CVS Health

Medical writer

• Support all care teams across the region in comprehensive and targeted chart reviews
• Facilitate efficient and effective medical care for our patients
• Partner with regional leaders, including the Population Health Director and Senior CIS
• Prepare and lead monthly Rejected Suspect Reviews
• Identify and analyze opportunities for improving patient quality outcomes and cost of care
• Monitor clinical documentation efforts
• Other duties, as assigned

Senior Specialist, Clinical Documentation

Manager

• Supports Provider Contracting and Relationship Management for the Commercial and Medicare Segments with large and small health systems
• Negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with providers
• Manages contract performance in support of network quality, availability, and financial goals and strategies
• Recruit providers as needed to ensure attainment of network expansion and adequacy targets
• Collaborates cross-functionally to contribute to provider compensation and pricing development activities, recommendations, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities
• Integrates cross-functional collaboration to contribute to provider compensation and pricing development activities and recommendations for negotiations and reimbursement modeling activities
• Identifying and making recommendations to manage cost issues and supporting cost saving initiatives and/or settlement activities
• Provides ancillary network development, maintenance, and refinement activities and strategies in support of cross-market network management unit
• Assists with the design, development, management, and/or implementation of strategic network configurations, including integration activities
• Optimizes interaction with assigned providers and internal business partners to manage relationships and ensure providers needs are met
• Ensures resolution of escalated issues related, but not limited to, claims payment, contract interpretation, and parameters or accuracy of provider contract or demographic information
• Coaches more junior colleagues in techniques, processes, and responsibilities.

Senior Manager, Contract Negotiation

DevOps Engineer

• Design and implement observability solutions using tools such as Splunk, Dynatrace, Datadog, Prometheus, Grafana, etc. to ensure visibility into retail and pharmacy systems
• Develop proactive alerting and dashboarding strategies to detect and resolve issues before they impact customers and store operations
• Manage Service Level Objectives (SLOs), Service Level Agreements (SLAs), and error budgets for critical store applications
• Involved in incident response and postmortem processes to drive continuous improvement
• Identify and eliminate bottlenecks in development and deployment workflows to improve lead time and reduce change failure rates
• Conduct performance testing and reliability audits to ensure system robustness
• Partner with development teams to embed Site Reliability Engineering (SRE) principles into the software development lifecycle
• Support and optimize applications deployed across CVS retail and pharmacy locations
• Collaborate with infrastructure and store operations teams to ensure high availability and performance of store systems
• Champion containerization and orchestration using OpenShift and Kubernetes in hybrid cloud environments
• Leverage CI/CD pipelines to enable automated deployments at scale
• Understanding of microservices architecture

Software Development Engineer – SRE, Retail & Pharmacy

Analyst

• The lead reviewer is accountable for the validation of existing Fraud, Waste and Abuse business rules/leads
• Research and ad hoc report development to identify fraud, waste and abuse schemes and trends
• Review company clinical & payment policies to determine the impact of the scheme on Aetna business
• Identify all possible issues related to fraud, waste and abuse when reviewing a new lead or referral
• Keep current with new & emerging fraud, waste and abuse schemes and trends through training sessions and industry resources
• Interpret, analyze and present key findings to internal customers providing recommendations based on analytical findings

Senior SIU Analyst, Lead Investigator

Artificial Intelligence

• Provide strategic leadership in the exploration, development, and implementation of advanced technology solutions that transform our contact center operations
• Drive the strategic vision for integrating innovative technologies such as IVA, AI Agents, etc. to deliver exceptional customer experiences while optimizing operational efficiency
• Oversee critical contact center systems, lead technology maintenance initiatives, and implement process improvements that enhance agent productivity, streamline workflows, and enable intelligent self-service capabilities across CVS Health's portfolio
• Serve as the strategic voice for technology transformation initiatives
• Work with geographically distributed teams to partner across functions to drive strategic initiatives that advance our contact center capabilities to cloud-based platforms and ensure the stability, reliability, and continuous improvement of our technology infrastructure

Senior Manager, AI Process Innovation and Technology

Actuary

• Leading actuarial support for the financial forecast modeling of the Medicaid line of business
• Leading trend storytelling and prospective trend development for the Medicaid business
• Analyzing program changes based on State-directed and internal benefit design changes
• Supporting budget and forecast storytelling for the Medicaid business
• Overseeing forecast model development and improvement

Lead Director – Actuarial, Medicaid

Infrastructure Engineer

• Design, build, and operate high-volume log, metric, and trace pipelines using Databricks, cloud data lakes, and distributed processing engines
• Architect and evolve an Observability Lakehouse aligned with OpenTelemetry (OTEL) data models and standards
• Implement ingestion and transformation workflows using technologies such as Cribl, Vector, Jenkins, GitHub Actions, or equivalent tools
• Normalize, model, and enrich telemetry data to support detection engineering, forensics, and operational analytics
• Develop scalable ETL/ELT frameworks, Delta Lake architectures, and automated data quality validation for unstructured and semi-structured data
• Partner with Security Engineering, SRE, Cloud, and SOC teams to improve enterprise visibility and detection accuracy
• Build and maintain CI/CD pipelines and reusable Infrastructure-as-Code (IaC) patterns for observability platform deployment
• Identify and resolve performance, latency, cost, and reliability issues across telemetry pipelines
• Contribute to engineering standards, documentation, and knowledge sharing across observability and security platforms

Staff Observability Data Infrastructure Engineer

Human Resources

• Define and execute the multi‑year HR technology strategy aligned to enterprise objectives, business roadmaps, and product‑model principles
• Provides leadership and expertise in defining the technical architecture and design principles for HR Technology solutions
• Develop the HR Technology team, providing direction, guidance, and mentorship to foster a high-performing and collaborative work environment
• Build and lead high‑performing HR technology teams to deliver critical roadmap commitments, drive operational excellence, and execute enterprise-wide strategic initiatives
• Govern roadmap prioritization, capacity planning, budget allocation, and enterprise‑wide dependencies
• Evaluate the relevance and potential impact of new technologies on the organization's HR systems capabilities
• Facilitate cross‑functional reviews, portfolio operations, and business case refinement sessions
• Formulate the vision, strategy, and roadmap for Compensation products, ensuring alignment with business objectives to promote innovation and optimize employee satisfaction
• Partner with HR business owners and COEs to align on target outcomes, OKRs, and success metrics
• Control the product development process, from ideation to launch, ensuring adherence to timelines, quality standards, and budgetary constraints
• Partner with HR leadership, COEs (including Compensation), HR business owners, and HR Technology teams to gather requirements, analyze performance metrics and user feedback, incorporate industry best practices, and communicate product updates

Lead Director – HR Technology

• Manage all phases of the manufacturer agreement process
• Maintain version control and manage redlines for assigned agreements
• Customize and revise contract language to meet business needs
• Track and document all stages of the agreement lifecycle
• Ensure timely completion and execution of contracts
• Facilitate contract review with internal teams and pharmaceutical manufacturers
• Organize intent calls with cross-functional stakeholders to align on contract terms
• Coordinate calls with manufacturer representatives and legal counsel to finalize agreements
• Review final documents and secure all necessary internal approvals prior to signature

Senior Contract Analyst

• Acts as a liaison with member/client /family, employer, provider(s), insurance companies, and healthcare personnel as appropriate
• Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care
• Interacts with members/clients telephonically or in person
• May be required to meet with members/clients in their homes, worksites, or physician’s office to provide ongoing case management services
• 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 to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determination of eligibility for benefits as appropriate
• Communicates with member/client and other stakeholders as appropriate (e.g., medical providers, attorneys, employers and insurance carriers) telephonically or in person
• Prepares all required documentation of case work activities as appropriate
• Interacts and consults with internal multidisciplinary team as indicated to help member/client maximize best health outcomes
• May make outreach to treating physician or specialists concerning course of care and treatment as appropriate
• Provides educational and prevention information for best medical outcomes
• Applies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by individual insurance carriers and referral sources
• Conducts an evaluation of members/clients’ needs and benefit plan eligibility and facilitates integrative functions using clinical tools and information/data
• Utilizes case management processes in compliance with regulatory and company policies and procedures
• Facilitates appropriate condition management, optimize overall wellness and medical outcomes, appropriate and timely return to baseline, and optimal function or return to work
• 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/client’s overall wellness through integration
• Monitors member/client progress toward desired outcomes through assessment and evaluation

Case Manager, Registered Nurse – Medicare Advantage

Director

• Support sales teams in finalist presentations by addressing clinical questions and explaining the care model.
• Collaborate with Clinical Operations (Employee Assistance Programs, Resources for Living, and On-Demand teams) and the Office of Health Care Affordability (OHCA) to advance affordability initiatives and adhere to specific, measurable actions tied to performance goals or compliance standards that are evaluated and scored (SAIs).
• Analyze cost trends and work with network teams, Special Investigations Units, and other stakeholders to reduce costs and improve outcomes.
• Represent Aetna Mental Well-being at industry events, presenting analytics, clinical insights, and thought leadership on mental health and overall well-being.
• Partner with Aetna’s Performance Excellence Quality (PEQ) team to guide analytics design, interpret results, and present outcomes data to customers and industry leaders.
• Ensure efficient, effective delivery of healthcare services in collaboration with clinical operations.
• Work with senior clinical leadership, including the Chief Psychiatric Officer and Chief Medical Officer, to maintain clinical standards and policies.
• Develop strategies to improve member access, care quality, and affordability.
• Provide mental health expertise for HEDIS and NCQA initiatives in partnership with Quality teams.
• Offer clinical input for evaluating mental well-being vendors.
• Contribute to research and publications, supporting peer-reviewed submissions and initiatives to improve quality and total cost of care.

Executive Director, Clinical Health Services – Mental Well-being

Full-stack Engineer

• Take ownership of the myPBM Benefits applications portfolio
• Look at how we operate today and find smarter ways to do things
• Be the go-to person for new development initiatives
• Set a clear vision and strategy
• Partner with advisors and experts for automation and training
• Connect the dots between customer experience and business processes
• Build and lead a talented, diverse team

Senior Manager – Software Development Engineering

Architect

• Own the enterprise observability reference architecture covering metrics, logs, traces, and events across all environments (cloud and on-prem).
• Drive the OpenTelemetry-first instrumentation strategy -- standard libraries, semantic conventions, collector topologies (DaemonSet, gateway, sidecar), and pipeline design.
• Build and operate telemetry pipelines on Grafana Mimir, Loki, and Tempo, including multi-tenant configurations, retention policies, and capacity planning.
• Define how we measure reliability: SLOs, SLIs, error budgets, and alerting frameworks -- consistently across all lines of business.
• Own the integration between observability tooling and incident management (ServiceNow ITOM, xMatters).
• Drive telemetry schema standards to ensure teams emit data that is useful downstream, not just technically compliant.
• Build and maintain reference architectures for our hybrid footprint: OpenShift on-prem with KVM/libvirt and Dell PowerFlex storage, plus Azure, AWS, and GCP.
• Lead standards work around workload identity and federation using SPIFFE/SPIRE and cloud-native IAM patterns.
• Provide guidance on compute runtime selection -- containers vs. VMs vs. bare metal vs. serverless.
• Help teams connect autoscaling and capacity planning behavior to actual telemetry signals.
• Push FinOps maturity forward by integrating cost data into the observability stack, establishing unit economics, and working toward open billing standards like FOCUS.
• Identify where AI/ML adds practical value in our observability stack.
• Define observability standards for AI-powered systems (agents, RAG pipelines).
• Ensure new AI-powered platforms are instrumented correctly from day one.
• Participate in cross-functional architecture working groups focused on observability and hybrid cloud standards.
• Publish architecture decision records and reference implementations that teams can actually use.
• Mentor architects and platform engineers; conduct architecture reviews to raise the bar across the org.
• Work with security and compliance on HIPAA, SOX, and PCI requirements as they apply to telemetry and cloud infrastructure.
• Represent CVS Health in vendor evaluations and stay connected to the open-source ecosystem (CNCF, OpenTelemetry, Grafana Labs).

Principal Architect – Cloud and Observability

QA Automation Engineer

• Serve as the technical owner for production support of automation and RPA solutions across critical business processes
• Lead incident triage, root cause analysis, and permanent remediation for high-severity automation failures
• Establish and enforce runbooks, support models, escalation paths, and on-call readiness for automation platforms
• Proactively identify systemic issues and implement stability, resiliency, and performance improvements
• Provide hands-on technical leadership for automation design, debugging, and optimization in production environments
• Review automation code and configurations to ensure adherence to standards, security, and reliability best practices
• Partner with development teams to ensure production readiness of new automations before release
• Guide architectural decisions that reduce operational complexity and technical debt
• Design and maintain monitoring, alerting, and health dashboards for automation platforms
• Drive adoption of AIOps, SRE, and automation-first support practices where applicable
• Improve observability by defining meaningful metrics such as uptime, failure rates, recovery times, and business impact
• Act as a key escalation point for automation-related production issues
• Collaborate with infrastructure, application, and vendor teams to resolve platform-level issues
• Communicate incidents, risks, and remediation plans clearly to technical and non-technical stakeholders
• Mentor engineers and support analysts in automation support best practices

Staff Software Development Engineer – Automation Engineer

Project Manager

• Act as a strategic partner to business leaders to ensure successful project delivery.
• Collaborate with stakeholders to define project scope, objectives, and success criteria.
• Provide timely updates throughout the project lifecycle.
• Develop, manage, and obtain approvals for project budgets and handle changes as needed.
• Create and update project plans, ensuring alignment with deliverables.
• Lead working sessions to identify tasks, resources, and dependencies.
• Apply techniques such as PERT to validate project logic and improve Gantt chart clarity.
• Schedule and facilitate technical and status update meetings regularly.
• Utilize agendas, status reports, meeting minutes, and a RAID log (Risks, Actions, Issues, Decisions) for effective project management.
• Develop plans to address escalations and resolve issues raised by the project team or documented in the RAID log.
• Review approaches with management, when necessary, before engaging colleagues for issue resolution.
• Deliver projects using Predictive (waterfall), Agile, and Hybrid methodologies.
• Coach others with project management methodologies.
• Initiate and oversee multiple projects of varying size from inception to completion.
• Manage project scope, resources, budgets, and plans.
• Build expertise when working across multiple projects on a common platform.
• Build and maintain strong relationships with stakeholders.
• Share feedback to improve processes and highlight success factors.
• Work with leadership to prioritize and implement improvements in processes, tools, and reporting.