CVS Health

Manager

• Partner closely with Aetna Medical Directors to support the clinical review of oncology-related appeals and complex coverage determinations
• Evaluate oncology therapies using published clinical literature, NCCN Guidelines, Aetna preferred drug lists, and medical necessity criteria
• Provide clear, evidence-based clinical summaries and recommendations to support consistent, high-quality oncology decision-making
• Stay current on emerging oncology therapies, indications, and guideline updates to inform appeal reviews and policy discussions
• Support the execution of oncology-focused medical pharmacy initiatives, including site of care strategies and oncology benefit design considerations
• Assist in the development and refinement of medical drug lists and oncology utilization management strategies
• Collaborate with cross-functional partners to ensure alignment of oncology strategies

Senior Manager, Medical Oncology Pharmacist – BCOP Required

General Counsel

• Provide timely, practical and actionable legal advice to internal business partners and leadership.
• Draft commercial prescription benefit management (PBM) contracts for CVS Health’s health plan and employer clients/payors.
• Advise internal partners on PBM program terms and an array of matters.
• Work in conjunction with other team members and business partners to interpret and administer PBM services agreements.
• Provide legal and regulatory compliance interpretation, and general corporate legal advice.
• Identify business and legal risks and recommend solutions that balance those risks with business objectives.

Counsel

Analyst

• provide consultative support and medical cost-based analysis of markets and network initiatives
• consult with network and clinical management on opportunities to improve discount position and strategic cost initiatives
• prepare for monthly presentations
• analyze and research utilization and unit cost medical costs drivers
• report on outlier cost issues

Analyst, Medical Economics – Medical Expense Review

Backend Engineer

• Analyze business requirements to design and implement new features to systems.
• Develop in .NET, React, C#, JavaScript and SQL Server.
• Write and execute comprehensive test cases, conduct code reviews, perform debugging, and troubleshoot issues to ensure the reliability, stability, and high quality of digital solutions.
• Explore new tools, frameworks, and techniques to improve digital solutions and drive innovation within the development team.

Full Stack Software Engineer, .NET, C#

Project Manager

• Learn and understand FEHB/PSHB plans and benefits in order to effectively and simply educate federal employees and retirees on their options.
• Support member communications and marketing efforts such as the maintenance of SharePoint database and QuickBase tools.
• Assist with managing website updates process and develop/write content for web updates.
• Will be required to track and update digital content on federal websites using WordPress Elementor.
• Coordinate moving materials through a multi-step compliance review process.
• Assist with managing several platforms and systems that support virtual lead generation capabilities, including Salesforce and Cvent.
• Coordinate participation in virtual health fairs, including staffing.
• Participate in Open Enrollment sales activities such as phone appointments, live chat, webinars, and in-person meetings.

Federal Plans Digital Content Project Manager

• Leads a team of PhDs who prepare and review Applied Behavior Analysis (ABA) service provision for medical necessity
• Reviews and prepares cases for medical necessity review of ABA
• Provide input into medical management programs/policies that pertain to neurodevelopmental disorders
• Responsible for overall medical policies of the unit to ensure the appropriate and most cost-effective medical care is received, and for the day-to-day management of ABA/Psychology team
• Responsible for recommending changes and enhancements to current managed care, review guidelines, and clinical criteria based on extensive knowledge of health care delivery systems, utilization methods, reimbursement methods, and treatment protocols
• Leads clinical staff in the coordination of quality care
• Provides clinical expertise and business direction in support of medical management programs through participation in clinical team activities
• Acts as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams
• Serves as a clinical subject matter expert supporting Special Investigative Unit Investigators, Managers, and Directors as appropriate in matters pertaining to the investigation of suspected healthcare fraud cases
• Provides clinical expertise and consultation in the creation of data analytic monitors to identify potential patterns of suspected fraud, waste, or abuse
• Providers subject matter expert support to enterprise-wide initiatives supporting members with neurodevelopmental disorders
• Uses available resources and technology in developing evidence, supporting allegations of fraud and abuse
• Researches and prepares cases for clinical and legal review

Senior Manager, Behavioral Health

• design, develop, and maintain backend services and APIs
• ensure that releases are well-coordinated, fully prepared, and successfully deployed to production
• drive operational excellence across the development lifecycle

Senior Java Software Engineer

Operations

• Lead high-impact quality improvement initiatives
• Uncover actionable insights from price guarantee quality and error data
• Implement, track, and sustain improvements
• Build and maintain a CNP quality scorecard

Senior Manager, Pricing Process Improvement

Security Engineer

• Independently manage and resolve DSCSA serialization and traceability exceptions impacting Mail and Specialty product flow, including quarantined inventory.
• Perform advanced investigation across SAP, TraceLink SCWM, and related systems to analyze purchase orders, receipts, inventory movements, scan data, and EPCIS transactions.
• Reconcile discrepancies across multiple systems and data sources, identifying root causes and implementing corrective actions.
• Investigate and resolve cross-system timing or data mismatches that result in receiving or compliance failures.
• Ensure all exception handling aligns with DSCSA requirements, internal SOPs, and audit standards
• Document investigations, actions taken, and outcomes in a clear, consistent, audit-ready manner.
• Serve as a point of escalation for complex, high-risk, or recurring exceptions, providing guidance to analysts and operational partners.
• Partner with IT, Compliance, Operations, and external trading partners to resolve systemic issues and support long-term fixes.
• Identify trends and recurring issues, contributing to process improvements, training materials, and preventive controls.
• Support enterprise readiness by maintaining strong awareness of DSCSA milestones, regulatory guidance, and system changes.

Senior Analyst – DSCSA Exception Management, SAP Specialist

Full-stack Engineer

• Lead Level 1–3 application production support for QL Eligibility, Drug, Prescriber business customers, including monitoring, incident resolution, and proactive system health checks
• Analyze and troubleshoot complex application and systems issues; perform root cause analysis and implement long-term corrective actions
• Collaborate with engineering, product, QA, operations, and business teams to ensure timely and accurate resolution of production incidents
• Code fix, optimize, and improve existing codebases to enhance system reliability, stability, and scalability
• Perform debugging, and validation across distributed application environments
• Handle Job failures, Batch processing, Job scheduling, and queues in DCU3 Mainframe Environment
• Participate in on-call rotations as needed to support critical production services
• Contribute to the technical roadmap, driving innovation and continuous improvement within the engineering ecosystem
• Document solutions, operational procedures, and knowledge-base articles to support cross-team learning and operational excellence

Staff Software Development Engineer – Mainframe

• Lead Level 1–3 application production support for QL Eligibility, Drug, Prescriber business customers, including monitoring, incident resolution, and proactive system health checks.
• Analyze and troubleshoot complex application and systems issues; perform root cause analysis and implement long-term corrective actions.
• Collaborate with engineering, product, QA, operations, and business teams to ensure timely and accurate resolution of production incidents.
• Code fix, optimize, and improve existing codebases to enhance system reliability, stability, and scalability.
• Perform debugging, and validation across distributed application environments.
• Handle Job failures, Batch processing, Job scheduling, and queues in DCU3 Mainframe Environment.
• Participate in on-call rotations as needed to support critical production services.
• Contribute to the technical roadmap, driving innovation and continuous improvement within the engineering ecosystem.
• Document solutions, operational procedures, and knowledge-base articles to support cross-team learning and operational excellence.

Software Development Engineer – Mainframe

• 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
• 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
• Prepares all required documentation of case work activities
• Interacts and consults with internal multidisciplinary team
• Provides educational and prevention information for best medical outcomes
• Monitors member/client progress toward desired outcomes

Case Manager, Registered Nurse – Illinois Medicare Advantage

Events

• build, coordinate, and manage strong relationships with clients, internal teams, venues, and vendors
• manage project budgets and timelines
• oversee the onsite execution of the event

Live AV Event Coordinator

Supply Chain

• Managing the end-of-life inventory strategy and execution across stores and distribution centers
• Owns the creation and governance of AMM events, item inactivations, and discontinuation flags
• Partner with Merchants, Inventory Planning, Store Operations, Logistics, and Vendors to drive cost-effective inventory removal
• Provide analytical insights on write-offs, margin impact, aged inventory, and withdrawal inquiries

Senior Supply Chain Analyst

Account Manager

• Own the strategy and execution of CVS Health’s external data licensing portfolio.
• Lead the sourcing, development, and management of partnerships, ensuring data products are commercially compelling.
• Identify, source, and develop new data partnership and commercialization opportunities across healthcare.
• Own the end-to-end operational health of active data licensing partnerships including tracking deliverables, schema changes, feed updates, and SLA compliance.
• Serve as the primary point of contact for internal analytics and products teams seeking to leverage external data assets.