CVS Health

Account Executive

• Acquisition of new members via engagement in community event activity to generate leads and referrals
• Assessing customer needs for products and services using insightful, probing questions, and demonstrating superior listening skills
• Servicing of existing members and inquiries related to utilization of their product, benefits, etc.
• Cross selling ancillary products as well as any other applicable products to existing members
• Retention of existing members
• Maintaining knowledge levels with respect to CMS and states regulations
• Ability to multitask, and effectively use computer while interacting with prospects and members via phone
• Ensuring that the relevant information is captured in Customer Relationship Management system (CRM)
• Meeting sales goals, conversion rates, and cross sell rates for acquisition of new members as outlined in the annual performance plan
• Contacting prospective members within the time limit outlined in the annual performance plan
• Achieving the member retention rate as outlined in the annual performance plan
• Highest levels of member satisfaction as measured by various member surveys and member retention rate
• Expert level understanding of products, services, and processes offered by the company
• Ability to pass on an annual basis: American Health Insurance Plans (AHIP), Continued Education (CE’s), Product Certification Required Security and Compliance, Client/Carrier Certifications, and any required CMS Certifications

Medicare Field Sales Representative

Community Manager

• Develop, implement, and track community outreach initiatives designed to increase MCO membership and trust; manage external experiential marketing agency.
• Build and maintain partnerships with local healthcare providers, community leaders, nonprofits, and government agencies.
• Identify key community organizations and coordinates outreach and event planning to promote organizational presence within the community.
• Plan and execute community events, workshops, and marketing campaigns to promote health literacy and MCO services.
• Develop, implement, and evaluate comprehensive community relations activities to promote membership growth and retention.
• Monitor, analyze, and report on outreach activities and community needs, making data-driven recommendations to improve engagement.
• Oversee, train, and support a team of six Outreach Coordinators to meet enrollment goals, increase brand awareness and ensure high-quality service.
• Manage operational aspects of the team (e.g., budget, performance, and compliance), and implement workforce and succession plans to meet business needs.

Senior Manager, Community Development

Bilingual

• Observing and recording patient encounters/examinations
• Documenting patient information, history, and diagnoses
• Assisting in medical management
• Documenting medical decision making
• Consultation with the care team and other providers on patient needs
• Other duties as assigned

Telehealth Scribe, Bilingual Spanish

Architect

• Designs and develops IT architecture solutions—spanning integrated processes, applications, data, cloud, and emerging technologies—to address complex business problems in alignment with enterprise architecture standards
• Performs technical planning, architecture development, AI/ML integration, and modification of specifications
• Develops specifications for new products/services, applications, and service offerings
• Evaluates the compatibility and interoperability of products and services proposed as standards to ensure an integrated architecture across interdependent technologies and cloud ecosystems
• Develop an architectural maturity model and strategic roadmap that moves teams from project delivery to production readiness and scales toward modern cloud-native, AI-enabled architectures
• Lead the transition of work execution into Agile and AI-augmented delivery frameworks
• Define and evolve enterprise patterns for AI/ML workloads, including model lifecycle, data pipelines, inference scalability, observability, and responsible AI controls
• Drive the adoption of cloud-native architectures across platforms (e.g., Azure, AWS, GCP) to support scalability, cost optimization, and modernization initiatives
• Introduce Generative AI and Agentic AI capabilities to enhance automation, developer efficiency, customer experiences, and decision intelligence
• Establish architectural guardrails for LLM integration, prompt engineering, vector search, and AI agents within enterprise applications
• Partner with Data, Cloud, and Security teams to ensure that AI-powered and cloud-based solutions meet regulatory, privacy, performance, and resiliency requirements
• Build actionable insights using in-house reporting tools, AI-driven analytics, and architectural visualizations to enhance decision-making, transparency, and competitive advantage
• Develop standard processes that improve decision-making speed, increase transparency, and support AI-enabled observability into team practices
• Inspect architecture patterns to ensure the right models—cloud-native, microservices, event-driven, AI/ML, and GenAI-enabled—are leveraged for scalability, resiliency, reliability, stability, and availability
• Apply advanced architectural knowledge to support teams in building seamless deployment and rollback strategies for key initiatives (e.g., Air Support, Omnichannel, Mail to Retail), including cloud and AI-powered components
• Consult with key stakeholders across Digital, Business, AI, Cloud, and IT functions to understand impacts, communicate changes, and define best practices for architectural schematics and AI-enabled workflows
• Develop processes to identify skill gaps and implement upskilling programs around cloud architecture, AI/ML engineering, GenAI, and modern delivery practices
• Partner with Digital, Business, and IT organizations to drive innovative cloud and AI strategies across the retail pharmacy line of business
• Lead architectural decision-making to ensure compliance with enterprise standards, including cloud governance, AI ethics, and emerging technology guidelines

Principal Architect

Artificial Intelligence

• Define and articulate the vision, strategy, and roadmap for your portfolio of digital health insurance products
• Align your product goals with organizational objectives and customer needs
• Work closely with architecture, design, content, engineering, legal, compliance, and analytics teams to develop and launch high-quality digital products
• Create, optimize, and implement processes for working together more efficiently
• Advocate for the user by integrating customer feedback, usability testing, and market research into product development
• Ensure products meet the needs of diverse user groups and accessibility standards
• Analyze performance metrics and user data to identify trends, inform product decisions, and optimize product features
• Utilize analytics tools to track KPIs and measure success
• Communicate product vision and updates to stakeholders, including executive leadership
• Manage expectations and solicit feedback to ensure alignment across the organization
• Roll up your sleeves and guide teams to resolve business, design, and engineering problems quickly and efficiently
• Lead agile epic and feature development and refinement processes, including PI planning, backlog management, and prioritization of features
• Stay informed about industry trends, competitive landscape, and emerging technologies for your subject areas
• Leverage insights to identify opportunities for innovation and differentiation.

Senior AI Digital Product Manager

Data Scientist

• Design, build, execute, and measure recruiting plans to attract top talent
• Use data to solve recruiting problems and provide insights
• Leverage internal resources and your team to achieve operational excellence and 100% compliance within Workday, our Applicant Tracking System (ATS)
• Enhance processes and champion innovative talent acquisition ideas
• Ensure exceptional experiences for candidates and hiring leaders through proactive communication and feedback
• Foster knowledge sharing and continuous learning within the team
• Recruit for various profiles (Data Scientist, Machine Learning, Software Engineering, Data Engineering, etc.) and adapt to different business areas

Senior Technology Recruiter – Data Science, Engineering

Product Analyst

• Own the definition and documentation of product requirements, user stories, and acceptance criteria.
• Maintain and refine the product backlog in partnership with the Product Manager and Operations.
• Support adherence to and measurement of feature KPIs that are aligned with the overall program.
• Translate high-level product strategy into detailed, functional specifications and workflows.
• Ensure requirements are clear, feasible, and testable for your data scientists and engineers.
• Work closely with clinicians and operations to confirm business value, inform problem statements, and quantify the value of your team’s potential solution.
• Facilitate sprint planning, backlog refinement, and retrospectives.
• Support the development of go-live timelines with your core data science team and engineering partners; align on timelines and scope with stakeholders.
• Lead problem solving and prioritization for your team, factoring in trade-offs between speed, scalability, accuracy, and quality.
• Liaise with clinicians to validate clinical AI model results and to facilitate review and refinement.
• Gather requirements, set-up product demos, and support feedback loops for your team with stakeholders.
• Work with internal customers, end users, and other stakeholders to maintain product roadmaps.
• Analyze product performance metrics, identifying opportunities for improvement and optimization.
• Clarify and coordinate dependencies with other product teams and stakeholders and mitigate the risks and dependencies proactively.
• Follow agile best practices including but not limited to working with and leading a scrum team.

Senior Product Analyst

Financial Planning and Analysis

• Collaborate with non-retail management and external groups to develop the department’s annual budget
• Provide financial reporting, accruals, forecast, and budget requirements to support multiple department managers
• Prepare annual development and training sessions on expense management requirements
• Review and approve department invoices using Service Channel
• Distribute weekly and monthly expense and capital expenditure reports
• Ensure compliance with Sarbanes-Oxley Act (SOX) regulations and assist with tax audits

Senior Financial Analyst

Analyst

• Analyze and interpret complex clinical, claims, and risk‑adjustment datasets to support enterprise decision‑making and drive strategic initiatives
• Perform advanced statistical analysis, data mining, and predictive modeling to produce actionable insights from large datasets
• Identify trends, patterns, and correlations, including those related to Medicare Advantage risk‑adjusted performance, HCC prevalence, Chronic Condition recapture, and RAF scoring
• Design and develop reports, dashboards, and visualizations using BI tools to communicate insights to stakeholders
• Ensure data integrity, quality, and consistency through effective data management strategies
• Conduct encounter validation, coding quality checks, and analyses for risk‑adjustment completeness and data gaps
• Analyze existing SAS scripts to understand business logic and convert or rewrite them into Python, R, or cloud‑native tools
• Apply cloud‑based data engineering and analytics using platforms such as AWS or GCP

Senior Informatics Analyst

• Own end-to-end design and delivery of Anaplan solutions across Workforce, Capex, P&L, and Balance Sheet planning domains.
• Lead model architecture decisions: modularization, data hub strategy, spoke models, integration patterns, and model lifecycle management.
• Translate complex business requirements into robust Anaplan user stories, model designs, and implementation roadmaps.
• Drive design reviews, establish best practices, and ensure solutions align to Anaplan platform standards and internal governance.
• Build and maintain Anaplan models: modules, lists, hierarchies, line items, versions, time ranges, and calculation logic.
• Implement advanced modeling techniques: Dimensionality optimization, formula efficiency, and performance tuning.
• Create scalable and auditable planning workflows.

Senior Anaplan Architect

Frontend Engineer

• Responsible for screening orders, research, and review of prescription overrides
• Accurately and efficiently reading, interpreting, and entering prescriptions into the computer system
• Addresses questions about over-the-counter medications, assists with product selection, and provides guidance on non-prescription healthcare products
• Processes payments, and accurately manages financial transactions, including insurance claims and copayments
• Provides patient education and counseling on over-the-counter medications
• Ensures compliance with pharmacy regulations, laws, and guidelines

Pharmacy Technician II – Front End

Compliance

• Serving as the principal liaison to the state Medicaid agency for all external audits and escalated state matters
• Facilitating the preparation for and management of external audits conducted by state Medicaid and related agencies or partners through final report and corrective action plan closure
• Supervising the submission of all audit deliverables and ad hoc state requests or escalated issues
• Conducting comprehensive lessons learned evaluations following post-audit and develop proactive corrective actions with executive leaders
• Conducting research and develop recommendations to help executive leadership develop compliant business operations
• Independently developing compelling compliance related communications on behalf of the health plan
• Maintaining an in-depth working knowledge of the health plan’s contractual, regulatory, and program policy related obligations
• Designing and managing tools for tracking and handling complex state external audits
• Utilizing systems unique to job functions, including standard-issue software such as Microsoft products and compliance specific tools
• Maintaining positive, productive relationships with internal and external senior level constituents
• Providing training and guidance to less experienced team members

Lead Director, Medicaid Compliance External Audits

• Perform bank reconciliations to ensure accuracy and completeness of financial records.
• Process wire transfers, including verifying transaction details and ensuring compliance with company policies.
• Review and process invoices, including verifying accuracy of charges and ensuring timely payment.
• Assist with month-end closing procedures, including preparing journal entries and account reconciliations.
• Prepare the daily Letter of Credit (LOC) reports, ensuring accuracy and timely distribution to stakeholders
• Prepare monthly claims schedules and associated financial reporting in line with federal and internal reporting requirements
• Provide support to the accounting team with various projects and initiatives.
• Ensure compliance with company policies and procedures, as well as relevant laws and regulations.
• Handle ad hoc requests as needed.

Financial Analyst, Reporting & Analysis

Accounting Manager

• Overseeing daily claims disbursement, cash activity, and reconciliations
• Partnering closely with Claims Operations, Treasury, and Accounting
• Supporting financial controls, audit activities, and claims related reporting
• Depositing refund checks into the designated refund account and ensuring proper tracking
• Completing the daily Letter of Credit (LOC) and related monitoring activities
• Reviewing and processing Return to Claims Office (RCO) checks
• Processing replacement check requests
• Processing weekly Rx claims payments with accuracy and timely release
• Performing daily reconciliations between multiple claims and financial systems
• Investigating and resolving reconciling items and discrepancies
• Assisting with interim and annual audits, including documentation support and auditor inquiries
• Supporting compliance with internal controls, policies, and procedures

Senior CDR, Accounting

Manager

• Deliver high-quality, member-centered care by conducting comprehensive in-home assessments
• Develop individualized care plans
• Coordinate services across physical, behavioral, and social needs for the pediatric demographic (0-21)
• Collaborate with providers, interdisciplinary teams, and member support systems to ensure safe, cost-effective care and optimal outcomes
• Facilitate access to Long-Term Services and Supports (LTSS)
• Advocate for members during care transitions
• Monitor progress toward care goals
• Document timely and accurately in the electronic health record.