for future projects to set realistic expectations for product releases.</li> <li>Help establish and implement a common language and framework for team collaboration.</li> <li>Improve team capacity and investigates potential bottlenecks to determine how to proactively address issues before they arise. Integrates the concepts of adaptability, transparency, and customer collaboration into department processes to promote a culture of continuous learning and experimentation.</li> </ul>Required Qualifications<ul> <li>5+ years of work experience</li> <li>3+ years of experience working with Scrum and Agile principles</li> <li>Adept at problem solving and decision making skills </li> <li>Adept at collaboration and teamwork </li> <li>Adept at growth mindset (agility and developing yourself and others) skills </li> <li>Adept at execution and delivery (planning, delivering, and supporting) skills </li> </ul> Preferred Qualifications Certified ScrumMaster (CSM) preferred EducationBachelor's degree preferred/specialized training/relevant professional qualificationAnticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$0.00 - $166,860.00This 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: 04/04/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Manager, Scrum Master

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.Company: Oak Street Health Title: Associate, Population Health - Corporate Role Description:The ideal candidate will have strong written and verbal communication skills, extremely detail-oriented, comfortable taking ownership &amp; following up, be self-directed, and enjoy working with a team in a fast-paced startup environment, while bringing their experience and innovative ideas. Core Responsibilities:<ul> <li>Development, testing, and troubleshooting all field facing tools / data related to Clinical Documentation including Care Report, HCCs Addressed, Bonus HCCs Addressed, Data Warehouse. </li> <li>Partner with Canopy product owners on development, design, functionality, and reporting needs as it relates to clinical documentation platforms / tools including Care Report Registry, Huddle, Canopy Charts, and additional platforms as to be developed</li> <li>Drafting proposals for new logic / tool functionality and illicit feedback / input from various cohorts including but not limited to PHDs, Sr. CISs, Clinical Coaches / Medical Directors. </li> <li>Finalize technical requirements for reporting needs / updates, collect / organize all technical requirements for the updates, and partner with BI on development / testing / production timing</li> <li>Establish communication cadence / content for regional leaders regarding bug resolution / logic additions as they are pushed into production</li> <li>Creation of metrics and reports to monitor success and identify opportunities for improvement</li> <li>Ensure all tools are functioning as intended and partnering with Business Intelligence for quick resolution if troubleshooting is necessary</li> <li>Identify and implement opportunities to improve accuracy and specificity of our clinical documentation</li> <li>Other duties as assigned</li> </ul>What are we looking for?We’re looking for motivated individuals with:<ul> <li>Experience in beta testing and strong familiarity / knowledge of ICD-10 / HCC Model / Care Report Intricacies</li> <li>Track record of effectively solving difficult problems</li> <li>Orientation toward analytical problem solving</li> <li>Practical, results-oriented mindset</li> <li>Ability to manage multiple priorities while maintaining a positive attitude</li> <li>Unimpeachable integrity</li> <li>1-2 years experience at a consulting firm or similar analytics experience</li> <li>Strong MS Excel skills</li> <li>Bachelor degree </li> <li>US work authorization</li> </ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$43,888.00 - $93,574.00This 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: 10/03/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Associate - Screening and Diagnosis Excellence

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.Aetna, a CVS Health Company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity to help transform health care. We believe that a better care system is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources.This is a remote based (work from home) full-time position and can be based anywhere in the United States.** The Behavioral Health (BH) Medical Director (Special Investigations Unit) will be responsible for performing reviews of BH medical records and/or CPT code/HCPCS codes of known or suspected acts of healthcare fraud and abuse.- Serves as a clinical liaison supporting SIU Investigators, Managers, and Directors as appropriate in matters pertaining to the investigation of suspected healthcare fraud cases.- Provides clinical expertise and consultation in the creation of data analytic monitors to identify potential patterns of suspected fraud, waste or abuse.- Provides consultation to staff regarding root cause analysis and identification of control gaps in Policies, Procedures, Claims edits etc., and assists in seeking appropriate departments to identify solutions.- Provides clinical expertise to internal and customers regarding healthcare fraud matters and Aetna's approach to fighting fraud.- Maintains open communication with constituents within the company.- Uses available resources and technology in developing evidence, supporting allegations of fraud and abuse.- Researches and prepares cases for clinical and legal review- Documents all appropriate information related to medical record review determinations.- Represents Aetna as a witness in court actions, as required, and as approved by Legal. The expectation is that the BH Medical Director will have a high level of knowledge when providing testimony during civil and criminal proceedings. The BH Medical Director must be able to travel, as needed, and provide detailed testimony based upon the BH Medical Director’s documentation.- Is responsible for Peer-to-Peer Reviews of SIU related claims in states that mandate such review - Exhibits behaviors outlined in Employee Competencies. Required Qualifications- Five (5) or more years of experience in a healthcare delivery system (e.g., clinical practice)- Board Certified Psychiatrist not "Board Eligible" - Active and Unencumbered license to practice medicine- Knowledge of pertinent policies and procedures related to claims payment of healthcare related services. Preferred Qualifications- 2 years’ experience within health care industry/knowledge of CPT and HCPCS coding guidelines and principles - Psychiatric experience using clinical expertise in reviewing medical records and making claim payment determinations according to Company, State, Federal and industry standard coding principles and guidelines.- Psychiatric experience in providing clinical guidance and input in the business analytic building process.- Child and Adolescent Psychiatrist Education - Active and current state medical license(s) without encumbrances - M.D. or D.O., Board Certification in psychiatry, including 5 years of post-graduate direct patient care experience.Pay RangeThe typical pay range for this role is:$174,070.00 - $374,920.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 04/18/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Medical Director - Behavioral Health - SIU

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.***This position is classified as either remote OR hybrid in the Cumberland, RI or Northbrook, IL CVS Health office location***Position Summary Reporting to the Senior Manager of the SOX and Controls Assurance (SCA) Team, the Senior Analyst of the SCA Team will supervise a team of approximately 2 audit/compliance professionals to perform execution of the company’s Sarbanes-Oxley (SOX) regulatory requirements for the related business segments (Enterprise, Retail, Pharmacy Shared Services, SOC 1, IT and Health Care Benefits), and promote collaboration with our business partners, external auditors, and management. The position assists with the annual planning process and supervises the execution of SOX testing . This role will be responsible for continually evaluating and recommending operational and process improvements to our financial compliance processes, and the efficiency and effectiveness of the company’s key control structure. Also, the role will have opportunities to collaborate on cross-functional project teams providing value in support of CVS Health achieving its transformational goals. Required Qualifications<ul> <li> Minimum 2 years prior experience in a relevant accounting or auditing role. </li> <li>Very minimal travel. </li> </ul> Preferred Qualifications <ul> <li> Practical knowledge of processes, risks, and internal controls. </li> <li> Professional designations such as CPA, CIA, CISA, etc., or measured progress in achieving such designations. </li> <li> Strong analytical, deductive, problem solving, and critical thinking skills. </li> <li> Good teamwork and collaboration skills. </li> <li> Solid meeting management and oral/written communication skills. </li> </ul> Education <ul><li>Bachelor’s degree in a relevant field such as Accounting, Information Technology, Finance, etc. OR equivalent experience. </li></ul> Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$46,988.00 - $112,200.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 04/23/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Sr. Analyst, Corporate Audit

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 Manages financial transactions, reconciles accounts, prepares financial reports, and ensures compliance with financial policies and regulations. Applies in-depth expertise in financial systems and processes to maintain accurate financial records, process payments, and contribute to the efficient operation of financial activities within the organization.A Brief Overview Manages financial transactions, reconciles accounts, prepares financial reports, and ensures compliance with financial policies and regulations. Applies in-depth expertise in financial systems and processes to maintain accurate financial records, process payments, and contribute to the efficient operation of financial activities within the organization. What you will do<ul> <li>Assists in the management of financial plans, budgets, and forecasts for the organization, including development and implementation.</li> <li>Confers financial reports and metrics to upper management, key stakeholders, and regulatory agencies in order to monitor financial operations.</li> <li>Directs teams to assess financial performance against budgeted goals, identify cost-saving opportunities, and implement strategies to control costs without compromising quality.</li> <li>Designs systems to ensure that the organization optimizes reimbursement, manages denials and appeals, and maintains compliance with healthcare regulations and insurance requirements</li> <li>Assesses metrics and output in order to ensure compliance with financial regulations.</li> <li>Helps establish and implement new initiatives including financial modeling, ROI analysis, and monitoring project budgets.</li> <li>Develops complex insights on specific contracts by assessing vendors, monitoring service level agreements, and optimizing financial arrangements with external parties.</li> <li>Manages team performance through regular, timely feedback as well as the formal performance review process to ensure delivery of exceptional services and engagement, motivation, and team development.</li> <li>Stays informed about financial regulations, reimbursement policies, and emerging financial trends, providing guidance and recommendations to drive strategic initiatives and maintain compliance.</li> </ul>Required Qualifications<ul> <li>5-7 years work experience</li> <li>Adept at problem solving and decision making skills</li> <li>Adept at collaboration and teamwork</li> <li>Adept at growth mindset (agility and developing yourself and others) skills</li> <li>Adept at execution and delivery (planning, delivering, and supporting) skills</li> </ul> Education<ul><li>Bachelor's degree preferred/specialized training/relevant professional qualification.</li></ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$60,300.00 - $132,600.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 04/08/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Manager, Finance OPS (IC)

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.Position Summary <h3>Accountable for driving innovation and operational excellence from ideation to delivery for small to moderate scale, complex, high value initiatives and parts of larger initiatives that impact the delivery of products and services to the internal and external environment.</h3> <ul> <li><h3>Evaluating, designing, and implementing new growth strategies</h3></li> <li><h3>Partnering cross-functionally to identify colleague and customer needs and develop solutions and tactics to drive growth</h3></li> <li><h3>Tracking progress against key milestones, and creating and implementing value-based metrics and analysis to measure outcomes</h3></li> <li><h3>Delivering quantitative and qualitative analyses with slide presentations and storytelling that will simplify complex problems into simple for solutions for leadership to weigh in on</h3></li> <li><h3>Assisting in creating executive level readouts and presentation materials for leadership</h3></li> <li><h3>Developing dashboards to be leveraged by key stakeholders to monitor performance of our business</h3></li> <li><h3>Conducting deep dive analytics to identify opportunities for innovation and process improvement</h3></li> <li><h3>Performing root cause analysis and ad hoc research to diagnose gaps in our workflow and patient experience</h3></li> <li><h3>Simplifying complex datasets and identifying actionable insights that drive value</h3></li> </ul> <h3>This job might be for you if:</h3> <ul> <li><h3>You're energized by being part of a large cross functional team working in a fast-paced environment. You enjoy working in teams with a diverse set of experiences and backgrounds. You listen to others’ ideas with an open mind.</h3></li> <li><h3>You’re a leader. And you know this means more than leading people. You know that it means taking initiative with a project - anticipating the next steps and taking action before asked. You also know that it can mean leading from behind and stepping in with much needed support.</h3></li> <li><h3>You enjoy solving complex problems. If you don’t know how to do something, you work to find the answers. You don’t get frustrated easily when something doesn’t go the way you planned.</h3></li> <li><h3>You can take complicated concepts and communicate them effectively to a variety of audiences. You write well. You pay attention to the details. You can articulate your thoughts eloquently. You have a track record of successfully influencing senior leadership and clients.</h3></li> <li><h3>You are self-motivated. You take ownership of your work and your team’s work. You pay attention to the details. </h3></li> <li><h3>You enjoy spending your weekends reading the health section of the paper or listening to healthcare podcasts. You’re interested in tracking how the industry is evolving and like understanding the intricacies of it.</h3></li> <li><h3>You love numbers and can track a multitude of key operational and financial metrics with ease</h3></li> <li><h3>You “think big” and encourage others to take calculated risks in exploring unconventional ideas and challenging the status quo</h3></li> </ul> <h3> Required Qualifications </h3> <ul> <li><h3>7+ years of experience in healthcare in a role that involves strategic problem solving and/or new product development (e.g., consulting)</h3></li> <li><h3>7+ years of demonstrated organizational skills (e.g. project management experience or managing cross-team/department initiatives with demonstrated success)</h3></li> <li><h3>5+ years of data analytics experience working with large data sets and using Excel, SQL, Python, and/or other equivalent analytics tools</h3></li> <li><h3>5+ years leading cross-functional teams in a matrixed environment</h3></li> </ul> <h3> Preferred Qualifications </h3> <ul> <li><h3>Demonstrated relationship management skills at the senior level; capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously.</h3></li> <li><h3>Demonstrated leadership with relevant initiatives: Business process, enterprise business project strategic planning and analysis, risk management, public health, process improvement (e.g., Lean Six Sigma certification).management/consulting. </h3></li> <li><h3>Demonstrated superior business process, project management.</h3></li> <li><h3>Demonstrated experience successfully implementing change in complex organizations.</h3></li> <li><h3>Experience with enterprise-wide and/or cross-functional large scale initiatives with high degree of complexity.</h3></li> </ul> <h3>Education</h3> <ul><li><h3> Masters degree preferred, but not required. Bachelor's degree required or equivalent experience.</h3></li></ul> Pay RangeThe typical pay range for this role is:$82,940.00 - $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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">Benefits | CVS Health</a>We anticipate the application window for this opening will close on: 02/22/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Senior Manager Project Management

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position SummaryThe Senior Software Development Engineer is responsible for the techno-functional impact analysis, understanding the requirements from the business, ensures efficient development processes by planning and strategizing test scenarios, collaborating with stakeholders, and staying updated with industry trends. Strong technical, functional, and interpersonal skills are key to perform this role successfully. The current suite of systems includes multiple applications in Medicaid Enrollment and Member domain. This person contributes to improved quality, faster delivery, and enhanced productivity by developing and maintaining test automation frameworks, creating robust and reusable test scripts, executing automated tests, and integrating automation into the CI/CD pipeline. Additional responsibilities include:<ul> <li>Partner and collaborate with the development manager, business analysts, architects, business partners, developers, and project managers to deliver business change and innovation to Medicaid business applications software.</li> <li>Involvement throughout the entire development life cycle of a product and must be able to deliver an efficient solution, as well as identify and properly mitigate any risks to the product before deployment to production. </li> <li>Guide teams’ performance through regular, timely feedback to ensure delivery of exceptional services and engagement, motivation, and team development.</li> </ul>Required Qualifications<ul> <li>5+ years of software development/testing experience in enterprise/web applications</li> <li>5+ years of experience as various technologies like .Net/Java with focus on backend skills</li> <li>5+ years of experience with software testing, support, CI/CD practices, and Agile/DevOps methodologies</li> <li>5+ years experience with Agile methodologies and familiarity with product management tools such as Jira, Confluence, Rally, or equivalent product engineering collaboration tools</li> </ul>Preferred Qualifications<ul> <li>3+ years of experience in healthcare domain (Medicaid Experience is an added advantage)</li> <li>Master's Degree</li> <li>Adept at problem solving and decision-making skills</li> <li>Excellent communication skills</li> <li>Extensive experience with building and driving adoption of software engineering best practices</li> <li>Strong work ethic, self-starter, and be able to be highly productive in a dynamic, collaborative environment</li> <li>Passion for innovation, with a customer-centric mindset focused on delivering exceptional user experiences</li> <li>Experience working with distributed teams, working across multiple time zones and geographies</li> <li>Ability to influence and inspire teams to align technical direction</li> <li>Ability to create and execute innovation roadmaps</li> <li>Ability to learn/work with emerging technologies, methodologies, and solutions in the Cloud/IT technology space</li> </ul>EducationBachelor’s degree, or equivalent experience (HS diploma + 4 years relevant experience)Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$101,970.00 - $203,940.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 04/09/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Senior Software Development 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.Position SummaryAt Aetna, our health benefits business, we are committed to helping our members achieve their best health in an affordable, convenient, and comprehensive manner. Combining the assets of our health insurance products and services with CVS Health’s unrivaled presence in local communities and their pharmacy benefits management capabilities, we’re joining members on their path to better health and transforming the health care landscape in new and exciting ways every day. Aetna is recruiting for a Lead Director, Value-Based Care (VBC) Enablement, who will develop strategies and supports to enable Aetna’s Medicaid VBC performance and execution across local health plans. <ul> <li>Applying highly-developed knowledge to advise on VBC contracting and provider performance strategies that support the development and implementation of strategic, value-based contract relationships.</li> <li>Identifying and prioritizing Aetna’s Medicaid managed care plans’ needs, including synthesis of information from key stakeholders to inform action plans. </li> <li>Conducting market gap analyses to inform a comprehensive strategy for VBC model implementation and development. </li> <li>Analyzing performance and efficiency, identifying areas for improvement, and implementing improvement initiatives to align contracting and performance management efforts across health plans, including development of frameworks and standard processes. </li> <li>Communicating succinct, actionable insights for team members on relevant industry and policy updates. </li> <li>Assessing data analytics and reporting needs to drive market strategy and performance improvement. </li> <li>Communications and thought leadership, including content development and management. </li> <li>Interfacing with internal teams, including health plan leadership, regional network VBC leadership, VBC operations, and VBC analytics to align company performance goals and objectives.</li> <li>Building and maintaining strong relationships with key stakeholders, fostering open communication channels, and addressing any concerns or issues that arise.</li> <li>Collaborating with other departments to align VBC strategies with overall business objectives, including sharing insights, coordinating efforts, and driving cross-functional initiatives.</li> <li>Providing 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 10 years in the healthcare industry.</li> <li>Familiarity with Value-Based Care across lines of business, including Medicaid.</li> <li>Adept at execution and delivery (planning, delivering, and supporting) skills. </li> <li>Adept at problem solving and decision making skills.</li> <li>Adept at collaboration and teamwork.</li> <li>Mastery of growth mindset (agility and developing yourself and others) skills.</li> <li>Adept at business intelligence.</li> <li>Experience working in a highly matrixed environment.</li> </ul>Preferred Qualifications<ul> <li>A minimum of 5 years of value-based care experience.</li> <li>Experience as a healthcare consultant would be a strong preference.</li> <li></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:$100,000.00 - $231,540.00 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: 04/19/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Lead Director, VBC Enablement

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position SummaryThe Informatics Manager (IC) will serve a key role within the Data Exchange team within AIS and will lead all business activities associated with external data acquisition and integration. This activity involves acquiring and integrating external healthcare data on behalf of Aetna HCB customers into the Aetna Data Warehouse where the data is then consumed by multiple areas around the enterprise for many different programs. Day to Day activities include client consultation, project management, ongoing customer retention/maintenance, revenue management, troubleshooting/research/data analysis, data trending/presentation and participation as needed in enterprise level projects including Data Transparency, Clinical Interoperability and more.Responsibilities:<ul> <li>Defines and delivers analytical solutions in support of healthcare business initiatives that drive short and long term objectives.</li> <li>Collaborates with internal and external partners and organizations in the design and execution of data integration solutions and analytics to answer business and research questions.</li> <li>Designs and conducts analyses and outcome studies using healthcare claims, pharmacy and lab data, employing appropriate research designs and statistical methods.</li> <li>Develops, validates and executes algorithms, statistical models and reporting tools that answer applied research and business questions for internal and external clients.</li> <li>Develops and participates in presentations and consultations to existing and prospective constituents on information services, capabilities and performance results.</li> <li>Turns analysis into business/customer solutions.</li> <li>Creates business applications to deliver clinical or analytic solutions to constituents.</li> <li>Develops project plans, research study designs and timelines.</li> <li>Manages personal resources and cross-functional projects and customer expectations to achieve constituent satisfaction.</li> <li>Responsible for project commitments to quality and on-time deliverables.</li> <li>Ability to manage conflicting priorities and multiple projects concurrently.</li> <li>Willingness to understand and probe into technical details.</li> <li>Contributes to a motivated work environment by working effectively to achieve common goals.</li> <li>Works independently and as part of a larger team to plan and conduct sophisticated analyses.</li> <li>Assists in team leadership and mentoring and may perform management functions in the absence of the Informatics Director.</li> </ul>Required Qualifications<ul> <li>5+ years of experience in reporting and analytical and data visualization in Excel, Tableau, Alteryx, Power BI, etc.</li> <li>5+ years working in a customer facing role providing consultative support</li> <li>5+ years working with healthcare data including claims, pharmacy, provider, membership, lab/test results, biometrics, supplemental data, etc.</li> <li>5+ years of experience in data querying as it relates to root cause analysis</li> </ul>Preferred Qualifications<ul> <li>Strong leadership experience, collaboration skills with the ability to work effectively with all levels of management and staff.</li> <li>Able to effectively collaborate with employees from many different backgrounds and disciplines.</li> <li>Experience supporting multiple types of customers with a particular emphasis on provider groups and hospitals.</li> <li>Familiarity with provider EMR systems, health information exchanges, and industry standard coding.</li> <li>Experience supporting industry standard national quality measure programs such as HEDIS and Medicare Stars as well as familiarity with common industry standard medical management programs (disease management, case management, patient safety, etc).</li> <li>Familiarity with healthcare interoperability and data transmission formats (i.e- HL7, FHIR, CCDA, 837, etc)</li> <li>Ability to interface/liaison between business users/consumers and technical data engineering teams.</li> <li>Strong problem solving skills and critical thinking ability.</li> <li>Understanding of relational databases such as Hadoop, Netezza, DB2, Google Cloud Platform, etc.</li> <li>Ability to query data to perform root cause analysis.</li> <li>Experience working in a ticketing/project management system such as JIRA or Quickbase.</li> <li>Experience acquiring data from outside sources through SFTP or comparable data transmission methods.</li> </ul> EducationBachelor’s degree, or equivalent experience (HS diploma + 4 years relevant experience)Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$54,300.00 - $119,340.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 04/09/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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