CVS Health

Backend Engineer

• Develop scalable and efficient server-side applications using Java.
• Design and implement APIs and data storage solutions.
• Collaborate with front-end developers to integrate user-facing elements.
• Troubleshoot, debug, and optimize existing applications.
• Conduct code reviews and ensure adherence to best practices.
• Document technical processes and codebase.

Senior Software Development Engineer – Java

Manager

• Help elevate our patient care to a whole new level!
• Join our Community Care team as an industry leader in serving our members by utilizing best-in-class operating and clinical models
• 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
• Use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost effective outcomes

Case Manager, Registered Nurse – Medicare

Actuary

• Develop a quarterly, market-level discount review process to inform Regional Leads and Chief Network Officers of changes in benchmarking based on the latest view
• Identify gaps and pressured areas to consider for future negotiations
• Provide meaningful information to the field on the impact and expected timing of new negotiations beyond current consultant benchmarking
• Engage cross-functionally with Network, MEU, and other teams to drive enhanced contract negotiation strategies using data-driven recommendations for MedRx and Behavioral Health
• Provide support for Aetna Whole Health / APCN Plus (Performance Networks), joint ventures, and narrow network pricing across all Commercial market segments
• Validate and refine pricing using contracting insights such as trend, PCRs, and area factors during Large Group Rate Review
• Build a suite of tools and analyses to provide optimal strategic support for Priority Markets and Strategic/Enhanced Providers
• Address a complex and error-prone mix of state-specific standard contracts by selecting a single, competitive fee schedule that is consistent across state lines.

Senior Actuary – Network

Compliance

• Drive strategic and innovative pharmacy initiatives with Boards of Pharmacy across your assigned regions
• Shape the development and implementation of regulatory and advocacy priorities
• Support relationship-building with Boards of Pharmacy, industry coalitions, associations, academic partners, and other external stakeholders
• Cultivate cross-functional partnerships across Corporate Affairs, Pharmacy & Consumer Wellness, Legal, and other business units

Lead Director, Pharmacy Advocacy, Regulatory Affairs

Operations

• Perform multi-system research and make outbound calls
• Process provider updates for new and existing members
• Provider validation and alignment to Medicare members
• Outreach to obtain Verification of Chronic Condition
• Meet demands of a high-paced environment while maintaining quality metrics
• Provide excellent customer service to members
• Collaborate with teammates, leadership, and other departments as needed

Plan Sponsor Service Consultant, Operations

Financial Planning and Analysis

• Execute month-end close activities, including journal entries, balance sheet reconciliations, control preparation, and delivery of financial reports to business partners
• Support quarter-end close activities, including STAT reporting and serving as a liaison for audit requests
• Identify and implement opportunities to improve reporting accuracy, strengthen controls, and increase efficiency by reducing manual processes
• Partner cross-functionally with Finance and Actuarial teams to ensure clarity, accuracy, and consistency in financial reporting
• Support system enhancements and finance transformation initiatives, as applicable

Senior Analyst, Financial Reporting & Analysis

IT Support

• Lead multiple complex audit projects at the same time
• Review business processes and risks before audits begin
• Create audit plans, timelines, and assign work to the team
• Manage audit scope, review work, and provide feedback
• Write clear audit findings and reports for senior leadership
• Perform and document audit work using professional standards
• Execute testing and create detailed work papers
• Analyze results, business impact, and control effectiveness
• Document processes, findings, and exceptions clearly
• Communicate findings and resolve issues with audit and business leaders
• Support internal audit initiatives and reporting needs
• Model integrity, ethics, and respect for diversity
• Contribute to a positive and collaborative audit team culture

Project Manager – Internal Audit, Pharmacy Benefit Manager

• Drive development and execution of Stop Loss product strategy and select projects
• Create a Stop Loss product strategy outlining key objectives, prioritized initiatives, feature roadmap and performance metrics
• Guides product performance, assesses monitors market trends, and makes data-driven decisions regarding product enhancements, updates, or retirement
• Identifies unique value propositions, defines product positioning, and ensures effective communication of product features and benefits to customers and the market
• Assess competitive positioning of current Stop Loss products and recommend options to improve differentiation and impact
• Enhance Stop Loss products, and associated processes and systems, to improve customer and member experience
• Monitor customer, member and broker/consultant feedback, regulatory changes, and competitive intelligence on a regular basis
• Creates and reimagines marketing collateral that highlight the value proposition of Aetna Stop Loss
• Managing the product lifecycle: from ideation and launch through ongoing improvement and sunset decisions
• Develop business cases for product enhancements with cross-functional partners

Senior Manager – Stop Loss Product

• Develop and maintain forecasting models that project Oak Street’s performance in various CMS Stars measures
• Regularly analyze performance data to identify areas for improvement and recommend strategies to enhance ratings
• Draw insights from performance data and highlight areas of opportunity by market for field leaders and Oak Street’s senior leadership team
• Prepare clear and concise reports, dashboards, and presentations to communicate performance metrics, trends, and recommendations to Oak Street senior leadership (VP, SVP, & C-suite) and other key stakeholders (Oak Street Medical leadership)
• Develop a reconciliation process to ensure Oak Street receives accurate and complete payer data files
• Partner with payer data teams and Managed Care Operations to address gaps in payer data
• Regularly review escalations from stakeholders regarding data quality
• Partner with Product and Engineering on improving data quality
• Collaborate with cross-functional teams, including Product, Data, Engineering, and Managed Care Operations to integrate analytical insights into Oak Street’s overall quality improvement efforts
• Other duties as assigned

Sr Associate, Stars – Operations Analytics

Analyst

• Support medical cost management initiatives through data-driven analysis and performance tracking
• Develop executive-ready presentations and written analyses to communicate insights, progress, and recommendations
• Track progress against key initiatives, milestones, and outcomes; surface risks and opportunities proactively
• Provide general project and workstream management to ensure priorities are clearly defined and executed
• Identify workflow bottlenecks across field-based and central patient support teams; design practical solutions to improve efficiency and effectiveness
• Present workflow improvement recommendations and progress updates to senior leaders
• Act as a bridge between field support teams and centralized patient support functions to ensure alignment and smooth transitions
• Partner closely with leaders to build analyses and presentations for leadership and leadership support teams

Senior Analyst – Medical Cost Strategy, Field Support

Full-stack Engineer

• responsible for the development and delivery of technology solutions that support the strategic direction of technology compliance and audit management
• applies deep technical expertise to design, modernize, and operationalize technology solutions that support various cybersecurity and regulatory frameworks
• collaborates with engineering teams, process and control owners, and security architects to develop robust, audit-ready control environments

Staff Engineer – Regulatory Technology

• Subject Matter Expert (SME) supporting process and system capabilities for Specialty Systems
• Evaluate and resolve pharmacy operations system and technology gaps
• Align integration data transfer deliverables
• Lead implementations across multiple operational business units
• Support leaders in delivery of key Integration initiatives
• Support defined playbook activities, measurement and tracking of outcomes
• Identify and clear roadblocks to unlock organization and operational barriers
• Optimize coordination and communication with internal stakeholders
• Actively contribute to team meetings, brainstorming sessions, and collaborative projects
• Process analysis across multiple Business Units
• Workflow and task evaluation across varying applications
• Issue identification and tracking related to Implementation execution

Senior Analyst, Business Integration

Customer Support

• Handle customer service inquiries for Fully Insured or High Profile role
• Address problems via telephone, internet or written correspondence
• Maintain department established performance metrics
• Work together as a team and apply the Aetna Core Values in day-to-day operations

Senior Customer Service Representative

• develop and present meaningful and insights-driven materials on analytical results with recommendations and go forward planning
• drive self-service capabilities with the business, train business teams on new technical capabilities and how to consume the data effectively
• prove out new tools/capabilities quickly through POCs and provide readouts to the management teams
• build relationships across the enterprise, working with analytics and data teams for insights and best practice sharing
• partner with functional and business stakeholders to understand strategic business analytics requirements
• provide guidance in driving solutions while delivering successful end results
• develop strategies aimed to improve business reporting and planning processes utilizing continuous improvement
• use data visualization techniques to effectively communicate analytical results and support business decisions

Senior Decision Scientist – Retail Pharmacy Operations

Analytics Engineer

• Lead, coach, and provide technical guidance to a team of analytics engineers
• Design and oversee scalable data pipelines, models, and architecture
• Partner with business and analytics stakeholders to turn complex questions into usable data solutions
• Build and automate data extraction, transformation, and loading (ETL) processes using industry standards
• Improve existing data pipelines by identifying performance, reliability, and quality issues
• Develop tools and standards to improve code quality, consistency, and development speed
• Create clear documentation to support long‑term sustainability
• Collaborate closely with data visualization and reporting teams