CVS Health

Manager

• Conduct comprehensive assessments using clinical tools, data, and member interaction
• Develop proactive care plans that address medical, social, and functional needs
• Identify and reduce health risks while coordinating care across programs and services
• Review claims and clinical history to support effective case management
• Engage members via phone to understand needs and drive participation in care plans
• Partner with interdisciplinary teams and participate in case conferences
• Ensure compliance with regulatory and organizational guidelines

Case Manager, Registered Nurse

Analyst

• Verify caller enrollment status with Mercy Care Plan.
• Collect and document accurate demographic information from members/callers, as well as from Mercy Care systems.
• Confirm details such as whether members receive special assistance (applicable to members with serious mental illness).
• Utilize the QuickBase database to complete intake forms, ensuring documentation of members' reasons for calling is thorough and precise.
• Provide empathetic and compassionate support to all callers.
• Assist with special projects as assigned.

Complaint & Appeals Analyst

• Drive strategic analyses, develop data-driven insights & own reporting
• Analyze data to inform strategic decision-making related to patient retention
• Build and pull reports on performance metrics related to patient retention
• Complete analyses to identify areas of progress and opportunity
• Communicate insights with local leaders and organizational leaders
• Drive patient retention at Oak Street through implementation of Patient Engagement and Retention workflows
• Manage relationship with key partners across provider services, Salesforce and patient comms and marketing
• Own proactive workflows related to patient communications and panel reassignment
• Contribute to key organizational retention goals through implementing initiatives to meet annual patient annual wellness visit completion goals
• Identify key factors that influence annual wellness visit completion and identify patient populations for targeted outreach
• Report on success of different engagement strategies for achieving annual wellness visit completion goals
• Project manager for scope of ongoing initiatives and activities related to patient segmentation
• Creation of metrics and reports to monitor success and identify opportunities for improvement across the implementation of new initiatives

Senior Analyst, Patient Retention Strategy and Analytics

Program Manager

• Provides management consultation to corporate clients around issues of safety and risk
• Coordinates critical incident and disruptive event response
• Provides member clinical assessments and triage into care
• Performs case management across scope of all types of management referrals
• Collaborates with management to ensure quality service delivery
• Documents clinical information that meets risk management and regulatory requirements

Employee Assistance Program Management Consultant

Pharmacist

• takes in-bound calls from providers, pharmacies, members, etc. providing professional and courteous phone assistance
• maintains complete, timely and accurate documentation of reviews
• transfers all clinical questions, escalations and judgement calls to the pharmacist team
• assist with outbound calls, reviewing and processing Prior Auth’s received via fax and ePA
• monitoring and responding to inquiries via department mailboxes
• complies with departmental, company, state, and federal requirements when processing all information to ensure accuracy of information
• communication with other internal groups regarding determination status and results
• identify and elevate clinical inquiries to the pharmacist team as appropriate.

Pharmacy Technician – Prior Authorizations

• Support the pharmacy team in delivering operational and service excellence
• Assist to ensure pharmacy operations run smoothly and patients’ prescriptions are filled promptly, safely, and accurately
• Complete basic inventory activities as directed by pharmacy leadership team
• Deliver additional patient health care services where allowable by law and supported by required training and certification

Pharmacy Technician

Supply Chain

• Support the organization in the removal of non-productive inventory
• Create product withdrawal and MCR (Merchandise Credit Returns) requests
• Maintain vendor relationships and contact information
• Manage communication with third-party processors regarding store returns
• Provide root cause analytics for withdrawal or aged inventory disputes
• Track and report on recalls within DCs and third party returns processor facilities

Senior Supply Chain Analyst

Full-stack Engineer

• Support and develop a collaborative team of software engineers to achieve goals.
• Guide the design of cloud-native, distributed microservices using Kotlin Spring Boot and event-driven patterns.
• Collaborate with product and design partners to refine impactful clinical workflows.
• Cultivate high code quality through automated workflows and robust peer code reviews.
• Champion standard clinical data practices utilizing modern FHIR and HL7 interoperability frameworks.
• Foster a dedicated team culture focused on psychological safety, innovation, and continuous growth.

Senior Manager – Software Engineering

Director

• Accountable for developing strategic partnerships for the Kentucky Medicaid Health Plan
• Focus on designing conceptual models and negotiating high value contracts
• Contracting responsibilities include Medicaid and managing provider compensation
• Collaborates cross-functionally to manage provider compensation and pricing development activities
• Responsible for identifying and managing cost issues and collaborating on cost-saving initiatives
• Represents company with high visibility constituents
• Promotes collaboration with internal partners
• Evaluates, helps formulate, and implements the provider network strategic plans
• Helps mentor and develop others within the department

Lead Director, Network Management

Security Engineer

• design, implement, and mature enterprise DLP policies and controls across cloud, endpoint, email, and network channels
• support the full DLP program lifecycle, including strategy, policy development, rule tuning, and continuous improvement
• lead data classification and labeling initiatives to ensure consistent governance of PII, PHI, PCI, and proprietary data
• monitor, investigate, and respond to data leakage incidents; manage cases, perform root cause analysis, and drive remediation to closure
• develop dashboards, metrics, and reporting to communicate DLP effectiveness, risk posture, and trends to leadership
• automate DLP enforcement, incident triage, and response workflows to improve accuracy and reduce manual effort
• extend DLP capabilities to cloud‑native and hybrid environments, leveraging CASB, CNAPP, CSPM, SASE, and Zero Trust architectures
• lead shadow AI discovery and enforce DLP controls across sanctioned and unsanctioned AI services
• design and implement data protection controls for AI/ML workloads, pipelines, model training, and outputs
• enforce secure data handling for generative AI, LLMs, and MLOps platforms to prevent improper ingestion, exposure, or transmission of sensitive data

Senior Cloud Data Security Engineer

• Conduct comprehensive telephonic and in-person assessments to evaluate members' medical and behavioral health needs
• Develop and implement individualized care plans, ensuring alignment with clinical and program guidelines
• Coordinate and monitor ongoing care plan activities, adjusting as needed to improve outcomes
• Collaborate in multidisciplinary care reviews to optimize member health results
• Engage members using motivational interviewing and coaching techniques to encourage healthy lifestyle choices
• Ensure accurate and timely documentation, adhering to regulatory, accreditation, and company standards

Registered Nurse Case Manager – Field

• Deliver high-quality case management services through telephonic and face-to-face engagement
• Conduct comprehensive telephonic and in-person assessments to evaluate members' medical and behavioral health needs
• Develop and implement individualized care plans
• Coordinate and monitor ongoing care plan activities
• Collaborate in multidisciplinary care reviews
• Identify and escalate quality of care concerns
• Engage members using motivational interviewing and coaching techniques
• Educate and empower members to participate in healthcare decision-making
• Ensure accurate and timely documentation
• Serve as a preceptor and mentor to new nurses
• Support onboarding by teaching policies, workflows, and best practices

Consultant

• Provides Plan Sponsors with benefit plan consulting services
• Ensures all plan contracts and certificates are completed accurately and in a timely fashion
• Executes both routine and non-routine business support tasks for the Benefit area under limited supervision
• Prepares, reviews and/or edits employer certificates, contracts, and employee booklets according to pre-determined standards ensuring benefits are mapped accordingly
• Communicates any required revisions and or changes to avoid unintended liability in support of the plan
• Completes legislative comparisons and assists with state filing processes

Senior Plan Document Consultant

Backend Engineer

• design, build, and support backend services and integrations that enable Clinical Shared Services technical engineering work across clinical platforms
• contribute to modernization initiatives, troubleshoot complex production issues through root-cause analysis, and improve automation and delivery practices that increase reliability, reduce risk, and improve time-to-market in a regulated healthcare environment
• Collaborate closely with Clinical products, QA, architects, vendors, and production support to meet clinical, operational, and compliance requirements

Senior Platform Engineer – Cloud, Backend Services

Artificial Intelligence

• Architect Signify’s AI Outreach and Rescheduling strategy, including the AI-driven orchestration logic required to capture and re-engage members following a cancelled appointment.
• You will leverage Conversational AI (Voice and RCS) to create intelligent, supply-aware re-engagement flows and rigorous evaluation frameworks that maintain care continuity and protect our clinicians' productivity.
• Communicate complex concepts, both written and verbally, to influence peers and stakeholders to make decisions or adjust approaches when needed.
• Proactively identify user or business needs and recommend innovative solutions.
• When necessary, drive tradeoff conversations and negotiate with teams and stakeholders to achieve roadmap objectives.
• Deliver incremental user value by having a cross-functional view of the problem.
• Develop a clear vision and short term and long-term roadmap with value definitions and measurable output; communicate this roadmap with customers and across the organization.
• Observe and interview users across multiple product lines to aggregate and connect their feedback into defined problem statements.
• Coordinate dependencies, communicate timelines, and manage stakeholder expectations across departments and product lines.
• Understand high-level strategic levers and drivers of the business.
• Develop and measure KPIs for the product to define, track and communicate value delivery.
• Understand the healthcare industry, key trends, and current news and movement in the market.

Case Manager, Registered Nurse

Complaint & Appeals Analyst

Senior Analyst, Patient Retention Strategy and Analytics

Employee Assistance Program Management Consultant

Pharmacy Technician – Prior Authorizations

Pharmacy Technician

Senior Supply Chain Analyst

Senior Manager – Software Engineering

Lead Director, Network Management

Senior Cloud Data Security Engineer

Registered Nurse Case Manager – Field

Registered Nurse Case Manager – Field

Senior Plan Document Consultant

Senior Platform Engineer – Cloud, Backend Services

Senior Manager, Digital Product – Conversational AI Strategy