CVS Health

Manager

• Serve as the subject matter expert on applicable guidance and regulations
• Lead implementation and continuous improvement initiatives to ensure compliance with current and emerging requirements
• Partner with key functional leaders across Pharmacy Network, PBM Finance, Underwriting, and Client teams
• Proactively identify, assess, and escalate business risks, financial impacts, and P&L implications to senior leadership
• Leverage financial data analytics to quantify and monitor regulatory impacts
• Perform variance and root-cause analysis versus forecast/plan
• Support KPI reporting for leadership decision-making

Senior Manager, Network Services

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, Spanish Bilingual

Technical Product Manager

• Act as the product owner for business solutions understanding product, business, and competitive landscape to successfully enhance the company's competitive advantage in the industry.
• Coordinate with business teams and other key business partners to create a product vision, understand and help identify business value, understand required capabilities and translate these into product requirements.
• Partner with business, product, analytics, and operational leaders across portfolios to drive shared prioritization, manage tradeoffs, and ensure aligned execution.
• Translate business needs and engagement strategies into well‑defined features and user stories, driving delivery within a SAFe Agile framework.
• Communicate product updates to stakeholders, including executive leadership.
• Manage expectations and solicit feedback to ensure alignment across the organization.
• Coordinate with technical partners from engineering, data science, user design, and architecture teams in a fast-paced, agile development process to successfully deliver roadmap capabilities.
• Define, monitor, and use KPIs to assess performance, inform decisions, and continuously improve engagement outcomes.
• Identify and proactively manage dependencies, integrations, platform constraints, and delivery risks for the product.
• Guide teams to resolve business, design, and engineering problems quickly and efficiently.

Senior Technical Product Owner – Mental Wellbeing

• Build strong relationships with new clients to understand their unique needs, requirements, and expectations for a successful implementation.
• Develop and manage detailed project plans, defining tasks, timelines, and key milestones while collaborating with internal and external stakeholders to drive projects to completion.
• Proactively identify risks, develop mitigation strategies, resolve issues efficiently, and provide consistent project status updates to clients and stakeholders.

Manager, Implementations

• Lead regional delivery of capacity performance targets, optimize clinician roster strategies and utilization, based on supply and demand drivers, and strengthen accountability for operational results across the region
• Optimize performance and outcomes based on identified supply constraints through daily monitoring of trends and metrics and management of risks
• Partner with the regional leadership team to align demand and supply expectations and define an approach for capacity
• Generate the capacity plan and forecast for the region, leveraging details from the production and network leadership team
• Direct and approach for the clinician roster, assignments or utilization, based on supply and demand drivers, promoting collaboration and communication between production and network teams
• Prepare of supply and demand balancing scenarios, analyzing optionality & choices around demand, as well as supply trade-offs
• Monitor and maintain a deep understanding of all metrics associated with capacity
• Relationship management with a wide range of stakeholders who own inputs and/or outputs necessary to achieve results (client, data, other operational teams)

Senior Manager, Regional Capacity

Compliance

• Lead and manage Medicare Compliance staff, including workload prioritization, performance management, and development.
• Oversee the Medicare Compliance Program for MA‑PD and D‑SNP in accordance with CMS Part C & D requirements.
• Monitor, interpret, and communicate CMS regulatory guidance; serve as a compliance subject matter expert to internal teams.
• Maintain Medicare Compliance policies, procedures, and governance processes.
• Lead Medicare compliance risk assessments, monitoring, and auditing activities; oversee CAP development and validation.
• Coordinate and support CMS Program Audits, internal audits, and external reviews.
• Oversee compliance training, communications, and required regulatory reporting.

Manager, Medicare Business Compliance

• Lead engagement with Compliance and Legal to interpret state, PBM, Medicaid, and Licensure reporting requirements
• Own accountability for determining whether reporting requests are new, changed, or unchanged year over year
• Ensure formal acknowledgment and documentation of scope decisions
• Govern Salesforce intake for PBM, Medicaid, and Licensure reports
• Serve as the primary business partner to Compliance and Regulatory teams
• Provide enterprise oversight and governance of client lists used for PBM, Medicaid, and Licensure regulatory reporting
• Manage report templates, instructions, and year-over-year version control
• Submit finalized PBM, Medicaid, and Licensure regulatory and state reports
• Identify, assess, and escalate year-over-year inconsistencies that may pose compliance or audit risk
• Establish and maintain centralized SharePoint repositories for state and regulatory reporting artifacts

Senior Manager – Regulatory Reporting Solutions

Analyst

• managing the execution of multi-channel communications, including the schedules, team meetings/agenda/recaps
• Project Manage assigned programs from initiation through deployment
• Manage the creative and data delivery to vendors
• Communicating with internal partners, customers and vendors
• Manage the Standard Operating Procedure (SOP) or work instructions for the programs they execute

Senior Analyst, Member Communication

Call Center Representative

• Provide programmatic support by conducting analyses
• Own high visibility reports
• Assist with strategic conversations
• Collaborate with cross-functional teams

Sales Call Center Analyst

Recruitment

• As a Campus Recruiter, responsible for attracting, engaging, and hiring pharmacy talent
• Own the end-to-end campus recruiting process, from candidate attraction through offer acceptance
• Screen resumes, conduct interviews, and assess candidates to identify the best fit
• Serve as a key coordination point with hiring managers
• Ensure all recruiting activities comply with company policies
• Track and monitor recruiting activity and outcomes
• Build and maintain relationships with career services and student organizations
• Own campus recruitment event coordination

Senior Analyst, Talent Acquisition – Campus Recruitment

Director

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Capture Director, Medicaid Proposals

Solutions Engineer

• Implement MAWM technical configuration controls, extend MAWM functionality, support MAWM production as well as integrate Manhattan with other systems (Host, MHE, 3rd Party systems etc.)
• Leverage programming skills to design and implement efficient and reliable digital solutions.
• Write code, develop software components, and implement functionalities according to project requirements.
• Collaborate with the development team and other stakeholders to design and define the technical architecture and infrastructure required for the digital solutions.
• Contribute to technical discussions, propose design patterns, and make architectural decisions to ensure scalability, performance, and maintainability.
• Test own code and participates in the overall quality assurance process.
• Write and execute unit tests, conduct code reviews, debug, and troubleshoot issues to ensure the reliability and stability of digital solutions.
• Participate in agile or other development methodologies, attend meetings, and contribute to project planning and progress tracking.
• Create and maintain technical documentation, including system designs, specifications, user guides, and other relevant documentation.
• Seek opportunities for professional development and growth, such as attending conferences, taking online courses, or participating in relevant training programs.

Senior Solutions Engineer – Manhattan Active Warehouse Management

Consultant

• Applies critical thinking and is knowledgeable in clinically appropriate treatment, evidence-based care and clinical practice guidelines for Behavioral Health, specific to ABA.
• Utilizes clinical experience and skills in a collaborative process to assess appropriateness of treatment plans across levels of care.
• Coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.
• Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage.
• Coordinates with providers and other parties to facilitate optimal care/treatment.
• Identifies members at risk for poor outcomes and facilitates referral opportunities to integrate with other products, services and/or programs.

ABA UM Clinical Consultant

• 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 Rep

Developer Relations

• Own the end-to-end architecture of the AI-assisted access model, ensuring it is scalable, explainable, and auditable.
• Partner with data and security teams to validate signal quality and model outcomes.
• Establish clear APIs and automation workflows.
• Ensure the platform supports continuous access evaluation and lifecycle management.
• Embed auditability, explainability, and policy enforcement into the platform by design.
• Collaborate with security, risk, and compliance stakeholders to ensure governance requirements are met without sacrificing developer velocity.
• Function as a technical authority and mentor for junior engineers.
• Drive engineering best practices, design reviews, and architectural standards.