CVS Health

ServiceNow

• Lead the development, configuration, integration, and operational support of ServiceNow IRM, GRC, and TPRM modules
• Collaborate with Risk and business stakeholders to refine and prioritize new demand
• Own the backlog and oversee the full development lifecycle for user stories
• Guide developers on platform standards and leading coding practices
• Stay current on ServiceNow release features; assess impact and review enablement plans with stakeholders
• Triage, investigate, and resolve issues in alignment with enterprise SLAs.

ServiceNow Risk Product Owner

Medical Billing and Coding

• Perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices
• Conduct a comprehensive medical record audit
• Provide detailed written summary of medical record review findings
• Articulate findings to investigators, Medicaid plan leadership, law enforcement, legal counsel, providers, state regulators
• Research and accurately apply state or CMS guidelines related to the audit
• Review and discuss cases with Medical Directors
• Assist with investigative research related to coding questions
• Identify potential billing errors, abuse, and fraud
• Identify opportunities for savings related to potential cases which may warrant a prepayment review
• Maintain appropriate records, files, documentation
• Use department resources regularly and follow workflows with minimal assistance or intervention

Analyst, SIU Certified Coder

Manager

• Provide consultative support and medical cost-based analysis of markets and network initiatives.
• Perform complex analytical projects to research utilization and unit cost medical cost drivers.
• Turn data into usable information by telling the story through data visualization.
• Support the development of scoreable action items by identifying outlier cost issues.
• Lead discussions and presentations with the local market plan leadership and within Medical Economics about medical cost drivers and mitigating cost opportunities.
• Be accountable for tracking and documenting all aspects of related work from beginning to end of a project.
• Work with Excel, MS-Access, Power BI, and Web-based query tools (data warehouse).

Medical Economics Manager – Medical Expense Review

Full-stack Engineer

• Establish and implement processes to streamline software development and ensure adherence to best practices
• Design and develop complex software systems to meet business requirements and optimize performance
• Assess project requirements and deliver projects on time and within budget
• Collaborate with cross-functional teams to ensure effective communication and alignment of software development efforts with overall project goals and timelines
• Ensure compliance with industry standards and best practices to maintain the quality and security of software products
• Integrate applications with cloud-native services such as serverless computing and managed databases
• Implement security measures and best practices for cloud deployments
• Optimize applications for cloud environments to maximize cost-efficiency and resource utilization
• Build and integrate APIs (both GraphQL and REST) for scalable service communication
• Deploy and manage services on Google Cloud Platform (GKE)
• Automate CI/CD pipelines using GitHub Actions and Argo CD

Senior Software Development Engineer

Backend Engineer

• Responsible for analysis, design, development, testing and review to ensure adherence to quality requirements and ensure the product works
• Work closely with the CVS leads on Analysis, Development and Estimation activities related to designated project/functional area in CVS Health PBM Domain
• Coordinate with offshore team members, resolve issues in production, prepare and execute project plans
• Perform requirement and gap analysis, raise change control to move changes to user acceptance testing server and then to production server
• Deploy changes to production per implementation plan
• Create/review technical solutions and document projects, including: Analysis & Designs Program specifications, Code Reviews and Test plan
• Help define standards / methodologies / guidelines and ensure compliance while aligning solutions to the CVS Health PBM Domain application architecture

Software Development Engineer, Java, Cloud

Affiliate Manager

• Respond to incoming calls from individuals seeking emotional support or mental health resources; may expand to message and video chats in the future.
• Create a safe and supportive environment for members by ensuring privacy and maintaining a calm, empathetic presence.
• Assess/Identify clinical risk and transfer member for clinical support.
• Help members navigate through employee assistance program and behavioral health benefits, internal and external resources, and connect to appropriate providers.
• Document all interactions in real-time using secure systems, in compliance with HIPAA and internal policies.
• Take direction to execute techniques, processes, and responsibilities.
• Determine purpose of call by actively listening and interacting with callers, triages call in a in a professional and timely manner.
• Assess client’s needs; researches and articulately communicates information regarding pertinent EAP/Worklife services and resources.
• Use screening tools to identify where urgent clinical intervention is needed, and transfers calls appropriately, including members in crisis and at risk.
• Perform appropriate research in internal databases and online to identify potential providers and resources.
• Enter member information into the appropriate EAP system to initiate the case and documents comments and information thoroughly and professionally.
• Communicate effectively with all internal stakeholders.
• Utilize relevant Aetna databases to research and identify validated, appropriate member resources.
• In the appropriate EAP system, maintaining an inventory of materials.
• Provide miscellaneous support functions including administrative support, follow-up calls, and other duties as assigned.

Care Partner – Employee Assistance Program

Analyst

• Collect, organize, and analyze healthcare data from various sources such as revenue and claims data
• Assist with the upkeep and general maintenance of databases
• Translate complex data into information and assist users in its interpretation
• Provide assistance in assessing, planning, organizing, implementing, and evaluating systems, processes, and applications
• Generate reports, dashboards, and performance metrics to track, monitor, and evaluate financial results and operational efficiencies
• Identify opportunities for process improvement by leveraging data analysis to identify bottlenecks, inefficiencies, and areas for automation

Healthcare Data and Analytics Analyst

Financial Planning and Analysis

• Partner with Coram leadership to align financial goals with strategy.
• Own the full expense budget & forecast (headcount, vendors, equipment, supplies, shipping, etc.)
• Prepare FP&A materials for senior leader reviews during planning cycles.
• Report on weekly and monthly performance against budget/forecast.
• Support and review your direct report’s work during month-end and planning cycles.
• Communicate insights, risks, and recommendations to leadership.
• Foster a high-performance, collaborative, and accountability-driven culture.

Senior Manager, Financial Planning & Analysis

QA Automation Engineer

• Ensures efficient and effective automation of software testing and development processes by planning and strategizing test scenarios, collaborating with stakeholders, and staying updated with industry trends
• Contributes to improved quality, faster delivery, and enhanced productivity by developing and maintaining test automation frameworks, creating robust and reusable test scripts, executing automated tests, and integrating automation into the CI/CD pipeline
• Designs and develops complex automated solutions, frameworks, and scripts to streamline and optimize manual processes
• Implements and maintains automation tools and technologies, ensuring efficient and reliable execution of automated tests and processes
• Identifies opportunities for automation within software development, infrastructure, and operations workflows, leveraging industry best practices and continuous improvement principles
• Communicates with cross-functional teams, including software developers, quality assurance, and operations, to define automation requirements and ensure seamless integration into existing systems
• Conducts routine tests and validation of automated workflows and scripts, ensuring accurate and robust functionality across different environments and scenarios
• Debugs automation issues, providing timely resolution and implementing preventive measures to minimize future occurrences
• Analyzes complex automated processes and test results, identifying areas for improvement and optimizing performance to enhance efficiency and reliability
• Trains and supports team members in the use of automation tools and frameworks, promoting knowledge sharing and empowering others to leverage automation capabilities
• Collaborates with stakeholders to define and document automation requirements, specifications, and test plans, ensuring alignment with business objectives

Automation Engineer

Operations

• Building a connected health experience
• Shaping a more convenient and compassionate health experience

Lead Director, Regional Operations

Frontend Engineer

• Screen orders, specializing in research, review and entry of prescription overrides
• Ensure patients receive their correct prescriptions in a timely manner
• Direct questionable prescriptions to the prescriber for clarification
• Meet specified production and quality standards as defined by the management team
• Perform other pharmacy functions as required

Pharmacy Technician – Front End Mail Operations, Non-Clinical Diverts

• The Store Manager In Training (SMIT) job is a development focused role that is crafted to prepare you for a CVS Store Manager position
• The SMIT program is designed to enhance your career as a future store leader
• Support your store as management team member and lead in a manner that is consistent with CVS values and policies
• Engage your colleagues in support of the company's purpose of "helping people on their path to better health"

Store Manager – Training

Business Operations

• Serve as a primary technology partner to business operations teams, supporting both ongoing projects and new initiatives
• Help ensure operational teams are prepared to use technology effectively through readiness assessments, documentation, and coordination with technology partners
• Act as a liaison between business operations and engineering teams to surface issues, clarify needs, and support timely resolution
• Assess current-state business processes and supporting systems to identify readiness gaps, operational risks, or unclear ownership
• Support operational readiness activities for new or changing technology capabilities, including support models and escalation awareness
• Help teams anticipate downstream operational impacts of system changes before they reach end users
• Support technology readiness for user-facing and sales-facing tools to ensure platforms are dependable and usable in production
• Identify opportunities to improve operational effectiveness through process refinement, system adjustments, or workflow improvements
• Support modernization efforts by helping business partners understand and prepare for new or evolving technology capabilities

Manager, Business Operations Support – Enablement

• Develops and implements strategic plans for clinical programs focused on behavioral health conditions
• Leads cross-functional teams in the execution of clinical initiatives
• Establishes strong partnerships with behavioral health network team and clinical partners
• Influences and engages with senior leaders and key stakeholders
• Monitors and evaluates program performance
• Stays abreast of industry trends and advancements in behavioral health
• Represents company with high visibility constituents

Senior Manager, Behavioral Health Clinical Strategy

• Remotely performing full protocol pharmacy diversion investigations utilizing advanced tools and partnership with analytic and field teams
• Analyzing pharmacy data to surface diversion concerns for further review
• Acting as the primary point of contact for pharmacy diversion concerns and validate if action is needed
• Becoming a trusted advisor to cross-functional business partners amongst field and Customer Support partners for all items related to internal pharmacy diversion