CVS Health

Analyst

• Leverage analytical skills to review claims data and identify patterns of suspected potential FWA.
• Assist in the triage, preliminary investigation of all internal and external FWA complaints
• Refer all cases of suspected FWA to regulatory agencies within required timeframes.
• Assist in the monitoring of the FWA hotline and FWA shared email box
• Participate in the prepayment review process including detailed review of medical records against claims data

Senior Analyst, Fraud, Waste and Abuse Investigation

Pharmacist

• Helping to manage and improve patient health through safe and appropriate dispensing
• Supporting the management, oversight, and operation of all aspects within your pharmacy
• Strengthening pharmacy performance measures through effective coaching
• Contributing to positive patient experiences by showing empathy and genuine care
• Proactively offering and delivering immunizations to keep patients healthy
• Supporting the effective management of pharmacy inventory

Staff Pharmacist, Part Time

Consultant

• Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.
• Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care.
• Communicates with providers and other parties to facilitate care/treatment.
• Identifies members for referral opportunities to integrate with other products, services and/or programs.
• Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization.
• Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function.

Utilization Management Nurse Consultant

QA Automation Engineer

• Design, develop and maintain automated solutions for relational database management systems (RDMS) using Database AI Ops
• Collaborate with software development teams to integrate database automation process into the software development cycle
• Implement and maintain database automation frameworks, tools, and scrips to streamline database operations and enhance efficiency
• Identify opportunities for process improvement and automation within the database environment and propose innovative solutions
• Troubleshooting automation pipeline failures
• Implementing Database DevOps
• Ensure high availability and optimal performance of production databases through effective automation strategies and monitoring techniques
• Document database automation process, procedures and configuration to ensure knowledge sharing and compliance with organization standards
• Keep up to date with the latest industry trends and advancement in database automation technologies

Database Automation Engineer

Underwriter

• Provide analytical and operational support to Caremark Underwriting leadership
• Investigate drivers of change in pricing and forecasting outputs
• Identify root causes of anomalies
• Coordinate with internal stakeholders to obtain clarifications, data sources, and supporting documentation
• Respond to a broad range of ad hoc requests by gathering facts, performing targeted analyses, and producing clear, concise readouts for leadership and business partners
• Perform diagnostic reviews to explain changes in results across pricing and forecasting tools/models
• Partner with stakeholders across the underwriting ecosystem
• Build and maintain “side” analyses (primarily in Excel)
• Work with structured datasets and support extraction/validation of inputs and outputs using relational data concepts and SQL
• Maintain organized notes, assumptions, and reference materials

Senior Analyst, Executive Underwriting Priorities

Application Engineer

• Partner with stakeholders to identify, evaluate, document, and shape GenAI use cases (copilots, automation, decision support, and insight generation) with clear success metrics.
• Design solution architectures that integrate LLMs with enterprise systems, data sources, and tool/function calling while meeting latency and reliability expectations.
• Develop prototypes rapidly and validate them through evaluation, red-teaming, and user feedback; document tradeoffs and recommendations.
• Build production-grade services and full-stack experiences (APIs, UIs, workflows) with secure authentication/authorization, audit logging, and scalable deployment patterns.
• Implement safety, privacy, and compliance controls (e.g., PHI/PII protection, prompt injection defenses, data residency constraints, and policy-based filtering).
• Instrument solutions end-to-end with metrics, traces, logs, and model/app observability; contribute to SLOs, error budgets, and operational runbooks.
• Build and maintain evaluation harnesses for LLM quality, safety, and business outcomes (offline tests, golden sets, regression suites, and online experiments).
• Implement RAG pipelines (chunking, embedding, vector search, reranking) and optimize for accuracy, cost, and latency.
• Collaborate with platform teams on deployment, monitoring, drift/quality detection, and incident response for model-backed services.
• Contribute reusable libraries and patterns for prompt management, retrieval, tool calling, and policy enforcement.
• Participate in design reviews and code reviews; mentor senior and mid-level engineers on GenAI engineering practices.
• Continuously improve developer experience through templates, CI/CD automation, and documentation that accelerates safe adoption.

Staff Machine Learning Engineer – Generative AI, Full-Stack Applications

Business Analyst

• Collaborate and inform the case management process to facilitate appropriate healthcare outcomes for members
• Provide care coordination, support, and education for members using care management tools and resources
• Conduct comprehensive evaluations of member’s needs/eligibility
• Recommend approaches to case resolution and/or meeting needs
• Identify risk factors and service needs that may impact member outcomes
• Coordinate and implement assigned care plan activities and monitor care plan progress
• Consult with case managers and other health programs to overcome barriers
• Identify and escalate quality of care issues through established channels
• Utilize motivation interviewing skills to ensure maximum member engagement
• Provide coaching, information, and support to empower members

Case Management Analyst – Field

• Support the pharmacy team in delivering operational and service excellence within your store
• Assist patients and customers to deliver an exceptional experience
• Ensure pharmacy operations run smoothly, prescriptions are filled promptly, safely, and accurately
• Provide caring service that exceeds patient expectations
• Complete a rigorous company training program and satisfy all registration, licensing, and certification requirements according to state guidelines
• Follow all company SOPs at each workstation to help Pharmacists manage and improve patient health
• Complete basic inventory activities as permitted by law
• Contribute to a high-performing team, embracing a growth mindset and being receptive to feedback
• Remain flexible for both scheduling and business needs
• Comply with all relevant laws, regulations, professional standards, and CVS policies to ensure patient safety

Pharmacy Technician

Product Designer

• Own design and delivery of core experiences
• Clearly communicate experience intent and guide conversation and decisions across product, design, and engineering partners
• Set clear direction and maintain a high bar for quality
• Champion user needs while balancing business goals and technical constraints
• Simplify complex problems and guide teams toward clear, actionable solutions
• Partner with product and engineering to define requirements and align on priorities
• Oversee the creation of key design artifacts (development-ready design, journey maps, service flows)
• Ensure delivery of intuitive end-to-end experiences across web and mobile platforms
• Guide the development of prototypes that reflect both user experience and underlying logic
• Promote accessible and inclusive design practices across all work

Senior Experience Designer

• Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members
• Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care
• Communicates with providers and other parties to facilitate care/treatment
• Identifies members for referral opportunities to integrate with other products, services and/or programs
• Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization
• Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function

Marketing

• Support the design, implementation, and maintenance of planning and resource management processes.
• Help establish and reinforce team-wide norms, workflows, and governance practices.
• Develop repeatable templates, frameworks, and schedules.
• Partner with portfolio and functional leaders to help sequence work, manage capacity, and surface risks.
• Serve as the primary owner and subject-matter expert for Asana within the organization.
• Translate planning processes into intuitive Asana workflows.
• Train, coach, and support teams to drive strong adoption of project management tools.
• Translate complex, cross-functional work into clear, concise leadership-ready materials.

Senior Manager, Strategic Marketing

Manager

• Dedicate 50-75% of the day to engaging with members and coordinating their care.
• Utilize all available resources to connect with and engage 'hard-to-reach' members.
• Partner with members to develop individualized care plans that encompass goals and interventions to meet their identified needs.
• Maintain meticulous documentation of care management activities in the member’s electronic health record.
• Work with the Interdisciplinary Care Team to address barriers to care and develop strategies for maintaining the member’s stable health condition.
• Identify and connect members with health plan benefits and community resources.
• Meet regulatory requirements within specified timelines.

Care Manager – Specialist

General

• Documenting Patient Encounters ~ 80%
• Joining the provider in the exam room to observe patient visits
• Documenting patient encounters in a structured note, including the history of the present illness, assessment, plan, and physical exam
• Assigning appropriate CPT and ICD-10 codes
• Preparing After Visit Summaries
• Consulting with provider to ensure accurate and specific documentation
• Clinical Documentation Improvement ~ 10%
• Requesting and reviewing medical records
• Leveraging Oak Street's population health tools to support clinical documentation improvement
• Preparing for and supporting Daily Huddles and Clinical Documentation Reviews
• Consulting with provider on clinical documentation opportunities
• Administrative support for your provider and care team ~ 10%
• Placing orders orders and referrals
• Addressing tasks
• Supporting the care team with additional responsibilities related to clinical documentation
• Other duties as assigned

Medical Scribe

• Conduct the annual Health Risk Survey to support needs identification for the member’s Individual Plan of Care
• Inform the assigned care manager of newly identified health/safety risks or service needs
• Complete care coordination activities delegated by the care manager within an established timeframe
• Inform the assigned care manager and/or associate manager of any identified quality of care issues
• Passionately support the member’s care coordination needs and drive solutions to address those needs
• Use problem-solving skills to find alternative contact information for members who are unreachable by care management
• Employ motivational interviewing techniques to maximize member engagement and promote lifestyle changes for optimal health
• Adhere to case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies

Care Management Coordinator

• Engage with members and coordinate their care for 50-75% of the day
• Utilize resources to connect with 'hard-to-reach' members
• Develop individualized care plans with members
• Maintain meticulous documentation of care management activities
• Work with the Interdisciplinary Care Team to address barriers to care
• Identify and connect members with health plan benefits and community resources
• Meet regulatory requirements within specified timelines

Senior Analyst, Fraud, Waste and Abuse Investigation

Staff Pharmacist, Part Time

Utilization Management Nurse Consultant

Database Automation Engineer

Senior Analyst, Executive Underwriting Priorities

Staff Machine Learning Engineer – Generative AI, Full-Stack Applications

Case Management Analyst – Field

Pharmacy Technician

Senior Experience Designer

Utilization Management Nurse Consultant

Senior Manager, Strategic Marketing

Care Manager – Specialist

Medical Scribe

Care Management Coordinator

Case Management Specialist