CVS Health

Full-stack Engineer

• Software Developer role focused on building and supporting modern full‑stack applications.
• Ideal for recent graduates or early‑career professionals with experience in AWS cloud development (including Python and PySpark) and SQL Server.
• Experience Agile practices and exposure to AI‑assisted development is also needed.

Software Development Engineer

Operations

• Lead business case development/ROI evaluation for future technology investments including Gen-AI
• Monitor and measure performance metrics, call trends and other analysis
• Support business case development and finance tracking across multiple workstreams
• Lead continuous due diligence and product evaluations with a focus on driving Operational Cost Reduction and Member Experience Enhancements
• Build relationships and collaborate cross functionally with key stakeholders across Caremark Operations, Finance, Digital, IT, Analytics and Enterprise Partners
• Deliver on new and timely Ad-hoc strategic requests from leadership

Senior Manager, Member Operations Strategy – Capital Management

Manager

• Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning
• Conducts comprehensive assessments of referred member’s needs/eligibility and determines approach to case resolution
• Provides crisis follow up to members to help ensure they are receiving appropriate treatment/services
• Analyzes all utilization, self-report and clinical data available to consolidate information and begin to identify comprehensive member needs
• Develops and monitors established plans of care to meet the member’s goals

Clinical Case Manager, Behavioral Health

• Play critical role in leveraging data analytics and strategic thinking to identify key insights and trends to drive high-impact initiatives across clinical documentation
• Lead other high-priority Clinical Documentation initiatives as needed
• Manage team member(s) who are supporting with these efforts
• Develop materials and lead discussions with relevant organizational leaders
• Other duties, as assigned

Manager, Screening and Diagnoses Excellence

Consultant

• Establishes key performance indicators (KPIs) and metrics to track progress, measure performance, and assess niche Medicare Conversion program and Call Center Innovation Lab initiative success.
• Implements novel processes (reporting, tracking) to monitor and analyze Connected Contact Center agent performance, Conversion program financial value, and provide insights and recommendations for optimization.
• Effectively collaborates with other Cross-Sell Business Analysts and Medicare Conversion program stakeholders to lead process improvement projects within our niche Medicare Conversions documentation, databases, and reporting (MA LIS, SPAP, CSNP, ISNP Conversions).
• Identifies opportunities to enhance processes, tools, and methodologies to increase Conversion portfolio performance and value.
• Collaborates with our sales team to improve the strategy on for our Medicare Sales programs.
• Updates Conversion Program reporting and distributes updated reports to involved Connected Contact Center stakeholders and requestees.
• Utilizes multiple reporting channels to maintain member enrollment and financial trackers for all Conversion Programs.
• Performs data/statistical analysis on Conversion Program performance to identify actionable opportunities for program improvement.
• Develops new reporting and database tools/methodologies to generate insights into Conversion Programs.
• Supports Conversions Team initiatives through presentation read-outs, reporting documentation, and status updates to leadership.
• Creation of PowerPoint presentations for our executive leadership team.
• Expand the use of AI and Automation into our conversion programs.

Business Consultant, Medicare Strategy

Pharmacist

• Serve as the clinical subject matter expert on the account team
• Provide clinical consulting services through analyzing drug utilization patterns and trends for Pharmacy Benefit Management (PBM) clients
• Leverage presentation skills by delivering quarterly and annual clinical insight reporting to customers
• Educate clients on CVS Health’s clinical programs and making strategic solution recommendations
• Update client-specific clinical benefit elections
• Maintain above average client satisfaction scores and contribute to account team’s ability to increase client revenue

Pharmacist – Clinical Advisor

Analyst

• The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process.
• The Case Management Coordinator facilitates appropriate healthcare outcomes for members by aiding with appointment scheduling, identifying and assisting with accessing benefits and education for members through the use of care management tools and resources.

Analyst, Case Management

• Vendor Performance Review : Own the end-to-end operational cadence of joint business reviews for the assigned vendor portfolio: scheduling, agendas, pre-reads, materials, action item capture, and post-meeting follow-through.
• Issue & Corrective Action Management : Maintain comprehensive tracking of performance issues, corrective action plans (CAPs), and remediation milestones across the assigned portfolio.
• Drive accountability for closure on commitments with vendors and internal owners.
• Audit & Compliance Support : Support audit activities related to vendor performance Ensure performance management documentation, artifacts, and evidence meet contractual, regulatory, and organizational compliance standards.
• Operational Process & Continuous Improvement: Own the operational playbooks, SOPs, and workflow artifacts for vendor performance review, CAP execution, and audit response.
• Identify process gaps and drive improvements that reduce friction without sacrificing rigor.
• Cross-Functional Coordination : Serve as the team's day-to-day operational connection point with business unit partners.
• Coordinate operational handoffs and surface opportunities where internal capabilities could replace or augment external vendor services. Partner with the governance function to ensure operational work and governance work stay aligned without duplication.

Senior Manager – Strategic Vendor Engagement

• Supervision of Case Managers who assess patient needs, evaluate plan of care, monitor effectiveness of care, communicate case objectives and act as patient advocate.
• Act as a resource for the Case Managers and support staff.
• Maintain a focus on timely customer service for internal and external clients.
• Establish professional working relationships with all members of the interdisciplinary team.
• Coach and utilize creative strategies that will allow all staff to become better case managers.
• Resolve staff issues and communicate information appropriately to the Manager of Case Management.
• Identify and address quality issues and participates in quality management activities.
• Assist in the preparation of reports that analyze and track quality of service and utilization statistics.

Associate Manager, Clinical Health Services

Auditor

• Responsible for performing audit and abstraction of medical records (provider and/or vendor)
• Identify and submit ICD codes for risk adjustment processes
• Support coding judgment and decisions using industry standard evidence and tools
• Conduct self-process audits to ensure compliance with internal policies

Data Quality Auditor

• Reviews and prepares cases for medical necessity review of ABA.
• Provide input into medical management programs/policies that pertain to neurodevelopmental disorders.
• Serves as a clinical SME supporting SIU Investigators, Managers, and Directors as appropriate in matters pertaining to the investigation of suspected healthcare fraud cases.
• Conducts clinical quality assurance audits of provider charts and review of key policies and procedures assuring consistent use of audit tools and internal policies
• Consistently collaborates with Senior SIU Medical Director, Senior QA Medical Director and BH Clinical Quality Lead Director Providers SME support to enterprise-wide initiatives supporting members with neurodevelopmental disorders
• Uses available resources and technology in developing evidence, supporting allegations of fraud and abuse.
• Researches and prepares cases for clinical and legal review.
• Provides day-to-day support and guidance for ABA prior authorization clinical team and the health plan medical directors.
• Attends and participates in clinical meetings with care management and utilization management.
• Provides subject matter expertise on all ABA-related questions and member issues.
• Supports provider education initiatives for providers with a neurodiverse specialty including quality assurance and Fraud waste and abuse issues.

Clinical Behavioral Health Consultant

Accounting Manager

• lead, coach, and develop a team of accounting professionals
• oversee rebate accounting, including receipts, payments, and reserves
• design and maintain strong internal controls and support SOX testing and audits
• serve as a subject‑matter expert on rebate‑related business initiatives and new contracts
• review key reserves and recommend adjustments to senior management
• identify and implement process improvements and automation to increase efficiency
• partner with internal teams, auditors, and senior leaders (VPs, Directors)

Senior Accounting Manager

Product Designer

• Creates intuitive and verbally engaging user interfaces and experiences for digital products and applications
• Conducts user research, creating wireframes and prototypes
• Collaborates with cross-functional teams to implement content solutions that meet user needs
• Ensures seamless user interactions and adheres to content design principles
• Iterates and improves designs based on user feedback
• Designs systems to deliver innovative and impactful digital UX solutions
• Assesses specialized, functional areas for enhancing digital user experiences
• Develops complex UX designs and prototypes
• Utilizes specialized UX content knowledge to influence strategic decision-making
• Assists in managing digital UX projects aligning with strategic objectives
• Conducts user research to understand target audience needs, behaviors, and pain points
• Implements processes to ensure compliance with organizational policies
• Coaches and mentors junior-level content designers

Manager – Digital UX Designer

Business Analyst

• Partner with business stakeholders to gather, analyze, and document business requirements
• Translate business needs into clear functional requirements, process flows, and user stories
• Facilitate discussions across business and technical teams to align on scope, priorities, and solutions
• Support requirements traceability, solution validation, and testing activities
• Identify opportunities to improve business processes, workflows, and operational efficiency
• Communicate recommendations, risks, dependencies, and status updates clearly to stakeholders
• Collaborate with project teams to ensure solutions meet business objectives and user needs
• Support change adoption by helping stakeholders understand impacts and required process changes