field_remote_option

job_industry

field_job_occupational_field_parents_all

job_organization_name

job_upgrade_is_featured

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary:The Clinical Pharmacist is an operation-based role that conducts criteria based &amp; clinical review of medical data collected to perform prior authorization as per policy and procedure. The Pharmacist/Clinician will apply clinical knowledge to plan approved criteria for reviews of cases. This role will work from CVS Caremark supported systems and take inbound calls from physicians or members regarding their pending, approved, or denied prior authorizations, internally support the Prior Auth team and member services department, as well as provide on-call after hours availability for urgent PA request as needed.This position is responsible for assisting front-line colleagues (i.e. Staff Pharmacists, LPN's and Pharmacy Technicians) with oncology process/procedural support by acting as a subject matter expert (SME) and performing any other complex tasks or addressing any escalation cases assigned by leadership. This includes providing on-the-job (OJT) training, answering questions from front-line colleagues, production support, and providing recommendations/solutions to effectively streamline systems and processes. The Pharmacist will be responsible for maintaining the most current oncology therapy knowledge through self-education.Responsibilities:1.) Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and plan design. Includes verifying insurance coverage and eligibility, interpreting clinical guideline criteria, consulting physicians and other healthcare providers, and appropriately utilizing clinical knowledge and resources while complying with department protocols. One of the crucial responsibilities is to guarantee that the decisions regarding cases are conveyed promptly and efficiently to all the healthcare providers, health plans/employers, patients, and other healthcare professionals following agreed-upon approval &amp; denial management processes. 2.) Collaborates with the technicians and prior authorization team members to process referrals, including answering clinical questions and collecting appropriate clinical/medical data needed to perform clinical assessments and reviews as per the health plan/employer-agreed criteria within the designated service level agreements. Performs and handles inbound and outbound phone calls with technicians, prior authorization team members, physicians, healthcare providers, and/or patients to facilitate prior authorization requests, answer inquiries, and/or resolve escalations.3.) Responsible for assisting front-line colleagues (i.e. Staff Pharmacists, LPN's and Pharmacy Technicians) with oncology process/procedural support by acting as a subject matter expert (SME) and performing any other complex tasks or addressing any escalation cases assigned by leadership.4.) Assist with standard or client specific oncology review process changes as needed. 5.) Assist with writing Work Instructions when needed.6.) Works collaboratively with internal and external business partners to provide solutions for customers, colleagues, and clients.7.) Provide feedback of trends pertinent to oncology reviews.8.) Maintains professional and technical knowledge of drug and disease states for the Specialty and Non-Specialty Pharmacy programs administered within the Commercial Prior Authorization and Case Review Unit (CRU) line of business.9.) Performs other related projects and duties as assigned, including attending training sessions and development meetings, and providing on-call and after-hours pharmacist availability as needed.This is a remote role, open to qualified candidates within the United States.Essential Functions: 1. Regular and predictable attendance2. Colleague may be required to work mandatory overtime/extended work week when needed3. Colleague may be required to travel when needed4. Comply with departmental, company, state, and federal requirements when processing all information to ensure accuracy of information being provided to internal and external customers.5. Adhere to all policies and procedures6. Attend on going training and development meetingsPhysical Requirements:1. Sits at desk for long periods of time (up to 100%)2. Talking on phone for extended periods of time (up to 100%)3. Computer use for extended periods of time (100%)4. Reading a computer screen (up to 100%)5. Light lifting of less than 10 lbsWork EnvironmentColleague is responsible for maintaining a HIPAA-compliant remote workspace. Must be able to provide a quiet, uninterrupted work environment. Must have a workstation that is not accessible to common traffic and is secure from unintentional access. Must have stable personal high-speed internet and ability to hard-wire into company computer (cannot use wireless internet)Education: BS in Pharmacy or PharmD requiredBoard Certified Oncology Pharmacist (BCOP) requiredActive, unrestricted pharmacist licensure in state of residence requiredRequired Skills &amp; Other Minimum Required Qualifications: <ul> <li>Licensed Registered Pharmacist</li> <li>Board Certified Oncology Pharmacist (BCOP) required</li> <li>2+ years clinical pharmacist experience, inclusive of prior authorization experience</li> <li>Knowledge of Microsoft Office Suite: Excel and Word required; Access, Outlook, PowerPoint, Visio preferable. Keyboard skills essential.</li> <li>Must be able to multitask and utilize multiple system applications simultaneously.</li> <li>Must be able to utilize available resources independently and provide high quality work.</li> <li>Must demonstrate problem solving ability and attention to detail.</li> <li>Ability to adapt and change with workflow and shifting priorities.</li> <li>Ability to work effectively in a team environment and provide mentorship to non-clinical staff on the PA team.</li> <li>Must possess excellent written, verbal, grammar, and listening communication skills.</li> <li>Must be able to effectively communicate with a diverse customer base (internal and external) in a friendly and confident manner.</li> <li>Ability to maintain confidentiality of PHI (Protected Healthcare Information).</li> </ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$45.43 - $101.54This 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: 05/12/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVSHealth

Clinical Pharmacist - Prior Authorization/Oncology (BCOP Required)

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 We are looking for a Principal Data Scientist to join our Government Consumer Analytics team at CVS Health. This high-level individual contributor will partner closely with the AVP of Government Consumer Analytics to drive hands on technical excellence across the most complex projects across the portfolio, lead a culture of technical rigor and excellence, and define key standards across an organization of ~80 data scientists and engineers.Description / Fundamental Components:Hands-On Data Science Excellence for Highly Complex Projects (60%)<ul> <li>Anticipates and solves strategic and high-risk business problems with broad impact on the business area by applying leading-edge theories and techniques to investigate problems, detect patterns and recommend solutions</li> <li>Leads development and execution of new and/or highly complex algorithms and statistical predictive models and determines analytical approaches and modeling techniques to evaluate scenarios and potential future outcomes</li> <li>Establishes analytical rigor and statistical methods to analyze large amounts of data, using advanced statistical techniques and mathematical analyses</li> <li>Evaluate advanced industry-leading approaches and determine which to incorporate into CVSH technical approach</li> <li>Work across 2-3 highly complex projects at a time (50/30/20), with a combination of hands-on, problem solving, and coaching</li> </ul>Technical Development &amp; Mentorship (25%)<ul> <li>Hold team-wide office hours regarding technical challenges and problem solving</li> <li>1:1 technical coaching with 10-20 individual contributor teammates</li> </ul>Define Data Science Standards &amp; Best Practices (15%)<ul> <li>Identify opportunities to implement improved best practices</li> <li>Provides guidance to develop enterprise-wide analytics strategy and roadmap</li> </ul>Required Qualifications<ul> <li>10+ years of progressively complex related analytics experience</li> <li>8+ years' experience leading analytics project from concept to delivery, coordinating across a diverse group of stakeholders, anticipating and preventing roadblock and driving business impact</li> <li>8+ years' experience with advanced analytics tools and languages, analyzing large data sets from multiple data sources</li> <li>8+ years' experience solving analytics problems using advanced statistics, machine learning, mathematical algorithms and predictive modeling</li> <li> 8+ years' experience with: Python, SQL, Cloud applications (GCP, AWS, Azure), machine learning, casual inference and experimental design </li> <li>5+ years' industry experience demonstrating strong written and verbal communication skills, including the ability to present complex ideas to various audiences</li> </ul>Preferred Qualifications<ul> <li>Excellent analytical and problem-solving skills</li> <li>Strong organizational, management and leadership skills</li> <li>Knowledge of the health care industry, products, systems, business strategies and products</li> </ul>Education<ul> <li>Bachelor’s degree in Mathematics, Statistics, Computer Science, Economics, Physics, Operations Research, Engineering, or related discipline</li> <li>Master's degree or PhD preferred</li> </ul>Pay RangeThe typical pay range for this role is:$144,200.00 - $288,400.00 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.

Principal Data Scientist - Government Consumer Analytics

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.Registered NurseCompany: Oak Street Health Title: Registered Nurse Role Description: Oak Street Health takes a team-based approach to providing outstanding patient care. The OSH Team is responsible for delivering excellent, high-touch, primary care, and coordinating the care of our patients throughout the healthcare delivery system. Registered Nurses (RNs) are an important part of Oak Street Health’s success. High levels of flexibility, attention to detail, and problem solving are required to be successful. You will be expected to build relationships with Oak Street Health patients, manage patient’s care plans, perform proactive phone and in-person outreach to our patients based on their care needs, support Care Team decision making, participate in weekly care team meetings, and generally coordinate all clinical and auxiliary services needed to provide a high quality health care experience from Oak Street Health. Core Responsibilities: Telephone support and triage for patients, scheduling problem visits or nurse visits when appropriate, offering symptom management, supporting refill requests and answering visit follow-up questions Provide patient education, particularly around chronic conditions; may occur in person, over the phone or in groups Monitoring and coordinating delivery of the care plan Forming relationships with patients and their caregivers to support prevention focused care and ED/ hospital diversion, where appropriate Provide direction to MAs to support delivery of procedures, telephonic support and patient instructions Conduct medication and testing authorizations Deliver an exceptional patient experience through service, responsiveness and care May periodically perform home visits Other duties as assigned What are we looking for? We’re looking for motivated Registered Nurses with: Current state license to practice as a Registered Nurse CPR Certification required EMR experience Strong communication skills and customer service orientation A problem-solving orientation, accountability, and a flexible and positive attitude A supportive attitude toward our patient population of older adults 2 or more years of healthcare experience working as an RN, preferably in a primary care office or other outpatient setting Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve, where necessary US work authorization Someone who embodies being “Oaky” What does being “Oaky” look like? Radiating positive energy Assuming good intentions Creating an unmatched patient experience Driving clinical excellence Taking ownership and delivering results Relentlessly Determined Why Oak Street? Oak Street Health offers our coworkers the opportunity to be at the forefront of a revolution in healthcare, as well as: Collaborative and energetic culture Fast-paced and innovative environment Competitive benefits including paid vacation and sick time, generous 401K match with immediate vesting, and health benefits Oak Street Health is an equal opportunity employer. We embrace diversity and encourage all interested readers to apply to oakstreethealth.com/careers.Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$54,095.00 - $116,760.00This 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: 11/01/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Registered Nurse

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.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. Role Description The purpose of the Welcome Coordinator at Oak Street Health is to create an inclusive environment for anyone who walks through our doors and to make a positive first and last impression on our patients. Welcome Coordinators are the face of our clinic and the glue that keeps our center operations efficient. Welcome Coordinators perform various administrative tasks that allow our broader teams to execute on creating an unmatched patient experience, deliver the best care anywhere and make Oak Street a great place to work. Welcome Coordinators juggle tasks such as scheduling patient appointments, managing inbound and outbound phone calls, as well as managing administrative tasks including fax and mail distribution. Welcome Coordinators are expected to be friendly and highly flexible. Welcome Coordinators are a part of our Service Team and report to the Practice Manager. The main focus of the Service Team is creating a seamless experience for our patients and community members. Welcome Coordinators are responsible for delivering excellent, high-touch assistance to our patients and guests everyday. Check out this pamphlet for a sneak peek into the life of an Oak Street Welcome Coordinator! Core Responsibilities: • Welcoming patients and guests • Conducting visit check-in and assisting patients with required forms • Collecting co-pays • Updating patient information and making changes in electronic medical record platform • Scheduling/rescheduling appointments within electronic medical records platform • Managing phone lines by answering, taking messages, and conducting outbound calls as instructed • Managing faxes in the electronic fax platform • Maintaining the cleanliness of the Welcome and Community Room areas • May be required to float to other centers in the region on an infrequent basis • Other duties as assigned What we're looking for Required • Strong computer skills required and basic knowledge of Google Suite • Professional phone etiquette • Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve (where necessary) • US work authorization Strongly preferred • Experience in customer service setting strongly preferred • Some college preferred Other Skills • A flexible and positive attitude • A welcoming and nurturing attitude toward our patient population of older adults • High level of integrity • Someone who embodies being "Oaky" What does being "Oaky" look like? • Radiating positive energy • Assuming good intentions • Creating an unmatched patient experience • Driving clinical excellence • Taking ownership and delivering results • Being relentlessly determined Why Oak Street Health? Oak Street Health is on a mission to "Rebuild healthcare as it should be'', providing personalized primary care for older adults on Medicare, with the goal of keeping patients healthy and living life to the fullest. Our innovative care model is centered right in our patient's communities, and focused on the quality of care over volume of services. We're an organization on the move! With over 150 locations and an ambitious growth trajectory, Oak Street Health is attracting and cultivating team members who embody "Oaky" values and passion for our mission. Oak Street Health Benefits: • Mission-focused career impacting change and measurably improving health outcomes for medicare patients • Paid vacation, sick time, and investment/retirement 401K match options • Health insurance, vision, and dental benefitsAnticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$17.00 - $25.65This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 11/22/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Welcome Coordinator

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 Behavioral Health Medical Director is responsible for behavioral health medical leadership providing their subject matter expertise to the health plan. They will have key roles in utilization management and case management programs for mental health and substance use disorder services. They will collaborate with health plan leadership to oversee the behavioral health benefit and work collaboratively with state agency leaders and other stakeholders as it relates to behavioral health needs. Responsibilities include ∙ Participation in the development of clinical practice standards, policies, and procedures ∙ Behavioral health care management performance and coordination with physical health care management ∙ Participation in state agency/stakeholder meetings when requested ∙ Oversight and implementation of the utilization management program for behavioral health services, including preventing contraindicated care ∙ Ensuring consistency in the application of utilization management standards, including those implemented by subcontracted entities ∙ Overseeing the complaint and grievance process for behavioral health denials, ∙ Review and resolution of quality-of-care concerns ∙ Participation in clinical staff recruitment and ongoing performance improvement. ∙ Provide strategic oversight and leadership for all behavioral health activities within the health plan. ∙ Serve as the subject matter expert on behavioral health for ABHKY, ensuring compliance and alignment with state regulations and expectations. ∙ Lead and coordinate efforts with the state and other health plan colleagues to promote integrated care models. ∙ Oversee coordination activities with the state, ensuring effective collaboration and adherence to regulatory requirements. ∙ Work closely with health plan leadership, the Chief Medical Officer, other Medical Leadership, Pharmacy Director, clinical staff (including those in utilization management, care management, quality management), and colleagues within network and provider relations, to enhance the delivery of holistic and integrated care. ∙ Contribute to the development and implementation of policies and procedures that support the health plan's objectives and comply with state guidelines. ∙ Advocate for and implement innovative approaches to behavioral health care, promoting evidence-based practices that enhance patient outcomes. ∙ Support duties as required regarding utilization management of the service benefit and pharmacy benefit within the state health plan and additional duties as assigned. ∙ Actively participate in continuous improvement activities, development and monitoring of SAI initiatives, and other activities that support quality of care and total cost of care oversight. ∙ Serve as a key health plan external facing liaison, regarding behavioral health initiatives, programs, and projects with state regulators, providers, vendors, and community organizations. ∙ Provides guidance and/or represents the Health Plan in all state fair hearings for services that are behavioral health related. Required Qualifications ∙ Board-certified Psychiatrist licensed in the State of Kentucky. ∙ Clinical experience in the treatment of substance use disorders, including utilization of ASAM criteria, and an understanding of the Kentucky system of care. ∙ At least five years combined experience in mental health and substance use services and at least two (2) years of BH leadership experience in a government, health management, or managed care organization, and/or at least two (2) years of experience as a Medical Director in clinical practice, and/or at least three (3) years of clinical BH experience (excluding psychiatric residency). Preferred Qualifications ∙ Experience with KY Medicaid behavioral health benefits and service ∙ Ability to effectively interact with providers, advocacy groups and State partners ∙ Excellent organization and time management skills ∙ Experience navigating a matrixed organization. ∙ KY Medicaid regulatory experienceEducationMD or DOPay 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: 07/25/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Behavioral Health Medical Director - ABH KY

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.Title: Community Health WorkerCompany: Oak Street HealthRole Description:The purpose of a Community Health Worker (CHW) at Oak Street Health is to act as the bridge between our patients, community, and medical systems in order to remove barriers and increase wellness across all life domains. A CHW is a patient’s advocate or liaison, accompanying patients through proactive in-person and phone outreach based on their care needs to promote health literacy and increase access to resources needed to live healthier lives. High levels of flexibility, problem solving, strong communication, and an intimate knowledge of the community served are required to be successful.CHWs work closely with Medical Social Workers to manage patient care plans, support care team decision making, and coordinate clinical and complementary services needed to provide high quality health care and improve the quality and cultural competence of service delivery. CHWs are expected to work within their scope of practice. There is no expected clinical license for this position.Core Responsibilities:<ul> <li>Establish and maintain strong interpersonal relationships with patients, community organizations, team members, and partners to coordinate patient needs</li> <li>Manage patient referrals defined by the care team &amp; collaborate with the Medical Social Worker on action plan</li> <li>Facilitate communication between all identified parties involved in patients’ care as needed (e.g., family members, caregivers, medical providers, community-based organizations)</li> <li>Form relationships with and build an inventory of local community organizations that may benefit our patients</li> <li>Connect patients to state and local community resources related to housing, transportation, food, and activities of daily living among other social and physical barriers to health.</li> <li>Assist patients with completion of applications for accessing eligible benefits and resources</li> <li>Promote goal setting and achievement to improve patients’ quality of life and self efficacy with patients. Goal definitions are agreed upon by the care team</li> <li>Meet with patients in patient-centered and patient-preferred locations (e.g., Oak Street Health center, patient’s home, external medical provider facility, community setting)</li> <li>Community Health Workers should plan to spend about half of their time outside of the center in patient-centered locations; this means having access to a reliable means of transportation to do so is required</li> <li>Drive engagement with high risk individuals (e.g., completed specialty appointments, adherence to Post Discharge Visits) may include accompaniment to appointments</li> <li>Complete referrals to organizations and agencies as needed</li> <li>Deliver culturally appropriate health education in the areas where OSH has provided competency training to the CHW</li> <li>Support care team decision making through participation in interdisciplinary team meetings</li> <li>Document interactions with patients in electronic medical record in a timely manner while maintaining HIPAA standards and confidentiality of protected health information</li> <li>Manage time, set priorities, work independently, and collaborate effectively with an interdisciplinary medical team</li> <li>Other duties as assigned</li> </ul>What we’re looking forRequired:<ul> <li>Minimum of 1 year of experience in healthcare, community-based, case management, or social service environment</li> <li>Strong oral and written communication skills</li> <li>Ability to manage multiple priorities while maintaining a positive attitude</li> <li>Dedication to serving the community and building meaningful relationships</li> <li>Proficient computer skills (i.e. Windows, GSuite, Microsoft, etc.)</li> <li>Access to reliable transportation and ability to travel throughout the community to various locations</li> <li>US work authorization</li> </ul>Strongly Preferred:<ul> <li>Fluency in language that is commonly spoken in the community when necessary. Most often this will include Bilingual English/Spanish</li> <li>Experience working on multidisciplinary teams with organizations, agencies, patients, and community members</li> <li>Knowledge of community resources and resource navigation</li> </ul>Preferred:<ul> <li>Community Health Worker certification or Associates or Bachelors in a related field is a plus</li> <li>Experience utilizing electronic medical record systems</li> <li>A problem-solving orientation and a flexible and positive attitude</li> </ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$18.50 - $31.72This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 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: 12/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Community Health Worker

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Job Purpose and Summary:At CVS Health, we are focused on transforming health care for our customers and making our company a great place to work. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. Within our Retail locations, we bring this promise to life with heart every day and our Pharmacy Technicians (Technicians) play a critical role in supporting our pharmacy teams to consistently deliver on our brand promise.As a Technician, you will support the pharmacy team in delivering operational and service excellence within your store. Technicians are often the first point of contact to assist our patients and customers to deliver an exceptional experience. Technicians assist the pharmacy team to ensure that pharmacy operations run smoothly, our patients’ prescriptions are filled promptly, safely, and accurately, and we are providing caring service that exceeds patient expectations. Technicians operate as part of the pharmacy team through consistent application of Standard Operating Procedures (SOPs), best practices, and effective communication. Throughout their shifts and in all customer and colleague interactions, they demonstrate genuine care and contribute to a safe and inclusive culture where all people feel valued and empowered.Once in role, Technicians are required to complete a rigorous company training program and satisfy all registration, licensing, and certification requirements according to their State’s Board of Pharmacy guidelines. Until the Pharmacy Technician has completed all necessary requirements, duties may be restricted by the Pharmacy Manager. A Technician is responsible for contributing to safe and effective operations of the pharmacy, including but not limited to: <ul> <li>Living our purpose by following all company SOPs at each workstation to help our Pharmacists manage and improve patient health</li> <li>Following pharmacy workflow procedures at each pharmacy workstation (i.e., production, pick-up, drive-thru, and drop-off) for safe and accurate prescription fulfillment</li> <li>Contributing to positive patient experiences by showing empathy and genuine care: creating heartfelt and personalized moments while serving patients at pick-up, drive-thru, and over the phone; keeping patients healthy by offering immunizations and other services at the register and over the phone; and demonstrating compassionate care by solving or escalating patient problems</li> <li>Completing basic inventory activities, as permitted by law, and as directed by the pharmacy leadership team, such as accurately putting away medication deliveries and completing cycle counts, returns-to-stocks, waiting bin inventories, etc.</li> <li>Contributing to a high-performing team, embracing a growth mindset, and being receptive to feedback; actively seeking opportunities to expand clinical and technical knowledge needed to better assist patients</li> <li>Remaining flexible for both scheduling and business needs, while contributing to a safe, inclusive, and engaging team dynamic; voluntarily traveling to stores in the market to work shifts as needed by the business</li> <li>Understanding and complying with all relevant federal, state, and local laws, regulations, professional standards, and ethical principles. Complying with CVS policies and procedures to ensure patient safety, compliance with controlled substance dispensing and recordkeeping, and to protect patient privacy and security</li> <li>Delivering additional patient health care services (e.g., immunizations, point-of-care testing, and voluntarily staffing offsite clinics), where allowable by law and supported by required training and certification</li> </ul>Where permissible, the Pharmacy Technician may also support immunizations, which includes the following responsibilities:<ul> <li>Completing additional licensure and training requirements, in compliance with state Board of Pharmacy regulations, to obtain Technician Immunizer status to support preparing and administering vaccines</li> <li>Educating patients about the importance of vaccines and referring patients to the Pharmacist-on-duty for vaccination questions</li> <li>Monitoring for, and responding to, adverse reactions; reporting adverse reaction events per public health requirements</li> <li>Reviewing and collecting patient information; tracking and documenting for each applicable patient</li> <li>Monitoring and managing vaccine supplies</li> </ul>Required Qualifications:<ul> <li>Must comply with any state board of pharmacy requirements or laws governing the practice of pharmacy, which includes but is not limited to, age, education, and licensure/certification<ul> <li>If the state board of pharmacy does not address or mandate a minimum age requirement, must be at least 16 years of age</li> <li>If the state board of pharmacy does not address or mandate a minimum educational requirement, must have a high school diploma or equivalent, or be actively enrolled in high school or high school equivalency program</li> </ul> </li> <li>State-level licensure and national certification requirements vary by state</li> </ul>Essential Functions: <ul> <li>Regular and predictable attendance, including nights and weekends</li> <li>Ability to complete required training within designated timeframe</li> <li>Attention and Focus:<ul> <li>Ability to concentrate on a task over a period of time</li> <li>Ability to pivot quickly from one task to another to meet patient and business needs</li> <li>Ability to confirm prescription information and label accuracy, ensuring patient safety</li> </ul> </li> <li>Customer Service and Team Orientation:<ul> <li>Actively look for ways to help people, and do so in a friendly manner</li> <li>Notice and understand patients’ reactions, and respond appropriately</li> </ul> </li> <li>Communication Skills:<ul> <li>Use and understand verbal and written communication to interact with patients and colleagues</li> <li>Utilize active listening by giving full attention to what others are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times</li> </ul> </li> <li>Mathematical Reasoning:<ul><li>Ability to use math to solve a problem, such as determining the total number of tablets to dispense, day’s supply, and/or number of full bottles and additional bottles needed to fill a prescription</li></ul> </li> <li>Problem Resolution:<ul><li>Identifying challenging patient or colleague interactions and choosing the best course of action when faced multiple options</li></ul> </li> <li>Physical Demands:<ul> <li>Be mobile and remain upright for extended periods of time</li> <li>Lift, scan, and bag items</li> <li>Reach overhead; stretch or reach out with the body, arms, and/or legs to grasp items</li> <li>Move fingers repetitively; picking, pinching, typing, or otherwise working primarily with fingers rather than whole hand or arm</li> <li>Extend hand(s) and arm(s) multiple directions to place, move, or lift items</li> <li>Control precision; quickly adjust machines to exact positions</li> <li>Stoop to a considerable degree, requiring full use of the lower extremities and back muscles to move items between low and high positions, including bending spine at the waist</li> <li>Close visual acuity to perform activities such as: transcribing, viewing a computer terminal, reading, visual inspection involving small parts</li> <li>Occasionally lift of up to 20 lbs and/or exert up to 20 lbs. of force; Frequently lift of up to 10 lbs and/or exert up to 10 lbs. of force; Consistently lift and/or exert a negligible amount of force to move objects.</li> <li>Express or exchange ideas by means of spoken word where detailed or important spoken instructions must be conveyed accurately</li> <li>Have the ability to receive detailed information through oral communication</li> </ul> </li> <li>Any additional tasks as directed by Supervisor or Manager</li> </ul>Preferred Qualifications: <ul> <li>1-3 years previous experience as a Pharmacy Technician</li> <li>Previous experience in a pharmacy, retail, medical, or customer service setting</li> <li>Ability to work in the home store, and across the market in other locations, to meet business needs</li> </ul>Anticipated Weekly Hours29Time TypePart timePay RangeThe typical pay range for this role is:$16.00 - $24.00This 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. 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: 09/10/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Pharmacy Technician

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.Overview:Aetna, CVS Health is looking for top talent! The Telesales Representative is directly responsible for building a book of business via acquisition of new members using state-of-art lead generation platform supported by real time analytics. Upon acquisition the Telesales Representative will own the member relationship throughout the year and will be the primary contact for member inquiries, including but not limited to, any questions related to plan benefits, product, and services offerings, as well as resolving any issues with respect to the utilization of the product. The position will be a part of a high performing team with strong emphasis on personal and professional development and career growth. Job Responsibilities:<ul> <li>Acquisition of new members via inbound and outbound calls</li> <li>Assessing customer needs for products and services using insightful, probing questions, and demonstrating superior listening skills</li> <li>Servicing of existing members and inquiries related to utilization of their product, benefits, etc.</li> <li>Cross selling ancillary products as well as any other applicable products to existing members</li> <li>Retention of existing members</li> <li>Maintaining knowledge levels with respect to CMS and states regulations</li> <li>Ability to multitask, and effectively use computer while interacting with prospects and members via phone</li> <li>Ensuring that the relevant information is captured in Customer Relationship Management system (CRM)</li> </ul>Accountabilities:<ul> <li>Meeting sales goals, conversion rates, and cross sell rates for acquisition of new members as outlined in the annual performance plan.</li> <li>Contacting prospective members within the time limit outlined in the annual performance plan.</li> <li>Achieving the member retention rate as outlined in the annual performance plan.</li> <li>Highest levels of member satisfaction as measured by various member surveys and member retention rate.</li> <li>Expert level understanding of products, services, and processes offered by the company.</li> <li>Ability to pass on an annual basis:<ul> <li>American Health Insurance Plans (AHIP)</li> <li>Continued Education (CE’s)</li> <li>Product Certification</li> <li>Required Security and Compliance</li> <li>Client/Carrier Certifications</li> <li>Any required CMS Certifications</li> </ul> </li> </ul>Qualifications:<ul> <li>4-year college degree or 1 to 2 years’ experience of selling multiple Medicare products (i.e., Medicare Advantage, Medicare Supplement)</li> <li>Life &amp; Health insurance license is not required to be employed. It is required to obtain the license within 60 days from the employment start date</li> <li>Active use of computer for carrying out daily job activities</li> <li>Ability to multi-task while talking on the phone</li> <li>Excellent communication and listening skills</li> <li>Self-starter with positive attitude and ability to control emotions when dealing with unhappy customers (i.e. “Customer is always right” attitude)</li> <li>Adaptable to high pressure, achievement-oriented environment</li> <li>Drive to build, manage, and grow a book of business and become successful entrepreneur</li> <li>High level of computer proficiency including, but not limited to, Microsoft Office package</li> <li>Ability to quickly perform basic mathematical operations w/out use of calculator</li> </ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$15.00 - $24.23This 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. 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: 06/27/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Inside Sales Representative

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. Medical Director - SIU (Special Investigations Unit) CVS Health - Special Investigations Unit (SIU) Join our mission to safeguard healthcare integrity and protect patient well-being. As the Medical Director of Healthcare Fraud Investigations, you'll lead our efforts to detect, prevent, and combat fraudulent activities in the healthcare system. **This is a remote based, work from home role.** Key Responsibilities: The Special Investigations Unit (SIU) Medical Director will be responsible for performing reviews of medical records in support of healthcare fraud investigations. Serving as a clinical liaison supporting SIU activities across all lines of business the SIU Medical Director will be responsible for making both pre and post-payment claim payment determinations based on Aetna Clinical Policy and/or state and federal regulations. Additional responsibilities include: <ul><li>Serves as a clinical liaison supporting SIU Investigators, Managers, and Directors in matters pertaining to the investigation of suspected healthcare fraud cases </li></ul> <ul><li>Develops and delivers presentations to internal and external customers regarding healthcare fraud matters and Aetna’s approach to fighting fraud. </li></ul> <ul><li>Provides clinical expertise and business direction in the creation of analytical solutions designed to identify potentially fraudulent scenarios </li></ul> <ul><li>Maintains open communication with constituents within and external to the organization </li></ul> <ul><li>Uses available resources and technology in developing evidence, supporting allegations of fraud, waste, or abuse </li></ul> <ul><li>Documents all appropriate information related to medical review determinations </li></ul> <ul><li>Proactively builds relationships with other internal MDs to obtain clinical guidance when required to ensure accurate decision making </li></ul> <ul><li>Represents Aetna as a witness in legal matters as required, and as approved by the Legal Department. Demonstrates high level of knowledge and acts confidently when providing testimony during civil or criminal proceedings. </li></ul> <ul><li>Responsible for peer to peer reviews of SIU related claims based on provider escalation or state/federal requirements </li></ul> <ul><li>Supports legal efforts by providing expert medical testimony and </li></ul> <ul><li>Conducts root cause analysis to identify potential control gaps in the organization’s existing clinical policy, procedures, claim editing etc., and proactively seeks out appropriate contacts to help implement solutions. </li></ul> <ul><li>Mentor and educate SIU team members on clinical aspects of fraud schemes </li></ul> Required Qualifications: <ul><li>MD or DO with active license, preferably in emergency medicine or primary care </li></ul> <ul><li>5+ years of clinical practice experience </li></ul> <ul><li>Strong analytical and problem-solving skills </li></ul> <ul><li> Excellent communication and leadership abilities </li></ul> Preferred Qualifications: <ul><li>3+ years supporting healthcare fraud investigations or related field </li></ul> <ul><li>Board Certification in Emergency Medicine</li></ul> Education: <ul> <li>Active and current state medical license without encumbrances</li> <li>M.D. or D.O., Board Certification in a recognized specialty including post-graduate direct patient care experience</li> </ul> Pay RangeThe typical pay range for this role is:$174,070.00 - $374,920.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 07/28/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Medical Director - SIU (Special Investigations Unit)

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 This individual contributor position reports to the Lead Director, Medicare Member Materials. This is an exciting opportunity to join our team! You will be responsible for directly creating and influencing our Medicare materials, specifically the Mid-Year Enrollee Notification of Available Supplemental Benefits, sent to all beneficiaries outlining usage of supplemental benefits during the plan year.This role involves logic-based programming similar to advanced Excel formulas, not back-end software development.What You Will DoWhether it’s developing strategic logic-based configurations or troubleshooting issues in document logic, your role will be a very important one to ensuring our documents are created accurately. Day to day responsibilities include:<ul> <li>Responsible for configuration logic and rules for Medicare Advantage health plan documents using our proprietary front-end document authoring tools</li> <li>Participating in peer review and auditing to support accuracy</li> <li>Identifying coding issues and debugging</li> <li>Troubleshooting application errors</li> <li>Identifying gaps in processes or organization, and challenge self and others to develop and implement solutions</li> <li>Supporting a sense of urgency regarding managing tasks and timelines</li> <li>Promoting synergy through inter-departmental partnerships</li> <li>Managing projects and tasks in an independent manner</li> <li>Influencing all stake holders to support key projects/programs to ensure positive outcomes that deliver on results</li> <li>Collaborating and partnering with other functional/business areas to ensure all workflow processes and interdependencies are identified and addressed</li> <li>Acting as an advocate for change requiring influencing others to see the value in project</li> </ul> Required Qualifications<ul> <li>3+ years of Medicare member materials experience at a regional or national health plan</li> <li>3+ years of experience supporting health care applications</li> <li>Ability to use logical thinking to design efficient front-end rules and logic (similar to conditional formulas or scripting) to achieve desired outcomes</li> <li>Ability to troubleshoot document logic or rule-based configuration errors as well as application errors</li> <li>Ability to meet strict deadlines</li> <li>Excellent communication and interpersonal skills</li> <li>Strong attention to detail</li> <li>Drives change to improve performance results, organization effectiveness and/or systems/quality/services (e.g., policies, processes or systems)</li> </ul> Preferred Qualifications<ul> <li>Prior experience in working with translation vendors to support creating multi-lingual materials</li> <li>Demonstrated success working to build new technologies and software to support member materials compliance</li> <li>Knowledge of Medicare Advantage rules, including the Medicare Managed Care Manual and Medicare Marketing Guidelines</li> <li>Familiarity with markup or logic-based languages (e.g., HTML, XML, or conditional scripting)</li> <li>Master’s degree</li> </ul> EducationBachelor's degree or equivalent experiencePay RangeThe typical pay range for this role is:$67,900.00 - $149,328.00 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: 06/15/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

36 CVSHealth Jobs