CVS Health

Counselor

• Responsible for provision of telephone-based assessment, triage, consultation, counseling and informational services, delivered in a call center environment using a variety of advanced clinical assessments, motivational interviewing and solution-focused/short-term problem resolution.
• Provides risk, substance abuse and mental health assessments to develop immediate action/safety plans based on level of urgency.
• Has an understanding of various levels of care (mental health and substance use) to aid in appropriate recommendation of care based on the assessment of need.
• Has an excellent ability to join with and collaborate with a member to understand their needs and be in alignment with the member’s theory of change.
• Provides information to members regarding mental health, substance abuse, community treatment, and related mental health programs to assist members with linkage to resources to aid in the alleviation of stressors.
• Collaborates with team of professionals in a way that supports a positive clinical outcome and continuity of care for all members.
• Requires use of multitasking skills to type/document while also using other tools to assist with call handing while speaking with members.
• Protects the confidentiality of member information and adheres to enterprise, EAP policies regarding confidentiality.
• Maintains accurate and complete documentation of required information that meets risk management and regulatory requirements.
• Maintains current independent behavioral health license in good standing in the state where they reside, seeking professional development and meeting all state licensure requirements.
• Holiday work is expected.

Clinical Counselor, Employee Assistance Program

Manager

• Lead complex medical economics analyses supporting Non‑Participating (Non‑Par) pricing, No Surprises Act (NSA) compliance, audits, and strategic initiatives.
• Translate highly technical data into clear insights for actuarial, legal, and business stakeholders.
• Present key trends, financial performance, tools and analyses with a broad MEU audience.
• Analyze, draw conclusions, and communicate the financial impact resulting from changes in Aetna’s network provider agreements.
• Ensure pricing defensibility, regulatory compliance, and financial integrity.

Manager – Medical Economics

Account Executive

• Develops and implements sales strategies to sell Supplemental Health products and services to new large group accounts and public entity customers in an assigned geography.
• Performs business development activities in pursuit of new growth channels and identifies potential new clients in a specified territory or geographic area.
• High influence on driving new business revenues through the sale of new customers or new products to existing customers.
• Develops new business opportunities and cultivates strong, productive, and influential relationships to generate new sales including large accounts and prospects.
• Implements strategies necessary to attain sales objectives in assigned geographic territory.
• Develops practical business plan that includes broad territory and business strategic objectives along with tactical activities to meet/exceed assigned business and revenue goals.
• Collaborates with internal business partners to identify targeted opportunities and develops specific actions and timelines to win these customers.
• Works with the clients to identify their needs and utilize our full product array to put together a multifaceted package for the client.
• Manages the integration of client's and Aetna’s internal organizations and partners cross-functionally to complete sales, installation, servicing, and product development activities as appropriate.
• Identifies opportunities to partner with the client by drawing from the entire spectrum of product lines.

Supplemental Health Sales Executive

• The Case Manager RN is responsible for telephonic assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness within a high-risk maternity case management program.
• The Case Manager RN develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration.
• Utilizes case management processes in compliance with regulatory and company policies and procedures.
• Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.
• Conducts evaluations of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transitions to Aetna programs and plans.

Maternity Case Manager, Registered Nurse

Financial Planning and Analysis

• Support Enterprise Finance by establishing and operating governance that enables responsible use of AI across Finance.
• Help define principles, accountability, and decision rights for AI use cases.
• Ensure AI solutions are defensible, auditable, and aligned with Finance control expectations while enabling innovation and speed.
• Partner across Finance, Technology, Risk, Compliance, and Audit stakeholders to ensure AI initiatives are introduced with appropriate oversight.

Manager, AI Strategy – Governance, Enterprise Finance

Analyst

• Assessing, planning, implementing, and coordinating all case management activities with members
• Evaluating the medical needs of the member to facilitate the member's overall wellness
• Managing a caseload that includes supportive and medically complex members
• Developing a proactive course of action to address issues presented to enhance the outcomes
• Determining appropriate services and supports due to member's health needs

Bilingual Analyst, Case Management

• Utilize critical thinking and judgment to collaborate and inform the case management process
• Conduct comprehensive evaluation of referred member's needs/eligibility
• Recommend approach to case resolution and/or meeting needs by evaluating member's benefit plan
• Identify high 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, supervisors, Medical Directors and/or other health programs to overcome barriers
• Identify and escalate quality of care issues
• Engage and motivate members to achieve optimum level of health
• Document care using case management and quality management processes

Analyst, Case Management – Transition of Care

• Deliver on-demand single session consultations, clinical assessments, triage, and informational services
• Leverage advanced technology platforms to enhance customer experience, ensuring optimal outcomes by connecting members to the right solutions at the right time to meet their needs
• Support members in their preferred communication modality, whether via phone, video, or chat, for personalized and effective care

Clinical Counselor – Employee Assistance Program, Thursday-Sunday

• Develops and implements sales strategies to sell Supplemental Health products and services to new large group accounts and public entity customers in an assigned geography
• Performs business development activities in pursuit of new growth channels and identifies potential new clients in a specified territory or geographic area
• High influence on driving new business revenues through the sale of new customers or new products to existing customers
• Develops new business opportunities and cultivates strong, productive, and influential relationships to generate new sales including large accounts and prospects
• Implements strategies necessary to attain sales objectives in assigned geographic territory
• Develops practical business plan that includes broad territory and business strategic objectives along with tactical activities to meet/exceed assigned business and revenue goals
• Collaborates with internal business partners to identify targeted opportunities and develops specific actions and timelines to win these customers
• Works with the clients to identify their needs and utilize our full product array to put together a multifaceted package for the client
• Manages the integration of client's and Aetna’s internal organizations and partners cross-functionally to complete sales, installation, servicing, and product development activities as appropriate
• Identifies opportunities to partner with the client by drawing from the entire spectrum of product lines, illustrating a keen understanding of clients' multifaceted needs and benefits utilizing Aetna's full product array
• Coordinates sales materials, testimonials, and subject matter expert involvement in support of the successful delivery of constituent presentations
• Oversees communication and planning among key stakeholders and presents a successful finalist presentation
• Identifies and capitalizes on emerging trends in the marketplace by participating in community and industry events as an Aetna representative
• Collaborates with account management on their assigned book of business
• Ensures product, pricing and services meet client's needs while meeting Aetna revenue growth and profit objectives
• Collaborates with internal and external partners to uncover profitable growth and cross-sell opportunities within new or existing customers and to support post-sale activities
• Manages/coordinates the integration of client’s and Aetna’s internal organizations and partners cross-functionally to complete sales, installation, and servicing
• Accountable for overall Sales Planning, Distribution Channel, Sales Processes, RFP & Quoting Process.

Business Analyst

• Lead and coordinate regulatory filing completion, partnering with teams across CVS Health to update and continuously improve content
• Review new Enterprise Risk Management related business compliance requirements, conduct research, and develop recommendations to help develop compliant ERM practices
• Maintain documentation and data within the designated project management and tracking tools
• Build and maintain positive, productive relationships with internal and external constituents, fostering collaboration and open communication to inform projects, provide status updates, and address issues
• Facilitate and lead cross-functional project initiatives, often serving as the point of contact and discussion leader with subject matter experts and business leaders
• Utilize systems unique to job functions, including Microsoft products (Excel, Word, PPT) and compliance-specific tools such as Archer; maintain system documentation, serve as subject matter expert, train users of system, contribute to system design, oversight, or maintenance
• Support Quantitative team with research for stress scenario development and execution, International regulatory requirements, and communication packages
• Demonstrate exceptional attention to detail in managing documentation, data integrity, and regulatory submissions
• Proactively seek opportunities to streamline processes, ask thoughtful questions, and recommend improvements
• Take ownership of assignments, driving projects forward with minimal supervision
• Support ongoing ERM initiatives
• Other duties as assigned

Enterprise Risk Management Analyst

AI Engineer

• Define and implement the overall technical strategy and design principles for the AI Platform
• Evaluate and recommend technology platforms, frameworks, and tools that align with strategic business goals
• Define, engineer, and implement strategic automation and AI use cases that enhance AI capabilities for the organization
• Engage in research and development activities to explore new technologies, conduct proofs-of-concept, and identify innovative solutions to advance AI Platform capabilities
• Collaborate with cross-functional teams, including product, design, engineering, and business stakeholders to ensure alignment between technical decisions and business objectives
• Provide technical leadership and expertise to guide the organization in adopting and leveraging emerging technologies

Executive Director, Distinguished Engineer – AI Platform

Consultant

• Collaborate with facility leaders and staff to coordinate pharmaceutical services within long term care facilities
• Ensure facilities remain compliant and aligned with federal regulations
• Complete clinical reviews as required by federal and state regulation
• Own issue resolution and communicate early warning signs of potential issues
• Drive adoption of Omnicare programs and service offerings
• Use existing customer relationships to promote and drive organic growth as well as new business
• Conduct Executive Reviews and other customer meetings as required
• Collaborate with Account Management, Sales, Operations, and appropriate corporate functions to meet overall site goals and objectives
• Perform Medication Regimen Reviews (MRR) as outlined by regulation or contract for facility type and provide written reports of these reviews to applicable facility staff
• Spend an appropriate amount of time on each resident’s review as defined by their clinical needs
• Use OSC2OR software on-site to generate MRR, including therapeutic interchange and Omnicare clinical program-related recommendations and document responses to previous recommendations
• Utilize the 'Minimum Data Set' (MDS 3.0) health assessment tool to identify specific residents needing targeted focuses
• Complete the 'Quality Improvement: Consultant Pharmacist Summary Report' for all applicable facilities and transmit this and the 'Summary for Consultant Services' after each month of consulting has been completed
• Educate facility staff including the Director of Nursing, Medical Director, and Administrator when new programs are implemented and perform specific functions required of new programs to be conducted by Consultant Pharmacist

Pharmacist Consultant – Long Term Care

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Clinical Case Manager – Licensed Behavioral Health Clinician

Sales

• Oversees a sales team dedicated to Supplemental Health products
• Building strong personal and collaborative partnerships to meet or surpass sales goals
• Increasing revenue, membership, and earnings
• Working closely with colleagues to uphold the Aetna Brand promise for Plan Sponsors and Producers
• Establishing effective structure, consistent sales practices, and active broker or consultant engagement in the market
• Analyzing competitive environment to support and improve pricing, underwriting and product development strategies
• Cultivating and maintaining strong relationships with all constituents
• Recruiting, attracting, and retaining a diverse workforce and engaging them through mentoring and coaching

National Lead Director – Supplemental Health Sales

• Develops new business opportunities and cultivates strong, productive, and influential relationships
• Implements strategies necessary to attain sales objectives
• Develops practical business plan including broad territory and business objectives
• Collaborates with internal business partners to identify targeted opportunities
• Works with clients to identify their needs and utilize product array
• Manages integration of client's and Aetna’s internal organizations
• Identifies and capitalizes on emerging trends in the marketplace
• Collaborates with account management on their assigned book of business