CVS Health

Director

• Serve as the “voice of Quality” for the Louisiana market, leading all quality strategy and execution.
• Own end-to-end performance for: HEDIS and hybrid measure performance, P4P / withhold maximization, CAHPS and member experience, Quality of Care and clinical outcomes.
• Develop and execute market-specific strategies aligned to enterprise priorities and Measures That Matter Most (MTMM).
• Lead and oversee the Louisiana QAPI and Continuous Quality Improvement (CQI) programs in alignment with contract requirements, State and federal regulations, NCQA accreditation standards.
• Ensure readiness for NCQA surveys, EQRO audits, State audits and RFP evaluations.
• Maintain documentation, policies, and reporting consistent with regulatory requirements.
• Act as primary Quality contact with Louisiana Department of Health (LDH), External regulators and auditors, Provider partners and delegates.
• Provide clinical oversight for Quality of Care investigations, Performance improvement projects (PIPs), Preventive health and population health initiatives.
• Direct HEDIS and quality reporting, including Data collection and validation, Measure performance monitoring, Gap identification and closure strategies.
• Lead provider performance strategy, including Value-Based Contracting (VBC) quality alignment, Provider education and engagement, Practice transformation initiatives.
• Maintain full accountability for quality-related financial performance, including Withholds and incentive programs, Quality-related cost management.
• Lead, develop, and mentor a multidisciplinary quality team, driving a culture of accountability, performance, and continuous improvement.

Quality Management Lead Director

General

• Present a positive and professional demeanor to clients, health plan members, clinicians, and co-workers.
• Leverage multiple internal and external systems to facilitate member scheduling of appointments, and ensure smooth communication between health plan members, providers and Signify/CVS.
• Assist health plan members with coordinating a PCP connection following a health Assessment, facilitate relay test results, schedule mammograms and vaccinations, assist with member enrollment in mail order prescription programs, and coordinate annual wellness visits on behalf of members.
• Meet all quality, customer service, and productivity goals set by the department (i.e., number of calls per day, appointments set per day, shift and attendance policy adherence, quality targets, etc.) in their remote environment.
• Must be able to utilize various regulated scripts approved by both clients & Signify.
• Follow internal scripts and processes, track data as requested by Management, and maintain accurate record notes on member files.
• Receive/enable warm transfers from within or outside the department, including clinician, doctors’ offices, pharmacies, and call center representatives.
• Follow departmental procedures when communicating with members, colleagues, and business partners.
• Handle additional tasks as requested by Management within expected timeframe.
• Support business needs by conducting manual outbound calls and handling inbound phone calls, as well as receiving outbound calls placed by the telephony system as needed, potentially managing 300+ calls daily.
• Act as a subject matter expert for peer side-by-side coaching. Assist with training fellow employees.
• Accept constructive feedback and respond appropriately.
• Ability to work overtime and on-call as requested per Signify.
• Be responsible for the security and privacy of any protected health information accessed at all times.

Member Engagement Service Coordinator

Executive Assistant

• Conduct online 'Video Visits' with health plan members
• Provide 40 hours of availability weekly, consistently providing 320+ capacity units per month
• Execute a strong visit completion rate, consistently pacing 220+ completed visits per month
• Maintain training, affiliation, and compliance with Video Visit requirements (regular training required)

Virtual Clinician – Nurse Practitioner, Physician Assistant

• Conduct online Video Visits with health plan members
• Provide education about health and answer member questions
• Maintain training and compliance with Video Visit requirements
• Achieve key performance indicators and metrics

Virtual Clinician, Nurse Practitioner or Physician Assistant

Clinician

• Conduct online “Video Visits” with health plan members, working in a private space with adequate internet connection
• Provide 40 hours of availability weekly, consistently providing 320+ capacity units per month
• Execute a strong visit completion rate, consistently pacing 220+ completed visits per month
• Maintain training, affiliation, and compliance with Video Visit requirements (regular training required)
• Be trained and credentialed for all health plan clients and lines of business in primary coverage state(s)
• Consistently engage with regular manager, team and clinical meetings
• Be accountable to Signify Health operational, clinical, and member experience key performance indicators and metrics
• Maintain active state licenses in coverage areas
• Engage with health plan members primarily online, helping to close gaps in care.

Virtual Clinician, Home Evaluations, Physician, Full Time

QA Engineer

• Define and implement quality assurance strategies and test plans.
• Design, develop, and maintain automated and manual test suites for functional, regression, performance, and security testing.
• Oversee the automation of regression and sanity test cases, ensuring coverage and reliability.
• Enable automated data setup for recurring test scenarios to streamline test execution.
• Participate in defect triage meetings and drive root cause analysis for critical issues.
• Work closely with developers and product managers to understand requirements and ensure test coverage.

Senior Quality Engineer

Product Manager

• Partner with Product Owners, product leaders, and cross-functional stakeholders from ideation through execution to shape analytics product vision, validate opportunities, and define scalable solution approaches.
• Develop functional requirements, acceptance criteria, and detailed product specifications to communicate feature requirements to data science, engineering and stakeholder teams
• Support engineering and data science teams to implement features by clarifying requirements, facilitating squad ceremonies, and helping technical team members ground on users and business needs
• Manage product backlog, facilitate problem solving, scoping, and prioritization
• Run day-to-day planning and ceremonies, and champion Agile practices
• Clarify and coordinate dependencies with other teams and stakeholders
• Champion a data-driven, and innovation-focused mindset with a strong commitment to product excellence and continuous improvement.
• Stay current on emerging trends in analytics, data platforms, AI/ML, and digital technologies, and identify opportunities to apply them across lines of business.

Senior Manager – Digital Product

Revenue Operations

• supporting end to end Medicare Part B claims processing activities
• ensure compliance with Centers for Medicare and Medicaid Services (CMS) requirements by facilitating accurate claim processing and submission
• assist with initiatives to collect and validate prescriber documentation in accordance with CMS guidelines
• maintain and manage a centralized repository of prescriber documentation and leveraging this data to identify actionable claim volume in alignment with established Standard Operating Procedures

Medicare Part B Operations Coordinator, Revenue Cycle

Manager

• Administers processes to coordinate and facilitate comprehensive care for pediatric individuals enrolled in DCS CHP
• Assesses needs and develops personalized care plans
• Coordinates services across healthcare providers
• Serves as advocate for Pediatric DCS CHP patients
• Ensures effective communication, resource utilization, and continuous monitoring of progress

Care Manager, RN

• Manages the product management team
• Assesses market trends, customer needs, and competitive landscape
• Assists in the management of product portfolios
• Coaches and mentors product management professionals
• Conducts market research and competitive analysis
• Confers with cross-functional teams to align product development efforts
• Defines product requirements, features, and specifications
• Delivers high-quality products on time and within budget
• Designs systems and processes to streamline product management operations

Full-stack Engineer

• Design, develop, and maintain a full-stack application using React (TypeScript) and Python + gRPC/REST
• Build out frontend interfaces and backend services — including data models, APIs, caching, and observability
• Integrate with Kafka-driven pipelines and the Snowflake data platform
• Own the full lifecycle of the application — from architecture and implementation to CI/CD and monitoring
• Apply best practices for testing, logging, error handling, and scalability
• Contribute to infrastructure automation with Terraform
• Leverage Claude AI, MCPs and other AI tooling for assisted development and code reuse
• Mentoring other developers

Senior Full Stack Software Development Engineer

Associate

• Supports medical prior authorization operations by taking inbound calls from members and providers
• Builds cases in multiple systems
• Ensures accurate documentation and HIPAA-compliant handling of PHI/PII

Inbound/Outbound Queue Associate

• supports comprehensive coordination of healthcare services through telephonic outreach to and enrollment of eligible members
• demonstrate a highly energetic blend of salesperson, healthcare navigator, and health plan customer support representative
• responsible for direct member outreach and engagement, facilitating case assignment, and connecting identified members to care managers immediately through warm transfer
• enroll members into care management to promote effective utilization of healthcare services

Care Management Associate, Engagement Hub

• Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits.
• Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning.
• Conducts assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality.
• Uses a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members.
• Collaborates with supervisor and other key stakeholders in the member’s healthcare in overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences.
• Utilizes case management processes in compliance with regulatory and company policies and procedures.
• Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.

Case Manager, RN - Field

• Develop and maintain features for a full-stack application using React (TypeScript) and Python.
• Build frontend components and contribute to backend services — including APIs, data models, and basic caching.
• Write clean, well-tested code; ensure thorough unit and integration test coverage for your changes.
• Participate in code reviews, giving and receiving constructive feedback to uphold team quality standards.
• Communicate blockers and progress clearly; escalate issues with appropriate urgency.