CVS Health

Data Engineer

• Design and build highly scalable, reliable, and fault-tolerant data pipelines and platforms.
• Be a hands-on expert in developing and optimizing our core data pipelines using technologies like SQL, Python, Apache Spark, and cloud-native services.
• Mentor and coach other data engineers, providing technical guidance and fostering a culture of best practices, code quality, and professional growth.
• Partner with data scientists, analysts, and product managers to understand complex business requirements and translate them into robust, efficient data solutions.
• Ensure the operational health of our data systems. Implement monitoring, alerting, and logging to proactively identify and resolve performance bottlenecks and system failures.
• Champion and lead the adoption of new tools and approaches that will enhance our platform and our team's capabilities.
• Establish and enforce data quality standards and governance practices to ensure the integrity and reliability of our data assets.

Staff Data Engineer

Program Manager

• Develop and maintain processes for the management, execution, and oversight for all operational functions including benefits, claims, materials, clinical, finance to ensure SNP program requirements are met
• Support and/or lead operational calls, plan leadership meetings and cross functional meetings to drive coordination of operational activities for product success

Senior Manager, Project Program Management – Dual Program Management

Manager

• Leads and oversees the successful delivery of onboarding/client experience
• Develops talent, refines processes, executes strategic initiatives
• Emphasizes cross-departmental collaboration
• Guides and mentors a dynamic team of approximately 14 Pharmacy Implementation Consultants
• Focuses on retention, growth and maximizing potential of team members
• Reinforces a culture of accountability, collaboration, engaged and compassion
• Analyzes department’s processes and procedures, identifying areas for improvement
• Ensures alignment with organizational objectives and stakeholder expectations
• Attends meetings with department implications and collaborates with multiple departments
• Communicates key insights and feedback to leadership team
• Conducts personnel evaluations and assessments, monitoring progress

Senior Manager, Pharmacy Benefit Management – Implementation

Account Executive

• Manage sales growth by building a book of business leveraging field sales marketing activity and telesales programs
• Sell, cross-sell, up-sell, and retain through the use of the Aetna IVL Medicare product portfolio
• Deploy an operating model that supports 3 days in the field and 2 days in a call center queue to support the organization
• Own the member relationship throughout the year and be the primary contact for member inquiries
• Document in the hybrid field sales integrated tech stack the call interactions
• Develop, continuously train, and learn new sales skills

Field Sales Representative

• Partnering with other product leads, business analysts, and system team experts to understand overall business requirements and decompose them into actionable user stories that development teams can execute on.
• Collaborating across the Brilliant Basics portfolio to align on domain requirements and cross portfolio impacts
• Leading and facilitating Program Increment (PI) Planning activities, ensuring alignment across teams, clear prioritization, and readiness of features and enablers.
• Collaborating with engineering teams to accept and validate backend code, ensuring it meets functional and non-functional requirements.
• Driving the creation, refinement, and prioritization of user stories with a strong emphasis on technical accuracy, completeness, and traceability.
• Helping lead the team to success by working across groups to drive discussion and engagement, create and track user stories in a SAFe/Agile framework.
• Managing cross-team dependencies to mitigate risks and issues, ensuring timely delivery of features.
• Promoting transparency and alignment by effectively communicating priorities, progress, and risks within and across teams.
• Leading or participating in Agile ceremonies, including daily stand-ups, sprint planning, retrospectives, and system demos.
• Engaging in technical discussions and solutioning sessions to collaboratively determine the best path forward for the product.

Senior Manager – Digital Product

Underwriter

• As Manager, you will function as a Product Owner responsible for understanding PBM pricing and forecasting tools and providing business user support to resolve questions and problems.
• Responds to Production Support tickets, isolates root cause, and determines path to resolution.
• Facilitates best practice user training exercises
• Suggests and prioritizes product improvements based on materiality
• Communicates to business users and other ecosystem stakeholders using professional and customer service focused demeanor
• Leverages understanding of the business to ensure product requirements are accurately captured and communicated
• Develops tools and procedures to create efficiencies in areas such as testing and defect resolution
• Assists with UAT and broader testing efforts to minimize future defects stemming from initial development
• Develops financial analyses to support future modeling improvements
• Designs technical solutions and reporting capabilities addressing Business issues and concerns.

Manager, Underwriting Model Product Support

Production Engineer

• Lead resolution of critical production incidents for enterprise integration systems
• Own root cause analysis and drive permanent fixes
• Define, track, and report on service metrics and KPIs
• Establish and enforce integration support standards
• Provide technical leadership to the support team

Senior Application Production Support Engineer

Operations

• Takes in-bound calls from providers, pharmacies, members, etc.
• Provides professional and courteous phone assistance to all callers through the criteria-based prior authorization process.
• Maintains complete, timely, and accurate documentation of reviews.
• Transfers all clinical questions, escalations, and judgment calls to the pharmacist team.
• Assists with duties such as outbound calls, reviewing and processing Prior Auths received via fax and ePA, monitoring inquiries via department mailboxes.

Tech I – Prior Authorization Operations

• Assessing, planning, coordinating, and implementing comprehensive case management services to support members’ medical, functional, and social needs.
• Conducting holistic assessments using clinical tools, data review, and member interviews to determine needs, benefit eligibility, and care coordination requirements.
• Developing individualized care plans to address medical, behavioral, and social factors impacting member health.
• Identifying risk factors, barriers, and opportunities to improve wellness and reduce health complications.
• Collaborating closely with internal and external partners to support seamless transitions into Aetna programs and services.
• Reviewing claims history and clinical information to guide care decisions and evaluate potential case management impact.
• Presenting complex cases in multidisciplinary conferences and consulting with supervisors to overcome barriers to goals.
• Ensuring compliance with company policies, regulatory requirements, and case management standards.
• Using effective interviewing and engagement techniques to understand member needs and encourage active participation in their care plan.

Case Manager, Registered Nurse – Field

• Serve as the main point of contact for clients, third‑party auditors, and internal teams.
• Manage all phases of audits from kickoff through completion.
• Review and respond to auditor questions, including those related to pharmacy rebates.
• Investigate issues, resolve discrepancies, and communicate outcomes.
• Track audit progress, deliverables, and timelines.
• Identify process improvements and control gaps, and escalate concerns to senior leaders.
• Maintain accurate documentation and correspondence.
• Support internal partners and keep client disruptions to a minimum.

Manager, Client Audit

General Counsel

• Provide strategic legal counsel to internal business partners regarding Federal and state healthcare and privacy regulations
• Proactively advise business partners on a variety of legal matters related to pharmacy and pharma services, data analytics, health insights, and other health services solutions
• Identify business and legal risks and work with the business to provide solutions that balance legal compliance and business objectives
• Collaborate with other attorneys/partners on legal and regulatory compliance matters

Legal Counsel – Privacy

Backend Engineer

• Design, develop, and maintain high-quality, reusable reference libraries, frameworks, and foundational services that empower application teams to build scalable and robust solutions (e.g., common patterns for Kafka integration, gRPC/Protobuf communication, and Role-Based Access Control (RBAC)).
• Create comprehensive, documentation-first resources, examples, and templates that serve as blueprints for engineering teams.
• Collaborate closely with product-aligned engineering teams to understand their needs and ensure enablement solutions are practical, maintainable, and widely adopted.
• Contribute to fostering a culture of technical excellence, standardization, and continuous improvement across the engineering organization.
• Provide guidance and support to engineering teams on the effective adoption and utilization of enablement tools and libraries.
• Independently drive the design, development, and delivery of reusable tools and libraries from conception to completion, effectively managing project scope and communicating progress.

Principal Software Development Engineer – Golang

• Serve as the single point of contact responsible and accountable for health outcomes and equity within ABHLA and the provider network.
• Oversee Health Outcomes accreditation, Health Equity Task Force, and Cultural and Appropriate Linguistic Committee.
• Responsible for staff health equity training, annual health equity strategy and evaluation.
• Collaborate with providers, local and state government, community-based organizations to impact health disparities.
• Informs decision-making around best payer practices related to disparity reductions.

Senior Manager, Health Outcomes – Equity

Technical Product Manager

• Engage with business partners and teams, balancing priorities and negotiating solutions.
• Partner with designers, developers, and business leaders to drive successful product delivery.
• Champion user needs, foster engagement, and refine products based on data-driven insights.
• Prioritize development efforts, write clear user stories, and track performance metrics.
• Ensure security standards, regulatory adherence, and proactive risk management.
• Lead cross-functional collaboration for complex efforts, ensuring alignment across teams, managing dependencies, and driving efficient execution at scale.
• Collaborate with third-party vendors, ensuring seamless integration and value-driven partnerships.
• Evaluate product performance in terms of revenue, cost, and operational efficiency, tying decisions to business outcomes.
• Lead adoption strategies and provide user support for new features and solutions.
• Mentor peers in execution best practices and optimize workflows for scalability and impact.

Technical Product Manager – Member Management

• Nurse Case Manager is responsible for face to face and telephonically assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness.
• Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration.
• Conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans.
• Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.
• Reviews prior claims to address potential impact on current case management and eligibility.
• Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.