CVS Health

Project Manager

• Implements and evaluates the current process and recommends improvements to ensure the efficiency of business processes
• Provides account management support, customer support, project coordination services, service level management, and consulting services to maximize the return on investments
• Builds strong client relationships by consistently delivering client interactions that develop trust and show value
• Develops and implements business growth strategies
• Ensures effective sales, inventory, and financial metrics management
• Meets with managers to discuss objectives and analyze the efficiency and costs of existing business processes
• Creates and presents process improvement reports
• Oversees the implementation of new business processes
• Identifies at-risk accounts and consults with internal partners to assist with the development of action plans to address customer risks and opportunities, and update on progress
• Manages all controllable expenses to meet monthly, quarterly, and annual budgets
• Develops a cadence of regular, proactive meetings to establish strong connections with key stakeholders, deliver financial and operational reviews and business deliverables, and evaluate new opportunities
• Assesses client needs and communicates to leadership propositions for new products and services to grow the base
• Conducts regular performance evaluations, and provides constructive feedback to help individuals on their team grow and excel in their roles
• Delivers training and support new program implementation

Project Manager, Strategic Initiatives

Sales

• 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 of large or more complex 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 (e.g., fully vs. self-insured, product combinations and/or product specializations by industry).
• 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.
• Identified within the business unit as "a person to ask" when complex questions.
• Participate in more senior level discussions with higher-level leaders.
• Consistently provide practical/relevant ideas and perspectives on process or practice improvements.

Voluntary Benefits Sales Director

Analyst

• Conducts routine care coordination, support, and education through the use of care management resources
• Helps implement projects, programs, and processes for Case Management
• Applies practical knowledge of Case Management to administer best of class policies, procedures, and plans for the area
• Consults with case managers, supervisors, medical directors and/or other health programs using a holistic approach
• Presents cases at case conferences to obtain a multidisciplinary review
• Identifies and escalates quality of care issues through established channels
• Demonstrates negotiation skills to secure appropriate options and services
• Delivers influencing/motivational interviewing skills to ensure maximum member engagement
• Provides coaching, information, and support to empower the member for independent choices
• Conducts comprehensive evaluations of referred members’ needs/eligibility using care management tools

Analyst, Case Management – Field

• Conduct standard quality reviews and audits to ensure compliance with internal policies, procedures, and regulatory guidelines
• Identify, document, and communicate errors to business partners for resolution
• Support daily operations and maintenance of assigned functional units
• Analyze audit data to identify trends and recommend process improvements
• Participate in special projects and targeted quality audit initiatives
• Provide subject matter expertise on workflows, systems, and operational procedures
• Collaborate with business owners to support the design and implementation of new processes
• Develop and implement quality programs and contribute to test plan development
• Analyze and resolve complex claims scenarios within established timeframes
• Respond to internal and external customer inquiries and complaints
• Monitor and reconcile system activity to ensure data integrity and financial accuracy

Provider Network Audit Quality Analyst

QA Automation Engineer

• Design, develop, and maintain UI, API, and integration automation frameworks for web and backend applications
• Analyze functional and technical requirements to identify high-value automation candidates and test coverage gaps
• Create, execute, and maintain automated test scripts within Agile sprints and release cycles
• Collaborate with developers and product owners to shift testing left and ensure quality from design through deployment
• Integrate automated test suites into CI/CD pipelines to support continuous testing and faster feedback loops
• Perform API testing, data validation (SQL), and backend verification to ensure end-to-end quality
• Identify, log, track, and triage defects using standard defect management tools, and perform root cause analysis
• Support SIT, UAT, regression, and smoke testing, including automation of repetitive test scenarios
• Continuously improve automation frameworks for stability, scalability, and maintainability

Software Quality Automation Engineer

Manager

• Applies advanced clinical judgement to facilitate appropriate member physical health and behavioral healthcare
• Implements strategy to assess and plan care, direct provider collaboration, and coordinate psychosocial wraparound services
• Instructs the application of available resources to produce optimal, cost-effective outcomes

Clinical Case Manager, BH Field

• Serve as one of the primary SME’s for existing / future forecasting, replenishment, and supply planning modules
• Own legacy configuration knowledge to ensure continuity during migration
• Define system sunset and decommissioning criteria
• Translate business requirements into functional design for the Next Gen platform
• Partner with planners & analytics partners to configure forecasting, safety stock, and order optimization logic
• Integrate ML forecasts and demand sensing into replenishment execution
• Lead capability mapping, parallel runs, validation, and cutover planning
• Define acceptance criteria for accuracy, service, inventory productivity, and adoption
• Mitigate operational and service risks during transition
• Monitor forecast accuracy, bias, service levels, and exception quality
• Perform root-cause analysis across data, models, and configuration
• Drive post-go-live continuous improvement
• Enable transition to exception-based planning
• Drive adoption of planning solutions through clear communication, training, and enablement of planning teams
• Act as escalation point for system issues
• Partner with Planning, IT, Data Science, and Operations
• Translate system performance into business outcomes
• Contribute to long-term planning roadmap

Senior Forecast & Replenishment Systems Manager

Clinical Operations

• Core driver of operational performance and quality
• Lead and optimize staffing, scheduling, and workload distribution
• Analyze operational performance metrics and KPIs
• Establish and enforce compliance guidelines and quality control processes
• Investigate operational incidents and address stakeholder concerns
• Facilitate communication and foster a culture of continuous improvement

Manager, Clinical Operations Support

Financial Planning and Analysis

• Lead Enterprise Finance’s strategy and governance capabilities to ensure Finance data is trusted, timely, audit-worthy, and AI-ready
• Drive the establishment and execution of a modern, well-governed Finance Data Hub anchored to audit worthy sources
• Define roles, responsibilities, ownership, and issue escalation to ensure effective data stewardship across Enterprise Finance
• Monitor and enforce data quality thresholds with clear remediation processes across domains
• Establish and enforce metadata standards and cataloging practices across unified data environments and marts
• Maintain access controls, security policies, compliance, and audit trails to support regulatory adherence and defensible finance reporting
• Manage and govern migration roadmaps prioritized by business demand and organizational strategy
• Define Enterprise Finance data-product strategy with clear definitions, boundaries, and alignment to business value
• Partner to build and operationalize curated, domain-specific data products within a unified data environment
• Ensure uniform representation of core business concepts across domains to prevent duplication and inconsistencies
• Align product design with cloud platform capabilities, balancing performance, cost, and usability
• Serve as a design authority to safeguard consistency, strategic alignment, and scalability through governance and architecture guardrails
• Drive adoption of curated products by enabling business teams, measuring usage, and identifying opportunities for incremental value creation
• Establish controls for model risk, bias, explainability, and human-in-the-loop oversight to support defensible outcomes
• Govern AI data usage, validation, and lifecycle management aligned to privacy, security, and regulatory standards
• Monitor AI performance, drift, and business impact through continuous measurement, auditability, and remediation practices
• Build and run governance routines (e.g., intake, prioritization, escalation, and standards forums) that accelerate delivery of trusted finance data and AI enablement
• Lead a team aligned to the org model to execute strategy, controls, and adoption at scale
• Partner closely with other Reporting & Analytics Strategy leaders to ensure governance accelerates (not blocks) the broader Finance outcomes.

Director, Data & AI Strategy, Governance – Enterprise Finance

Full-stack Engineer

• Develop scalable engineering solutions for the feature flagging platform
• Contribute to technical decisions alongside staff and distinguished engineers
• Collaborate cross-functionally with product, design, and application teams
• Provide technical support to product teams and advise on best practices
• Actively participate in peer code reviews
• Contribute unit and functional tests to uphold the quality of the platform
• Ensure adherence to performance & security standards
• Monitor, debug, and optimize application performance
• Engage in continuous improvement projects within the team

Senior Engineer – Feature Flagging Platform

Strategy

• Assess and define new strategic business innovation opportunities to reduce operational costs
• Drive discovery and data analytics efforts to develop business cases
• Enhance current operational processes and improve member self service capabilities
• Support pilots and implementation of new technology within the Caremark Tech Stack
• Develop, maintain, and deliver Senior Leader level content describing the value proposition of key initiatives and innovations
• Lead business case development/ROI evaluation for future technology investments
• Monitor and measure performance metrics, call trends, and other analysis
• Support business case development and finance tracking across multiple workstreams
• Build relationships and collaborate cross functionally across Caremark Operations, Finance, Digital, IT, Analytics and Enterprise Partners
• Deliver on new and timely Ad-hoc strategic requests from leadership

Senior Strategy Manager

Consultant

• Conducts high-acuity, timely, and comprehensive clinical reviews for members
• Collaborate with providers and internal teams to ensure medically appropriate, efficient, and family-centered care
• Perform prior authorization clinical reviews of acute admissions using evidence-based criteria
• Ensure medical necessity, appropriateness, and length-of-stay determinations align with standards
• Communicate clinical decisions to providers, member families, and internal stakeholders
• Identify barriers to care, escalate complex cases, and participate in interdisciplinary rounds
• Maintain accurate, timely documentation in UM systems
• Participate in quality improvement, policy review, and education related to utilization management

Utilization Management Nurse Consultant – Prior Authorization

• Acts as a liaison with member/client/family, employer, provider(s), insurance companies, and healthcare personnel
• Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care
• Interacts with members/clients telephonically or in person
• Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status
• Develops a plan of care to facilitate the member/client’s appropriate condition management
• Communicates with member/client and other stakeholders
• Prepares all required documentation of case work activities
• Interacts and consults with internal multidisciplinary team
• Provides educational and prevention information for best medical outcomes
• Conducts an evaluation of members/clients’ needs and benefit plan eligibility

Case Manager, Registered Nurse

Product Manager

• Serve as the primary Product Manager for all production incidents across the underwriting ecosystem
• Receive, triage, prioritize, and drive resolution of incidents raised by underwriters, business users, and partners, ensuring adherence to SLAs for live client deals
• Assess business impact, deal risk, and urgency, and coordinate rapid resolution with engineering, data science, QA, and operations teams
• Provide clear, timely communication to stakeholders during incidents, including status updates, mitigation steps, and resolution timelines
• Lead and document root cause analyses (RCAs) for production incidents and escalations
• Translate RCAs into actionable short term fixes and long term solutions to address issues at the root
• Identify systemic patterns, data quality issues, model gaps, or process weaknesses and partner with teams to prevent repeat incidents
• Own run the business activities for the underwriting platform, ensuring operational stability and readiness for ongoing deal activity
• Drive continuous improvements to user experience, operational efficiency, data accuracy, and business outcomes
• Collaborate closely with engineers, data scientists, QA, business partners, and end users to resolve incidents and improve product performance
• Act as the single point of product accountability during escalations, ensuring alignment across technical and business teams
• Partner with underwriting and business stakeholders to understand deal impacts and prioritize fixes accordingly
• Leverage strong analytical skills to diagnose issues within analytical products that forecast pricing and calculate P&L for underwriting deals
• Analyze production data, trends, and incidents to identify improvement opportunities across models, data pipelines, and workflows
• Ensure accuracy, reliability, and transparency of analytical outputs that directly impact client pricing and financial outcomes.

Senior Product Manager – Production Support

• Analyze and interpret data from multiple sources to support layout decisions.
• Manage multiple projects concurrently to meet timelines and support cross-functional partners.
• Communicate effectively, both verbally and in writing, with internal teams, field leadership, and external vendors.
• Support pilot testing and rollout of new layout concepts
• Evaluate pharmacy layouts and space constraints to identify opportunities for efficiency, capacity growth, and improved team experience.