CVS Health

Customer Support

• Actively listen and be an advocate for customers, understand their needs and provide guidance and support
• Resolve customer inquiries and issues efficiently while documenting all interactions
• Educate customers about available resources and assist them in navigating their options
• Anticipate customer needs and provide proactive solutions to enhance satisfaction
• Collaborate with team members and other departments to address service issues and improve outcomes
• Document all customer correspondence and maintain confidential records of patient information
• Follow policies, procedures, and the CVS/Aetna Code of Conduct

Customer Service Representative, Bilingual – Spanish

Analyst

• Maintains the Provider Data for all network and non-network providers
• Ensures all provider information is accurately recorded and maintained
• Develops and maintains standards for database integrity
• Provides support for baseline provider data transactions
• Performs baseline demographic transaction updates in provider system applications
• Conducts audits of provider information and escalates issues for resolution as appropriate
• Automates and manually loads, maintains, and resolves new and revised participating provider data transactions

Senior Analyst, Provider Data Services – Bulk loading

Full-stack Engineer

• Provide technical leadership and work with the team to build high-quality, usable products to customers and stakeholders
• Help provide input to product roadmap, technical design, oversee engineering practices, and lead product build using agile (Scrum, Agile) software development practices
• Participate in feature refinement sessions with key stakeholders to ensure the specified needs are clearly articulated, gaps identified and propose adjustments as needed
• Maintain a user-centered and business-as-priority approach in design perspective and practice
• Write code, develop software components, and implement complex functionalities according to project requirements
• Collaborate with other members of the development team and stakeholders to make high-level architectural decisions, propose design patterns, and ensure scalability, performance, and maintainability of digital solutions
• Integrate various software components or systems, ensuring seamless communication and interoperability between different parts of the digital solution
• Write and executes comprehensive test cases, conduct code reviews, perform debugging, and troubleshoot issues to ensure the reliability, stability, and high quality of digital solutions
• Participate in agile or other development methodologies, attends meetings, contributes to project planning, and helps drive the progress and success of digital projects

Staff Software Development Engineer

Scrum Master

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Manager – Scrum Master

Manager

• Help elevate patient care to a whole new level
• Join Community Care team as an industry leader in serving members
• Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities.
• Develops, implements, and supports Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work.
• 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 including consultant referrals, home care visits, and alternative levels of care.
• Interacts with members/clients telephonically or in person.
• Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care.
• 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.

Clinical Case Manager

• The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process
• Facilitates appropriate healthcare outcomes for members by providing assistance with appointment scheduling, identifying and assisting with accessing benefits and education for members through the use of care management tools and resources
• Conducts comprehensive evaluation of referred member’s needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services
• Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate
• Coordinates and implements assigned care plan activities and monitors care plan progress
• Consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes
• Identifies and escalates quality of care issues through established channels
• Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs
• Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health
• Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices
• Helps member actively and knowledgably participate with their provider in healthcare decision-making
• Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Analyst, Case Management

• Support the ongoing management of this one-of-a-kind program to support clinicians in their transition to practice in a value-based care model and development into a clinician leader
• Help devise, establish, and maintain key aspects of the program, evaluation, scheduling, and coordination with internal and external stakeholders
• Partner with the Program Director to oversee the operations of the Provider Leadership Institute, ensuring alignment with strategic goals and excellence in execution
• Oversee program participant recruitment and selection process, including plan and execute engaging recruitment events to attract top talent
• Collaborate with the marketing team to create, update, and disseminate promotional materials to relevant channels
• Maintain and regularly update the program’s promotional content to ensure consistency and appeal
• Facilitate the application and selection process
• Work closely with Harvard faculty and administrators to ensure seamless program operations and contribute to the development of innovative program components and strategies for continuous improvement
• Track progress on program work plan activities, proactively communicate challenges to supervisors and recommend solutions to address issues effectively
• Lead the creation, dissemination, and management of program participants’ schedules, including executive training and project assignments
• Develop professional development content and curriculum for fellows, creating resources that can be utilized by providers organization-wide
• Collaborate with program faculty and Oak Street leaders to design the didactic curriculum schedule and identify new opportunities for fellows
• Plan, coordinate, and lead key program events, including orientation, graduation, and other milestone activities
• Maintain comprehensive program data, and provide regular updates to the team, ensuring insights are shared effectively
• Schedule and lead regular team meetings to foster collaboration, address challenges, and share update
• Update program standard operating procedures and the fellowship calendar periodically to reflect best practices and ensure consistency
• Perform additional duties as assigned to support the program’s success and organizational goals

Analyst, Program Coordinator – Provider Education

Data Engineer

• Architect and develop robust, scalable ETL/ELT pipelines using Cloud Dataflow, Cloud composer (Airflow), and Pub/Sub for both batch and streaming use cases.
• Leverage BigQuery as the central data warehouse and design integrations with other GCP services (e.g., Cloud storage, Cloud functions).
• Build and optimize analytical data models in BigQuery.
• Implement partitioning, clustering, and materialized views for performance and cost efficiency.
• Ensure compliance with data governance, access controls, and IAM best practices.
• Develop integrations with external systems (APIs, flat files etc.) using GCP-native or hybrid approaches.
• Utilize tools like Dataflow or custom Python/Java services on Cloud Functions or Cloud Run to handle transformations and ingestion logic.
• Build automated CI/CD pipeline using Cloud Build, GitHub Actions, or Jenkins for deploying data pipeline code and workflows.
• Set up observability using Cloud Monitoring, Cloud Logging, and Error Reporting to ensure pipeline reliability.
• Lead architectural decisions for data platforms and mentor junior engineers on cloud-native data engineering patterns.
• Promote best practices for code quality, version control, cost optimization, and data security in a GCP environment.
• Drive initiatives around data democratization, including building reusable datasets and data catalogs via Datapelx or Data Catalog.

Senior Data Engineer

Program Manager

• key member of the Claim Optimization Technical Team
• supporting the Commercial Claim Rework Reporting program
• responsible for preparing and delivering production and ad hoc reporting
• performing data analysis using multiple system data sources
• transforming complex data into clear, actionable insights
• manage multiple priorities while maintaining a high level of accuracy and timeliness
• partner closely with the Claims organization and supporting teams

Manager, Project Program Management

Business Operations

• manage operational components of pharmaceutical manufacturer partnerships
• ensure contract execution, invoicing accuracy, and revenue realization
• track enhanced services milestones and invoicing process
• develop enhanced services marketing and sales materials
• coordinate industry conference and tradeshow activities
• implement process improvements to increase efficiency

Lead Director, New Business Operations and Enablement, Trade Strategy & Innovation

Executive Assistant

• Conducts routine complex administrative office coordination assuring smooth, timely, and efficient office operations for the Business Development, Proposals and Product departments within Aetna’s Medicaid business.
• Administers assignments research, collection, analysis, and compilation of data and information for department reports.
• Handles files, reports, financial records, and confidential record retention, ensuring regulatory compliance and sensitivity/confidentiality as appropriate.
• Implements a high degree of customer service by fielding internal and external inquiries, finding resolutions, or redirecting as appropriate.
• Viewed as an extension of the team.
• Establishes efficient workflow and office operations of the departments by communicating and adhering to established policies and procedures.
• Controls the internal and external department point of contact ensuring concise and effective communication with employees, stakeholders, and senior leaders.
• Adept at communicating effectively with stakeholders at all levels in the organization.
• Applies critical thinking skills to situations to promote timely, efficient and effective communication.
• Prepares complex and comprehensive financial records and files about departmental expenditures (including expense report preparation and submission), budget balances, investments, payroll, and operations.
• Arranges travel and logistics for executive leaders.
• Examines performance evaluations within the department ensuring compliance and continuous improvement.
• Identifies opportunities to staff support and administrative assistance to executive-level, senior management, or senior individual contributors as needed to ensure consistent department operations.
• Performs ad hoc tasks (e.g. special requests and executive support) as needed, including but not limited to onboarding support, IT and device requests.

• Provide strategic advisory on Trade implications of PBM client pricing strategies and client requests, partnering with cross-functional stakeholders to address business needs
• Contribute formulary, rebate, and other Trade insights to inform Underwriting RFP strategy and enhance rebate value for prospects and renewing clients
• Ensure Trade-related contractual requirements are appropriately addressed within RFP responses
• Provide input on key Underwriting assumptions that may impact future rebate value
• Analyze and apply market intelligence to support strategies for formulary initiatives
• Partner with Trade, Underwriting, and Finance teams to support Connected PBM Ecosystem initiatives and ensure alignment across functions
• Maintain and improve processes related to RFP support, advisory workflows, and Trade-related deliverables

Senior Manager, Trade Contract Advisory

Medical Director

• Population Health program clinical leadership: This physician or Advanced Practice Provider will be the clinical leader for a set of programs within the Population Health and Centralized Services Teams.
• Liaison to other clinical and operational leaders: Patients receiving care through these clinical programs will, in most cases, also be receiving primary care through Oak Street's network of primary care centers.
• Organizational Strategy and Collaboration: The Medical Director for Population Health will participate in organization wide planning and strategy including helping vet new opportunities, plan staffing, and hiring staff.
• Drive Culture: At Oak Street, we foster a culture of innovation and open dialogue, and we work with urgency.

Medical Director – Health Care Delivery, Pop Health

Call Center Representative

• Make an average of 50 outbound calls per hour placed by an automatic dialer system to offer, explain, and schedule a free in-home or virtual health evaluation with a provider
• Follow 20+ approved scripts, ensure members understand and are comfortable with the terms, and respond to rebuttals persuasively and with professional courtesy
• Present a positive, professional, and high energy approach to clients, health plan members, and team members
• Meet daily goals set by the department (i.e., 300-400 outbound dials per day, 25 appointments set per day, shift and attendance policy adherence, quality targets, etc.) in an office or remote environment
• Adjust, reschedule, and cancel appointments with both members and contracted providers, as requested
• Monitor performance results including appointments, calls, handle time, and productivity using designated reporting systems
• Report member complaints and escalations immediately to Member Engagement Managers
• Participate in peer side-by-side coaching as needed
• Follow HIPAA and other security and privacy guidelines when handling protected health information accessed during normal work activities

Outbound Call Center Representative

Financial Planning and Analysis

• Maintain and update SQL databases and Excel reports
• Prepare monthly financial packages for senior leaders
• Develop analyses, projections, reports, and presentations
• Identify trends in competitive environments and prepare findings
• Carry out ad-hoc financial modeling and analysis
• Subject matter expert for 340B for FP&A