CVS Health

Product Designer

• Lead the experience strategy and service design for the Scheduling and Execution space, from early-stage research to implementation and refinement.
• Manage and mentor a small team of UX designers, providing feedback on performance and fostering career development.
• Serve as a thought leader within the product trio, challenging assumptions and using design methodologies.
• Facilitate high-impact cross-functional workshops to drive alignment, collaboration, and ideation.
• Move beyond feature requests and identify the root cause behind user pain points.
• Drive a culture of continuous user testing and iterative validation.
• Set the design vision and strategy for your product areas.
• Drive the adoption of AI-powered tools and methodologies.
• Partner with product management and engineering to co-lead the vision, roadmap, and prioritization.
• Oversee the design of conversational interfaces and multi-channel communication strategies.

Senior Manager, UX Design – Scheduling & Execution Product

Procurement

• Develop and evolve multi‑year category strategies, leveraging market intelligence, demand analysis, total cost of ownership, and negotiation strategies to drive sustainable value and risk mitigation
• Define and lead category‑level negotiation approaches, aligning objectives, negotiation levers, and concession strategies with financial goals, market dynamics, and enterprise priorities
• Lead stakeholder and leadership reviews to align category sourcing and negotiation roadmaps with financial, operational, and enterprise strategy
• Use advanced spend and market analytics to inform negotiation planning, guide cost reduction, optimize the supply base, and unlock category value
• Advance category strategy through emerging technology and AI, applying automation and analytics to enhance negotiation insights, improve cycle times, and strengthen decision‑making
• Lead end-to-end sourcing initiatives for complex categories (RFx through contract award)
• Execute negotiations with embedded productivity, continuous improvement, and market-based pricing mechanisms
• Deliver year-over-year savings through disciplined opportunity pipelines and value tracking
• Apply competitive bidding, should-cost analysis, and total value frameworks to maximize outcomes
• Act as a trusted advisor to senior leaders by translating sourcing strategies into clear business results
• Drive cross-functional alignment across Finance, Legal, IT, Contracting, and Operations
• Communicate insights and recommendations in concise, executive-ready formats
• Develop sourcing talent in analytics, negotiation, and sourcing methodologies
• Foster a high-performance culture grounded in accountability, continuous improvement, and data-driven decision-making

Senior Category Manager, Strategic Sourcing

Consultant

• Applies critical thinking, evidenced based clinical criteria and clinical practice guidelines for services requiring precertification
• The majority of the time is spent at a desk and on the phone collecting and reviewing clinical information from providers
• Precertification nurses use specific criteria to authorize procedures/services or initiate a Medical Director referral as needed

Utilization Management Nurse Consultant

Manager

• Determines negotiation strategies with pharmaceutical manufacturers and suppliers
• Implements pharmaceutical procurement strategies to enhance customers' bottom line
• Collaborates with trade professionals in creating and implementing pharmaceutical procurement plans
• Contributes to the achievement of business objectives
• Assists in the management of resources including assessing staffing needs
• Implements new strategies and business plans derived from project management tools, data analysis
• Delivers internal and external operations strategy communications and presentations
• Defines project requirements, objectives, and key targets
• Helps establish and implement financial and performance reports
• Promotes a culture of continuous improvement
• Oversees ongoing training to ensure compliance within respective roles.

Patient Engagement Manager

• Coordinate, document and communicate all aspects of the utilization/benefit management program
• Utilize clinical skills to assess appropriateness of treatment plans across levels of care
• Gathers clinical information and applies the appropriate clinical criteria/guideline to render coverage determinations
• Provides triage and crisis support
• Identify members at risk for poor outcomes and facilitate referral opportunities

Utilization Management Clinical Consultant – Behavioral Health

• Lead a team of professionals responsible for coordinating and managing financial audits
• Work closely with clients, governmental auditors, and internal departments
• Ensure timely and satisfactory resolution of exceptions identified during the audit process
• Identify process enhancement opportunities
• Document correspondence with internal partners, clients, and auditors

Senior Client Audit Manager

Underwriter

• Support Aetna's ability to achieve its financial and strategic goals through effective underwriting
• Prepare and deliver routine new business quotes and/or existing business renewals and/or accountings
• Review work with mentor/manager and respond to requests for pricing and/or accounting balance alternatives based on financial analysis, underwriting principals and business strategy
• Utilize basic functionality of underwriting tools, systems, and reference materials to produce accurate quotes, renewals and/or accountings
• Escalate underwriting exceptions/financial variances for assigned cases to the appropriate level
• Assist sale personnel in explaining rate/fee, accounting balance development and communicating underwriting policy
• Produce timely and accurate customer specific documents, deliverables and accounting related information

Senior Underwriting Associate

Collections

• Ensure timely follow-up on all patient accounts
• Escalate payer trending concerns to leadership
• Communicate with external departments
• Work with payers to ensure proper reimbursement on patient accounts
• Identify and prepare adjustments and write-offs
• Correct and resubmit claims
• Follow-up on daily correspondence
• Check claim status, submit written correspondence to payers and patients
• Interpret contracts with payers
• Send initial or secondary bills to insurance companies
• Process refunds and work to overturn insurance claim rejections

Senior Revenue Cycle Collections Specialist

Product Operations

• Monitor and evaluate vendor call center interactions by listening to calls
• Ensure Medicare supplemental benefits are accurately explained to members
• Provide actionable feedback to vendor partners
• Track, document, and report quality and performance trends
• Support departmental goals related to process controls
• Identify operational gaps and process improvement opportunities
• Research and resolve identified call center concerns
• Take ownership in delivering an exceptional member‑centered experience
• Support additional implementation or operational initiatives

Medicare Product Operations Analyst

Recruitment

• Locate, solicit, and recruit qualified Physicians, NPs, PAs, and clinicians nationwide
• Rapidly analyze talent data in new and complex markets to develop recruitment strategies
• Proactively build and maintain robust national talent pipelines using multi-channel sourcing strategies
• Manage the end-to-end recruitment cycle—from sourcing, screening, qualification to offer and onboarding
• Execute tailored recruitment strategies for 1099 contractor and/or W2 employee engagement models
• Act as the primary relationship owner for high-value clinician candidates
• Build and maintain strong relationships with senior operational leaders and other key stakeholders
• Serve as a Subject Matter Expert (SME) on 1099 and/or W2 engagement models
• Manage offer negotiations for complex clinician pay models
• Consistently meet or exceed ambitious monthly hiring and production targets

Clinical Recruiter

• Rapidly analyzes talent data in new and complex markets to develop and pivot recruitment strategies in real-time.
• Proactively builds and maintains robust national talent pipelines using sophisticated, multi-channel sourcing strategies (e.g., targeted cold outreach, database mining, national conferences, and building relationships with training programs).
• Manages the end-to-end, high-velocity recruitment cycle—from sourcing, screening, and qualification to offer and onboarding—to meet urgent national staffing demands.
• Executes tailored recruitment strategies for 1099 contractor and/or W2 employee engagement models, ensuring a clear articulation of each value proposition
• Acts as the primary relationship owner for high-value clinician candidates, guiding them through an accelerated and seamless process, including applications, scheduling, travel, payroll and escalating as necessary.
• Builds and maintains strong, collaborative relationships with senior operational leaders, HR, marketing, compliance, and other key stakeholders to streamline deployment and solve critical staffing challenges.
• Serves as a Subject Matter Expert (SME) on 1099 and/or W2 engagement models.
• Must possess a strong grasp of the competitive talent landscape and be able to articulate a compelling, differentiated value proposition (including compensation, benefits, and contract terms) to senior-level clinicians.
• Manages offer negotiations for complex clinician pay models, partnering with compensation and legal teams to ensure competitive and compliant agreements.
• Consistently meets or exceeds ambitious monthly hiring and production targets and meticulously documents all recruitment activity in the designated ATS/CRM.

Senior Clinical Recruiter

Operations

• serves as a day-to-day SME for operational and Medicare activities
• assistance with the lifecycle of plans starting with ideation, to bid filing, to implementation and final readiness
• support of all regulatory and operational facets, in partnership with the national segment and/or local Market
• ensure timely and compliant rollout of all plans and benefits
• ensure a seamless member experience

Manager, Government Programs Operations

Financial Planning and Analysis

• Support the HCD performance management reporting cadence (close and monthly deliverables), including timelines, templates, and coordination across business units
• Consolidate business unit submissions into a HCD-level view; perform completeness/accuracy checks and drive follow-ups to resolve gaps and inconsistencies
• Track and reconcile key financial and operating metrics and headcount across business units; ensure alignment between reported outputs and financial system results
• Perform variance and trend analysis; develop clear drivers/bridges and risks & opportunities commentary to support leadership discussions
• Support executive-ready materials for all enterprise asks; communicate insights to HCD finance leadership and coordinate responses/follow-ups

Senior Analyst, HCD FP&A

Risk

• Proactively oversee and manage TPA performance through reporting, auditing, and claim reviews.
• Oversee the daily work product of multiple lost time and medical-only workers’ compensation adjusters in your assigned territory, completing monthly audits and case reviews.
• Actively participate in internal claim reviews and legal roundtables.
• Ensure that reserves and settlement authorities are reviewed and granted in compliance with our internal processes.
• Review and interpret medical reports, expert reports, legal and various supporting claim documents.
• Analyze case and internal investigative materials to determine legal liability and that reserves are set for the known exposure.

Risk Management Analyst – Workers’ Compensation

Account Executive

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