CVS Health

Data Scientist

• lead a workstream within Caremark's sales and underwriting analytics portfolio — owning end-to-end delivery as a senior individual contributor, setting technical direction, and mentoring peers
• own multiple concurrent projects across model development, strategic analysis, and analytics product delivery — framing the business question, designing the approach, building the solution, and presenting findings to senior stakeholders
• set technical direction for your workstream, mentor junior data scientists, and partner directly with business leaders across sales, underwriting, and finance to turn analysis into action

Senior Data Scientist, Products

Manager

• Responsible for team backlog development and prioritization
• Collaborating closely with Engineering, Design, and other members of the team
• Creating and managing the product development roadmap
• Function as the main point of contact for successful Epic delivery and final customer outcomes
• Drive status for cross-product metrics and develop initiative-level measurement plans through alignment

Senior Manager – Digital Product, Client & Clinical Experience

Financial Planning and Analysis

• Developing complex budget insights based on analyses of historical financial data, market trends, and business strategies
• Working closely with the Account Team on changes to client contracts and implementing those changes to the system
• Communicating internally and externally to prepare financial reports, statements, and presentations for internal stakeholders
• Conducting routine cost analysis to identify cost-saving opportunities and improve efficiency
• Identifying opportunities for streamlining financial workflows, automating manual processes, and/or implementing new financial systems or technologies
• Implementing financial models and scenario analysis in order to provide insights for strategic initiatives, such as mergers, acquisitions, or new service line developments

Financial Operations Analyst

Executive Assistant

• Own and manage a complex, high-demand calendar for the VP of Digital
• Coordinate internal and external meetings with senior stakeholders
• Prepare comprehensive briefing documents and agendas
• Act as a trusted extension of the VP, managing high-volume communications
• Plan and coordinate domestic travel including flights and accommodations
• Track and follow up on action items and deliverables from meetings
• Manage onboarding logistics for new members joining the Digital leadership team

Senior Executive Assistant

• Apply expertise in data analysis and analytical tools
• Ensure efficient data management and promote data-driven insights
• Design, implement, and maintain reporting and analytical tools
• Support multiple projects/initiatives and deliver high-quality work products

Manager – Reporting Analytics, Insights Development

• Setting strategic oversight of ad technology product planning and rollout
• Single-source owner for data collection, activation strategies, and implementation
• Lead process to identify new opportunities and needs for media activation and measurement
• Define, document, and implement business requirements, policies, and processes
• Design, build and maintain a set of processes and products for monitoring different data collection configurations
• Lead cross-enterprise with business and technology partners
• Act as the key liaison between technology and business users on user identity projects via LiveRamp
• Provide product ownership over LiveRamp identity tool
• Directly manage the vendor relationship with LiveRamp
• Provide thought leadership and execution to delivering goals while maintaining privacy compliance
• Collaborate on data governance around how data is collected across our owned properties
• Ongoing Management of Media Tagging Capability
• Maintain a set of processes and products for monitoring different data collection configurations and audience enablement
• Set key tagging priorities within a tag management system

Senior Manager – Ad Tech

Director

• responsible for the successful execution of Aetna’s most critical and complex integration initiatives
• enable the Aetna API Framework and the enterprise APIs that integrate across systems
• oversee programs of significant magnitude regarding complexity, cost, time-constraints, and cross-team dependencies
• allocate appropriate resources to meet delivery commitments
• act as a central connector across stakeholders, driving transparent communication
• establish consistent governance and reporting standards
• ensure delivery practices are measurable, repeatable, and aligned to enterprise standards

Lead Director – Enterprise Delivery

Security Engineer

• Lead enterprise-wide vulnerability remediation efforts and execute risk-based strategies using CVSS, exploitability, asset criticality, and business impact
• Drive cross-functional collaboration with security, engineering, cloud, and infrastructure teams to ensure effective and timely remediation outcomes
• Oversee remediation lifecycle management, ensuring vulnerabilities are prioritized, tracked, and resolved within defined SLAs
• Establish and enforce prioritization models, including exception handling, risk acceptance, and escalation of high-risk issues
• Deliver executive reporting on exposure trends, remediation performance, and overall risk posture
• Improve remediation processes, tooling, and automation to enhance efficiency and reduce false positives
• Ensure alignment with regulatory and compliance frameworks and support audits, risk assessments, and governance activities

Senior Manager – Information Security, Exposure Management

Auditor

• Serve as an audit team member for a health plan(s) which currently administers benefits to Medicaid members across multiple lines of business including acute, behavioral health, individuals with developmental disabilities, and children in out-of-home care.
• Audit records on a routine basis, as well as records for audits (requested on an ad hoc basis) for all lines of business, in order to ensure coding and documentation meet regulatory standards.
• Coordinate audit documentation and reports for review for internal and external staff and stakeholders.
• Identify aberrant billing patterns and potential FWA, reporting this to internal staff.
• Assisting with further investigation and/or reports to state regulators through the utilization of developed critical thinking skills.
• Assist with the development and implementation plan for prospective and retrospective FWA avoidance, detection, and referral.
• Assist with the creation and submission of regulator deliverables through completion of timely audit activities.
• Provide technical assistance and education to providers including training on regulatory requirements, as well as coding and documentation rules.
• Maintain compliance with company policies and procedures.
• Perform other duties as assigned.

Program Integrity Auditor

• Utilize clinical skills to coordinate, document, and communicate all aspects of the utilization/benefit management program
• Apply critical thinking and knowledge in clinically appropriate treatment, evidence-based care and medical necessity criteria for members, specifically by providing care coordination, support, and member education through the use of care management tools and resources
• Conduct comprehensive evaluation of referred member's needs/eligibility and recommend an approach to case resolution and/or meeting needs
• Identify high-risk factors and service needs that may impact member outcomes and care planning components with appropriate referrals
• Coordinate and implement assigned care plan activities and monitor care plan progress
• Utilize case management processes in compliance with regulatory and accreditation guidelines, as well as company policies and procedures

Clinical Case Manager, Behavioral Health

• develop and deliver decision support tools & insights via creating and sustaining analytics & reporting assets and leveraging business intelligence resources in support of contracting, financial and operational strategic decision-making by Retail Health leadership.
• extract, analyze, and interpret contracting, utilization, financial, and clinical/quality data from various sources to support nationwide payer contract negotiations, market penetration, conversion, and expansion strategies, value-based care initiatives, and other quantitative analysis & reporting requirements.
• discovery and deployment of applicable solutions to address business needs and serving as a gatekeeper within cross-functional workflows with key internal stakeholders operating via an external-facing lens.
• Act as the SME for quantitative projects and qualitative workflows by driving data ingestion, storage & documentation protocol, data pre-screening & proactive risk mitigation, and task coordination & implementation.

Manager, Business Analytics

• Support the development and optimization of Adherence Solutions product suite
• Create and manage reports related to product operations, outcomes, and finances
• Complete analyses and use data to inform decisions on key product features
• Assist with day-to-day responsibilities to ensure products operate effectively
• Monitor program performance rigorously and resolve issues proactively
• Take ownership of key product roadmap items by defining strategies or features

Product Manager

Account Manager

• Collaborate with Account Directors to implement client strategies and ensure successful outcomes
• Build and maintain strong relationships with clients and brokers to support retention and growth
• Provide expert administrative support and guidance to client constituents
• Deliver insightful reporting and analysis to inform client decisions
• Monitor market trends and identify competitive opportunities
• Maintain accurate and up-to-date client records
• Participate in and/or lead client meetings as appropriate
• Partner with internal teams (underwriting, sales, operations, analytics, etc.) to ensure client needs are met

Account Manager, Middle Market – West Coast

Analyst

• Acts as the primary resource for assigned, high profile providers or groups to establish, oversee, and maintain positive relationships
• Optimizes interactions with assigned providers and internal business partners to establish and maintain productive, professional relationships.
• Monitors service capabilities and collaborates cross functionally to ensure that the needs of constituents are met
• Supports or assists with operational activities
• Performs credentialing support activities as needed.
• Educates providers as needed to ensure compliance with contract policies and parameters, plan design, compensation process, technology, policies, and procedures.
• Meets with key providers periodically to ensure service levels are meeting expectations.
• Manages the development of agenda, validates materials, and facilitates external provider meetings.
• May collaborate cross-functionally on the implementation of contracts or provider demographic updates.

Senior Analyst, Network Relations

• Achieves individual growth/retention targets and customer satisfaction levels
• Creates collaborative partnerships with sales to develop a comprehensive growth strategy for assigned book of business
• Executes tactical components of the account teams business plan for each customer
• Demonstrates proactive ability to diagnose and fix root cause drivers of service problems
• Develops and manages service plans in a proactive and strategic manner
• Proactively identifies potential service issues and takes steps to resolve them
• Takes the lead on management of the integration of clients and Aetna's internal organizations
• Educates customer on Aetna specific policies, product information, procedures, and industry issues