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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.Company: Oak Street Health Title:Assoc Mgr, Practice MgtRole DescriptionThe purpose of a Practice Manager at Oak Street Health is to lead and manage operations at a single primary care clinic location in accordance with company values and standards.Practice Managers supervise clinical and non-clinical team members, support operational initiatives, drive their team towards achieving patient satisfaction and clinical outcomes measured via a variety of metrics, and generally ensure the clinic is running smoothly and in a timely manner on a daily basis. Check out this <a href="https://drive.google.com/file/d/1K3vezzMTwL7Mm0a1obgY6imG7ppP1GyF/view?usp=sharing" target="_blank">pamphlet</a> for a sneak peek into the life of an Oak Street Practice Manager!Core ResponsibilitiesStaff Management and Development<ul> <li>Hire, train, supervise, coach, mentor and manage a multi-disciplinary team of 15+</li> <li>Ensure the center is a Great Place to Work and our teams are engaged and thriving; build a culture of engagement and demonstrate the Oaky Values and Service Behaviors at all times</li> </ul>Clinic Operations<ul> <li>Ensure clinic operations are running smoothly and safely on a daily basis, including ensuring there is adequate staffing each day, arranging coverage for any call-offs or scheduled PTO and ensuring that all Standard Operating Procedures are followed</li> <li>Ensure that we are providing an Unmatched Patient Experience and provide service recovery as needed</li> <li>Drive results for patients in Oak Street Health's care model by ensuring that standard meetings, huddles and best practices for preventive care are being followed. Support the clinical and service team in achieving a variety of patient experience, clinical outcomes and team member experience metrics</li> <li>Lead the implementation of in-clinic operational initiatives, including training the team on new initiatives and workflows</li> <li>Ensure our patient scheduling processes are executed efficiently</li> <li>Oversee our clinical and community areas, including handling any building-related issues in partnership with our Facilities team; serve as the point of contact for our alarm monitoring company, who may contact you if the alarm is tripped after hours.</li> <li>Use Oak Street Health's proprietary software, reporting systems and chosen EMR to monitor completion of a variety of tasks and workflows </li> </ul>Leadership and Community Engagement<ul><li>Partner with the Center Medical Director and Outreach Manager to lead the center as a triad and make collaborative decisions that support the best interests of the patients and team and drive profitability for the center</li></ul>Other duties as assignedThis role reports to the Regional Director of Operations or Regional Vice President (depending on location) and has an opportunity for advancement.What we're looking forWe're looking for motivated, experienced leaders with:Required:<ul> <li>2 or more years of experience in a supervisory role</li> <li>Ability to work flexible hours as needed, with occasional evenings </li> <li>Proficient PC skills</li> <li>US work authorization</li> <li>Someone who embodies being "Oaky"</li> </ul>Strongly Preferred:<ul> <li>Bachelor's or Master's Degree in a related field</li> <li>5 or more years of experience in a supervisory role within a clinical setting</li> <li>Where necessary, fluency in Spanish or other languages spoken by people in the communities we serve</li> <li>Experience successfully driving teams towards achievement of metrics</li> </ul>Preferred<ul><li>Experience with Google Suite </li></ul>Other Skills<ul> <li>A passion for mentorship and team development</li> <li>Ability to drive the culture of your center that is collaborative, patient-centric and oriented toward driving results for our current patients and growing our impact with new patients while making it a Great Place to Work for our teams</li> <li>A problem-solving orientation and eagerness to identify process gaps and implement practical solutions</li> <li>A flexible and positive attitude, including being comfortable with ambiguity </li> <li>A proactive and adaptable working style- able to cover tasks as they arise and regularly make independent decisions regarding competing priorities </li> <li>Impeccable judgment and maturity</li> <li>A supportive attitude toward our patient population of older adults</li> <li>Able to handle confidential information with discretion</li> </ul> What does being "Oaky" look like?<ul> <li>Radiating positive energy</li> <li>Assuming good intentions</li> <li>Creating an unmatched patient experience</li> <li>Driving clinical excellence</li> <li>Taking ownership and delivering results</li> <li>Being relentlessly determined </li> </ul>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: <ul> <li>Mission-focused career impacting change and measurably improving health outcomes for medicare patients</li> <li>Paid vacation, sick time, and investment/retirement 401K match options</li> <li>Health insurance, vision, and dental benefits</li> <li>Opportunities for leadership development and continuing education stipends</li> <li>New centers and flexible work environments</li> <li>Opportunities for high levels of responsibility and rapid advancement</li> </ul>Oak Street Health is an equal opportunity employer. We embrace diversity and encourage all interested readers to apply. Learn more at <a href="http://www.oakstreethealth.com/diversity-equity-and-inclusion-at-oak-street-health" target="_blank">www.oakstreethealth.com/diversity-equity-and-inclusion-at-oak-street-health</a>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$46,988.00 - $91,800.00This 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: 09/17/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVSHealth

Assoc Mgr, Practice Mgt

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 DescriptionThe purpose of a Medical Scribe at Oak Street Health is to support our primary care providers with clinical documentation so that they can focus on providing exceptional care to our patients. Scribes assist providers throughout the patient care journey - huddling each morning to plan for the day's visits, joining them in the exam room to observe and document, and touching base after the visit to assist with next steps.Beyond the typical Scribe role, these important care team members serve as clinical documentation assistants to their paired provider. Internally, we call them CISs (Clinic Informatics Specialists) in recognition of their important role in supporting accurate, specific, and timely clinical documentation. In addition to observing and documenting all patient encounters in real time, our Scribes become experts in our value-based care model and the documentation and care of chronic conditions, including ICD-10 and CPT coding. Scribes use this expertise to help providers identify and help close care gaps. Scribes receive extensive on-the-job training in clinical workflows, value-based medicine, preventative care for chronic conditions, accurate and specific documentation, population health data streams, and team based care.Because our patients and providers rely on our Scribes, the ideal candidate should commit at least 1-2 years to this role. This is an excellent opportunity for pre-med track individuals looking to gain practical, paid experience in a clinical setting before applying to an MD/DO/PA/NP program, as well as those pursuing careers in Health Informatics, Public Health, Healthcare Administration, Medical Coding, and other related fields. Check out this <a href="https://drive.google.com/file/d/1xNEBBvLUXmNPLViIRhhqr2hGpjTZrvin/view?usp=sharing" target="_blank">pamphlet</a> for a sneak peek into the life of an Oak Street Medical Scribe!Responsibilities:<ul> <li> Documenting Patient Encounters ~ 80% <ul> <li>Joining the provider in the exam room to observe patient visits</li> <li>Documenting patient encounters in a structured note, including the history of the present illness, assessment, plan, and physical exam</li> <li>Assigning appropriate CPT and ICD-10 codes</li> <li>Preparing After Visit Summaries</li> <li>Consulting with provider to ensure accurate and specific documentation</li> </ul> </li> <li> Clinical Documentation Improvement ~ 10% <ul> <li>Requesting and reviewing medical records </li> <li>Leveraging Oak Street's population health tools to support clinical documentation improvement</li> <li>Preparing for and supporting Daily Huddles and Clinical Documentation Reviews </li> <li>Consulting with provider on clinical documentation opportunities</li> </ul> </li> <li> Administrative support for your provider and care team ~ 10% <ul> <li>Placing orders orders and referrals</li> <li>Addressing tasks</li> <li>Supporting the care team with additional responsibilities related to clinical documentation</li> </ul> </li> <li>Other duties as assigned</li> </ul>What we're looking forKnowledge<ul> <li>Knowledge of medical terminology and common medications, either from a pre-medical degree or prior clinical experience [required]</li> <li>Prior clinical experience, including shadowing and/or volunteering [strongly preferred]</li> <li>Prior scribe or transcription experience [preferred but not required]</li> </ul>Skills<ul> <li>Advanced listening and communication skills [required]</li> <li>Strong computer literacy and ability to learn new technical workflows [required]</li> <li>Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve [required where indicated]</li> </ul>Abilities<ul> <li>Ability to adapt to new workflows and to quickly learn new concepts and skills [required]</li> <li>Ability to type 70+ words per minute [strongly preferred]</li> <li>Ability and willingness to take direction and be a member of a team providing patient care, including adapting to the provider's working style [required]</li> <li>Ability to be a self-starter within your role scope</li> <li>Excellent job attendance including ability to work in-person in our clinics (Our providers count on you.) [required]</li> <li>Ability to commit to at least 1 year in role (2+ is ideal) [required]</li> <li>Ability to work approximately 40-45 hours per week during clinic hours (full time position) with predictable hours and break times [required]</li> <li>Compliance with hospital and Oak Street Health policies, including HIPAA [required]</li> </ul><ul><li>US work authorization [required]</li></ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$17.00 - $28.46This 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: 09/17/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Specialist,Clinical Informatics

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 HealthTitle: Behavioral Health Specialist LCSW, LPC, LMHC, LMFT RequiredRole Description:The purpose of a Behavioral Health Specialist at Oak Street Health is to provide care management services and to provide evidence-based short-term psychotherapy to our patients with behavioral health needs. The Behavioral Health Specialist is a key resource for Care Teams across a region of Oak Street Health primary clinics. They are responsible for coordinating and supporting behavioral healthcare for our patients, in collaboration with Care Teams and a psychiatric consultant. The Behavioral Health Specialist will assess the needs of patients, make referrals to appropriate behavioral health resources and specialists, and provide short-term counseling and evidence-based treatments as indicated. Check out this <a href="https://drive.google.com/file/d/1Mf0tlfe1fMjF9O1pQ5ImdGPGUCQsc4SI/view?usp=sharing" target="_blank">pamphlet</a> for a sneak peek into the life of an Oak Street Behavioral Health Specialist!Core Responsibilities:<ul> <li>Collaborate with the primary care teams to identify appropriate patients to refer to the Oak Street Behavioral Health Program</li> <li>Screen and assess patients for common mental health and substance use disorders</li> <li>Develop care plans and provide or facilitate referrals to Oak Streetâs psychiatric consultant and/or external resources</li> <li>Provide short-term counseling and evidence-based treatments</li> <li>Coordinate care with Oak Streetâs psychiatric consultant, including warm handoffs for telehealth visits and collaboration on care plans </li> <li>Develop relationships with primary care teams and consistently communicate changes in behavioral health care plans</li> <li>Accurate and timely documentation of patient encounters and counseling sessions in Oak Streetâs electronic medical record</li> <li>Participate in regional and organizational efforts to advance Oak Streetâs Behavioral Health Program through workshops, feedback sessions, and surveys</li> <li>Possibly covering multiple clinics, depending on the maturity and panel sizes of those clinics</li> <li>Other duties, as assigned</li> </ul>What are we looking for?Required:<ul> <li>Masterâs Degree in the field of mental health counseling/healing arts required from an accredited school (Social Work, Counseling, Marriage and Family Therapy, etc.)</li> <li>Highest clinical level of license (or local equivalent) </li> <li>Experience with screening for common mental health and/or substance use disorders</li> <li>Experience with assessment and treatment planning for common mental health and/or substance use disorders</li> <li>Familiarity with brief, structured intervention techniques (e.g., Motivational Interviewing, Behavioral Activation, Problem Solving, Cognitive Behavioral, etc.)</li> <li>US work authorization</li> <li>Someone who embodies being Oaky</li> </ul>Strongly Preferred:<ul> <li>Proficiency in providing brief, structured intervention techniques (e.g., Motivational Interviewing, Behavioral Activation, Cognitive Behavioral)</li> <li>Working knowledge of differential diagnoses of common mental health and/or substance use disorders</li> </ul>Preferred:<ul><li>Proficient PC skills</li></ul>What does being Oaky look like?<ul> <li>Radiating positive energy</li> <li>Assuming good intentions</li> <li>Creating an unmatched patient experience</li> <li>Driving clinical excellence</li> <li>Taking ownership and delivering results</li> <li>Being relentlessly determined </li> </ul>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 patientâs communities and focused on the quality of care over the volume of services. Weâ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: <ul> <li>Mission-focused career impacting change and measurably improving health outcomes for Medicare patients</li> <li>Paid vacation, sick time, and investment/retirement 401K match options</li> <li>Health insurance, vision, and dental benefits</li> <li>Opportunities for leadership development and continuing education stipends</li> <li>New centers and flexible work environments</li> <li>Opportunities for high levels of responsibility and rapid advancement</li> </ul>Oak Street Health is an equal-opportunity employer. We embrace diversity and encourage all interested readers to apply. Learn more at <a href="http://www.oakstreethealth.com/diversity-equity-and-inclusion-at-oak-street-health" target="_blank">www.oakstreethealth.com/diversity-equity-and-inclusion-at-oak-street-health</a>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$60,522.00 - $129,615.00This 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: 03/16/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Behavioral Health Specialist

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 SummaryAetna, a CVS Health company has an outstanding opportunity for a Medical Director. Ready to take your career to the next level with a Fortune 6 company? This is a remote Work at Home position and can be located anywhere in the United States. In this role as Medical Director MPO (Medical Policy &amp; Operations) you will be responsible for providing clinical expertise and business direction in support of medical management programs to promote the delivery of high quality, constituent focused medical care with a focus on clinical and payment policy. This Medical Director provides subject matter expertise to provide clinical support and business direction in these areas. Knowledge of Aetna clinical and coding policy and experience with appeals, claim review, reimbursement issues, and coding is preferable, but a willingness to learn is essential. The Primary Responsibilities of the Medical Director include support of the appeal process, clinical claim review process, pre-certification, and predetermination of covered benefits in the Commercial and Medicare environment. This Medical Director provides subject matter expertise in clinical and payment policy to provide clinical support and business direction in these areas. In this role you will: ◾Participate on work groups as a clinical subject matter expert to identify and promote opportunities to improve the quality and efficiency of health care services. ◾Apply clinical coding and reimbursement expertise to ensure alignment and correct application of Aetna policies and practices to service and payment requests.◾Proactively use data analysis to identify opportunities for quality improvement and positively influence the effective delivery of quality care services. ◾ Be a subject matter expert and internal consultant and payment policy contributor subject matter expertise and internal consultant. ◾Demonstrate the ability to work within and lead as necessary teams comprised of a diverse group of health delivery professionals in order to manage the business objectives of the company. ◾Work Collaboratively with the functional areas. Required Qualifications*Five (5) or more years of experience in Health Care Delivery System e.g., Clinical Practice and Health Care Industry. *Active and current state medical license without encumbrances. *M.D. or D.O., Board Certification in an ABMS recognized specialty including post-graduate direct patient care experience Preferred Qualifications* Health plan/payor experience. * Foundational baseline skills in Medicine, Health Policy, Coding: HCPCS / CPT, Clinical Policy, Reimbursement and Health Care Systems. * Strong communication skills both written and verbal. Education* M.D. or D.O., Board Certification in an ABMS recognized specialty including post-graduate direct patient care experiencePay 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: 04/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Medical Director (Medical Policy & Operations)

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position SummaryAs a Manager, Network Disruption you will be responsible for managing inbound network disruption requests from the CVS Health Sales and Proposals teams in response to Requests for Proposals (RFP) which are used to win new clients and retain existing clients. You will distribute and track requests, review reporting for accuracy, assist in the creation of new tools and processes used to run network disruption reports, and communicate with internal partners in Sales, Account Management, Network Development, and Retail Analysis. You will also work with large claims datasets, analyze differences between current and proposed networks, manage multiple requests/priorities, and produce/develop custom reports for multiple lines of business and specific clients regarding retail pharmacy network accessibility using SQL, SAS, Tableau, Microsoft Access, Microsoft Excel, and other related applications. Key Responsibilities:<ul> <li> Request Management: Manage, distribute, and track network disruption requests from Sales and Proposals teams ensuring timely and accurate responses.</li> <li> Cross-Team Collaboration: Act as a liaison between the Network Disruption team and other internal departments, including Sales, Account Management, Network Development, and Retail Analysis, to ensure seamless communication and collaboration.</li> <li> Data Management: Build queries, perform data imports and extracts, analyze data, compare networks, and create reports to support network disruption requests from internal customers.</li> <li> Innovation: Assist in the development of new tools and processes for network disruption reporting.</li> <li> Custom Reporting: Produce and develop custom reports for various lines of business and specific clients regarding retail pharmacy network accessibility.</li> </ul> Required Qualifications<ul> <li>5+ years of experience in data analysis, network analysis, or a similar role.</li> <li>5+ years experience utilizing SQL, Big Query, Tableau, Microsoft Access, Microsoft Excel, or other related applications.</li> </ul> Preferred Qualifications<ul> <li>Experience in the PBM, healthcare or pharmacy industry.</li> <li>Familiarity with Requests for Proposals (RFP) processes.</li> <li>Advanced proficiency in data analysis and reporting tools.</li> <li>Excellent communication and interpersonal skills.</li> <li>Proven ability to manage multiple priorities and meet deadlines.</li> <li>Experience in network development or retail analysis is a plus.</li> <li>Strong analytical skills with experience in handling large datasets.</li> </ul> Education<ul> <li>Bachelors degree or relevant work experience required.</li> <li>Bachelor's degree in Computer Science, Information Technology, Data Analytics, or related field preferred.</li> </ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$54,300.00 - $145,860.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 04/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Manager, Network Disruption

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 SummaryAetna is recruiting for a Senior Manager, National Value Based Care (VBC) Development who will support innovative and strategic provider relationships as part of the VBC Business Development team. You will work collaboratively across the Network organization to ensure speed to market and to support segment leaders with growing our value-based care portfolio.You will make an impact by:<ul> <li>Support efforts focused on growing and maintaining strategic relationships with national provider partners with a focus on executing enterprise-wide initiatives.</li> <li>Support contracting efforts including negotiating contract deal terms and support the development and implementation of value-based contract relationships, serving as SME in support of business strategies across multiple lines of business, including Medicare Advantage, Medicaid, ACA, and Commercial.</li> <li>Develops relationships with providers and executes on go-to-market strategies and tactics around VBC risk deals to ensure attainment of network expansion and adequacy targets.</li> <li>Collaborates cross-functionally with various stakeholders internally and/or externally to scope/define projects, documentation of contractual information, and review/analysis of reports as part of VBC risk arrangement activities.</li> <li>Partners with cross functional teams, business areas, business segments to ensure all workflow processes and interdependences are identified and addressed.</li> <li>Provides network development/expansion, provider relationships, and refinement activities in support of cross-market network management.</li> <li>Support design, development, management, and/or implementation of strategic network configurations and integration activities as related to value-based care risk deals.</li> </ul>Required Qualifications<ul> <li>8-10 years of experience in Payer and Provider Value based care.</li> <li>Experience in Value Based Care financial models and value-based care contracting/negotiations</li> <li>Experience in Risk-based arrangements and Value-Based care in government services (Medicare Advantage, Medicaid, ACA)</li> <li>Proven negotiation skills including extensive experience leading Medicare advantage percent of premium/delegation deals.</li> <li>Ability to manage multiple priorities, and leading multiple complex negotiations at a time.</li> <li>Adept at execution and delivery (planning, delivering, and supporting) skills.</li> <li>Experience working in a highly matrixed environment.</li> </ul>Preferred Qualifications<ul> <li>Healthcare Industry experience with either a payer or provider</li> <li>Strong communication, critical thinking, problem resolution and interpersonal skills.</li> <li>Internal Aetna system knowledge a plus</li> <li>Proven working knowledge of provider financial issues and competitor strategies, complex contracting options, value-based agreements, financial/contracting arrangements, and regulatory requirements.</li> </ul>Education<ul><li>Bachelor's degree or or a combination of education and professional work experience.</li></ul>Pay RangeThe typical pay range for this role is:$67,900.00 - $199,144.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program. 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: 04/19/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Network Development and Contracting, Primary Care

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 SummaryAetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Cardiology) that can be remote based, work from home.This role can be remote based anywhere in the US.The Medical Director (Cardiology) will be a Subject Matter Expert (SME) with a background in Cardiology specialty, including post-graduate direct patient care experience specifically. This role expands Aetna's medical management programs to address member needs across the continuum of care. In this role you'll support the Medical Management staff ensuring timely and consistent responses to members and providers. You will lead all aspects of utilization review/quality assurance, directing case management. In this role you will provide clinical expertise and business direction in support of medical management programs through participation in clinical team activities You'll act as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams In addition, you will be responsible for predetermination reviews ad reviews of claim determinations, providing clinical, coding, and reimbursement expertise. Required Qualifications* 2 or more years of experience in Health Care Delivery System e.g., Clinical Practice and Health Care Industry.* Active and current state medical license without encumbrances* M.D. or D.O.,Board Certification in Cardiology specialty including post-graduate direct patient care experience specifically Preferred Qualifications * Previous healthcare insurance experience. Education * M.D. or D.O.,Board Certification in a Cardiology specialty.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. 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: 05/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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