CVS Health

Project Manager

• Support intake, prioritization, and sequencing of new AI use cases.
• Coordinate the full lifecycle of AI initiatives from intake through deployment.
• Collaborate with IT and business stakeholders to define requirements and AI use cases and to deliver AI-enabled solutions to meet operational challenges.
• Track initiative status, dependencies, risks, and outcomes.
• Support vendor onboarding and contract coordination.
• Ensure consistent project documentation and post-implementation reviews.
• Support executive presentations and leadership updates.
• Build clear narratives on AI value, risks, and progress.
• Stay current with AI trends, tools and regulatory developments.

Project Manager – Automation/AI

Analyst

• Manage daily Maryland Medicaid claims pend buckets to ensure timely and accurate claims adjudication and payment
• Oversee inventory levels, turnaround times (TAT), backlog reduction, reduction of claims interest, suspended claims work queues, and provider dispute resolution
• Drive improvements in auto-adjudication rates, accuracy, and first-pass resolution
• Ensure all claims processes comply with State Medicaid regulations and billing guidelines, CMS requirements and Federal managed care rules, and timely filing laws
• Support readiness reviews, audits, Corrective Action Plans (CAPs), and state submissions
• Implement QA programs to monitor claim accuracy, provider payment integrity, and policy adherence
• Review and analyze claims performance dashboards, error trends, and key metrics
• Partner with Finance on claims reserves and cost-of-care reporting
• Work closely with Configuration, Cotiviti, and Claim Xten to resolve system issues
• Collaborate with Utilization Management/Medical Management on authorization-related claims issues
• Coordinate with Compliance and Legal on regulatory changes and required process updates
• Lead initiatives to streamline workflows, automate processes, reduce manual interventions, and improve accuracy
• Drive root-cause analysis and implement sustainable corrective actions
• Participate in the development of policy and procedure updates for Medicaid claims operations

Senior Business Analytics Analyst

Software Engineer

• Responsible for the successful design and delivery of complex analyses, reporting solutions and applications to meet business needs.
• Interacts directly with internal customers and colleagues in the development of reporting and analytic solutions.
• Acts as security coordinator assisting with access requests for various tools across the organization.
• Collaborates with internal partners and organizations in the design and development of reporting solutions, analytic studies and applications to support business needs.
• Develops, validates and executes complex queries, develops complex reports and performs complex data analysis that answers business questions for internal customers; interprets results, and makes recommendations to business areas based on findings.
• Designs and Develops applications for internal customers.
• Evaluates data needs of assigned projects, assures data integrity and suitability, and determines data collection methods, metrics definitions and evaluation methods.
• Turns data into actionable information through reporting solutions.
• Troubleshoots technical details / issues.
• Presents analysis and reports to internal customers and stakeholders.
• Works with internal customers to provide them with access to the necessary tools and resources within the department.

Senior Analyst – Informatics Developer

Growth Marketing

• Candidates for this role must reside in North Carolina and be willing to travel up to 70%.
• This role reports to Lead Director, State Strategy and Growth within the Medicaid Business Development Department.
• Focus on building strategic community partnerships in new market states.
• Engage with state stakeholders, attend community events, and support business development activities across the state.
• Serve as a local ambassador, engaging with community-based organizations (CBOs), coalitions, and stakeholders.
• Map community assets and identify strategic partnership opportunities aligned with state health priorities.
• Secure letters of support, agreements, and pilot initiatives that demonstrate Aetna’s commitment to local needs.
• Attend and represent Aetna at community events, health summits, and stakeholder forums.
• Collaborate with internal teams to integrate field insights into RFP responses.
• Track engagement metrics, document outcomes, and maintain a community partnership database.
• Support oral presentations and site visits during the RFP evaluation period.
• Transition partnerships into implementation plans if the contract is awarded.

Manager, Growth Strategist

Compliance

• Research, analyze, and interpret state regulatory requirements
• Develop and draft state-specific benefit contract language
• Manage regulatory submissions through approval
• Negotiate with regulatory authorities
• Perform compliance activities to support CVS Health products

State Consultant, Product and Regulatory Approvals

Full-stack Engineer

• Develop and execute Enterprise Solution Strategy with High Visibility Enterprise teams
• Compile and research technologies across the organization into one cohesive Technical Roadmap
• Create Proof of Concepts to improve projects that address customer challenges
• Drive delivery excellence and partner with business and IT leaders to build digital assets
• Provide expert level support to resolve complex issues and provide RCA
• Identify gaps in systems and provide solutions to enhance overall performance
• Establish and ensure adherence to technical direction, standards, guidelines, and methodology for use of specified technologies
• Lead the Technical Advisory council that performs application architectural reviews
• Develop and improve strategic technical direction for functional areas
• Engage senior technical and business leaders in the development of the technical roadmap

Principal Software Development Engineer – Flutter

Consultant

• Designs enterprise-wide and/or cross-functional solutions to address business problems.
• Partners with business owners to optimize the achievement of strategic business objectives.
• Directs the day-to-day complex business consulting operations.
• Administers processes and assignments for research, collecting, analyzing, and compiling data.
• Handles files, reports, and financial records, and manages department record retention.
• Leads individuals to develop a high degree of customer service.
• Collaborates internally and externally with clients and senior management.
• Develops reports for the organization regarding current business trends and best practices.

Senior Business Consultant

• Build and lead a multi-disciplinary SRE organization
• Ensure platform availability, reliability, and scalability
• Manage operational baselines and monitor all changes
• Drive observability and improvement cycles
• Build a high-performing 24/7 operations model
• Oversee three Innovation PODs for continuous development
• Manage vendor relationships and program governance

Executive Director, AI Ops Engineering

Financial Planning and Analysis

• Financial analysis of manufacturer contracts negotiated by the CVS Caremark Trade Relations team
• Pre and post-implementation financial analysis of implemented strategies
• Providing analytics and data for contract negotiations
• Develop and maintain sophisticated financial models to support the Trade organization
• Extract and analyze drug utilization data from multiple databases, ensuring adherence to time-sensitive deadlines
• Collaboration with Trade and other partner teams on data and analysis needs
• Maintaining relationships with Trade Relations and other partnering organizations
• Involvement in project work to improve underwriting operations

Analyst, FP&A

Manager

• Directing in-depth market, customer, and competitor research to inform capture strategy and proposal development
• Curating market intelligence on customer and competitor programs, weaknesses, innovations, and performance in new and existing markets
• Developing actionable insights from market research that inform strategic decision-making, drive customer-centric approaches and contribute to organizational growth and success
• Collaborating closely and directly with capture leadership, proposal teams, and consultants to ensure research is timely, strategic, and aligned with Aetna’s pursuit of all Medicaid managed care contracts
• Organizing and maintaining research outputs in SharePoint, ensuring key insights and source materials are easily accessible to proposal writers and stakeholders
• Synthesizing research findings into clear and concise reports, presentations, and dashboards, communicating research results effectively to stakeholders at various levels
• Tracking progress and ensuring timely completion of deliverables
• Directing proposal team members during the proposal process by providing insight, recommendations, and relevant intelligence in support of content development

Manager, Medicaid Market Research, Competitive Analysis

Sales

• Contribute to product vision and roadmap aligned to business goals and user needs
• Lead product discovery efforts, including stakeholder interviews and workflow analysis
• Evaluate opportunities using business value, user impact, and technical feasibility
• Identify risks, dependencies, and opportunities to improve product performance and scalability
• Own execution across the product lifecycle, from requirements through launch and iteration
• Translate business needs into clear user stories, epics, and acceptance criteria
• Manage and prioritize the product backlog in Jira in partnership with engineering and business stakeholders
• Coordinate and support user acceptance testing (UAT) to ensure solutions meet defined requirements and outcomes
• Collaborate across product, operations, clinical, and technology teams
• Communicate product direction, timelines, and tradeoffs clearly to stakeholders at all levels
• Facilitate working sessions and demos to drive alignment and transparency
• Advocate for user-centered design and intuitive workflows
• Partner with stakeholders to support go-to-market efforts, training, and change management
• Gather and synthesize user feedback through pilots, testing, and ongoing engagement
• Contribute to end-to-end solution design across Salesforce and integrated systems
• Analyze and improve business processes to drive automation, efficiency, and consistency

Senior Manager, Digital Product – Salesforce

Account Manager

• optimizes interactions with assigned providers and internal business partners
• collaborates cross-functionally to ensure resolution of escalated issues or projects
• educates internal and external parties as needed to ensure compliance with contract policies and parameters
• meets with key providers periodically to ensure service levels are meeting expectations
• manages the development of agenda, validates materials, and facilitates external provider meetings
• may collaborate cross-functionally on the implementation of large provider systems
• may be responsible for provider recruitment, contracting, or re-contracting activities
• drives provider engagement, and may recruit providers as needed
• assists with the design, development, management, and or implementation of strategic network configurations

Provider Network Relationship Manager

Security Engineer

• The Senior Analyst will lead the execution of tactical and strategic projects
• Support master data governance initiatives in alignment with enterprise DSCSA serialization requirements
• Collaborate with the Manager and Senior Manager to focus on master data corrections, exception mitigation, and supplier product master data enrichment

Senior Analyst – Supply Chain Master Data Compliance, Governance

• Provide front-line operational support and issue resolution for Enterprise Quarantine Management process
• Ensure timely triage, tracking, and closure of quarantine events
• Act as the central point of contact between field operations, distribution centers, suppliers, and governance teams
• Monitor, troubleshoot, and resolve serialization quarantine and traceability exceptions

Senior Analyst – Help Desk Specialist, Enterprise Quarantine, Drug Supply Chain Security Act

Product Manager

• Own product vision, strategy, and roadmap for retail and pharmacy digital experiences
• Partner with engineering and design leaders to drive discovery, definition, and delivery
• Define success metrics tied to customer outcomes; learn and iterate through experimentation
• Lead prioritization decisions across complex problem spaces, balancing impact, effort, and feasibility
• Influence cross-functional partners (including legal, finance, and operations) to align decisions and remove blockers
• Build, mentor, and grow product talent; model an outcome-oriented product mindset
• Communicate clearly in executive settings, including trade-offs (build vs. buy) and technology choices (including AI)