CVS Health

Pharmacist

• Deliver compassionate care to patients and customers
• Support medication needs and regulatory compliance standards
• Maintain ethical conduct and patient confidentiality
• Manage assigned pharmacy workstations and tasks
• Promptly, safely and accurately fill patient prescriptions
• Provide caring service that exceeds customer expectations
• Work in compliance with Federal, State and Local laws and regulations
• Build clinical, technical and insurance knowledge through available tools and training

Pharmacy Technician

Care Coordinator

• Oversee operational aspects of the Utilization Management team’s activities
• Identify opportunities to streamline and optimize utilization management workflows
• Improve efficiency and reduce administrative burden
• Collaborate and communicate with internal departments, external partners, and vendors
• Navigate efficiently between multiple electronic platforms
• Meet standard performance and quality metrics
• Perform other duties as required and assigned
• Interact with UM physician reviewers, external payer partners, and vendors
• Report to and work alongside the Manager of Operations, Utilization Management

Care Coordinator, Utilization Management

Manager

• Manage relationships with assigned strategic providers
• Serve as a primary point of contact for provider operational issues, inquiries, and escalations
• Investigate and resolve complex provider concerns involving claims, rework, appeals, provider data, credentialing, and reimbursement
• Partner with Claims, Appeals, Operations, Provider Data, Credentialing, Medical Management, and Contracting teams
• Analyze provider service trends, operational performance, and issue root causes
• Support provider performance initiatives related to quality, access, operational efficiency, and member experience
• Educate providers on health plan programs, administrative processes, self-service tools, and operational requirements
• Support value-based care initiatives through provider engagement, education, and operational support
• Assist with network adequacy activities, provider recruitment, and regulatory initiatives
• Research and respond to provider complaints, disputes, executive escalations, and regulatory inquiries
• Monitor provider issues through resolution and communicate status updates
• Support implementation of network and operational initiatives affecting providers
• Prepare provider-facing materials, business summaries, issue analyses, and leadership updates
• Ensure compliance with contractual requirements, regulatory standards, and company policies
• Support special projects and cross-functional initiatives

Manager, Provider Relations – National Health Systems

• Support the pharmacy team in delivering operational and service excellence within the store
• Assist patients and customers as a first point of contact and provide exceptional service
• Follow pharmacy workflow procedures at production, pick-up, drive-thru, and drop-off workstations
• Fill prescriptions promptly, safely, and accurately according to SOPs and best practices
• Provide empathetic and personalized patient service, solve or escalate patient problems, and offer immunizations and other services where permitted
• Complete inventory activities including medication deliveries, cycle counts, returns-to-stocks, and waiting bin inventories
• Remain flexible for scheduling and business needs, including voluntarily traveling to market stores for shifts
• Comply with pharmacy laws, controlled substance requirements, patient privacy, and security policies
• Deliver additional services such as immunizations, point-of-care testing, and offsite clinics where legally permitted and appropriately trained
• Where permitted, obtain Technician Immunizer status, prepare and administer vaccines, educate patients, monitor adverse reactions, document patient information, and manage vaccine supplies
• Perform additional tasks as directed by a Supervisor or Manager

Business Analyst

• Coordinate care to support optimal member health outcomes
• Provide education and facilitate access to appropriate healthcare services
• Use care management tools and data analysis to assess member needs and identify risks
• Develop and implement effective care plans
• Collaborate with internal teams, providers, and external resources to address barriers
• Improve quality of care and ensure services align with member benefits
• Promote member engagement, informed decision-making, and healthy behavior changes through communication, coaching, and motivational techniques
• Monitor care plan progress
• Document activities
• Ensure compliance with regulatory standards, company policies, and quality management guidelines

Case Management Analyst – Field

Full-stack Engineer

• Design, develop, and support Hyperion Planning, Financial Management (HFM), Essbase, Financial Reporting (FR), and Smart View solutions
• Develop and maintain interactive Power BI dashboards, reports, and semantic data models
• Collaborate with Finance, Accounting, and Business teams to gather reporting and planning requirements
• Perform data integration, validation, reconciliation, and financial data analysis
• Optimize reporting processes and automate manual financial reporting activities
• Support month-end, quarter-end, annual planning, forecasting, and budgeting cycles
• Troubleshoot system issues and provide user support for Hyperion and Power BI platforms
• Ensure compliance with enterprise data governance, security, and audit requirements
• Partner with cross-functional teams to drive reporting modernization and continuous improvement initiatives

Senior Software Development Engineer

• Support the pharmacy team in delivering operational and service excellence
• Serve as an initial point of contact for patients and customers
• Follow company SOPs and pharmacy workflow procedures across production, pickup, drive-thru, and drop-off workstations
• Help ensure prescriptions are filled promptly, safely, and accurately
• Provide caring, empathetic, and personalized patient service in person and by phone
• Offer immunizations and other services at the register and over the phone where permitted
• Resolve or escalate patient problems
• Complete inventory activities, including medication deliveries, cycle counts, returns-to-stocks, and waiting-bin inventories
• Expand clinical and technical knowledge and contribute to a high-performing team
• Remain flexible for scheduling and business needs, including traveling to other market stores for shifts
• Comply with federal, state, and local laws, regulations, professional standards, ethical principles, and CVS policies
• Deliver additional services such as immunizations, point-of-care testing, and offsite clinics where lawful and properly trained
• Where permitted, obtain Technician Immunizer status and prepare and administer vaccines
• Educate patients about vaccines and refer vaccination questions to the Pharmacist-on-duty
• Monitor and respond to adverse vaccine reactions and report events
• Review and document patient information and manage vaccine supplies
• Perform additional tasks assigned by the Supervisor or Manager

General

• Engage telephonically with members for 50–75% of the day and coordinate their care
• Conduct annual Health Risk Assessment Surveys
• Address social determinants of health needs and close preventive and health maintenance care gaps
• Conduct outreach to hard-to-reach members using available resources
• Develop individualized care plans with members
• Document care management activities in members’ electronic health records
• Collaborate with the Interdisciplinary Care Team to address barriers to care
• Identify and connect members with health plan benefits and community resources
• Meet regulatory requirements within specified timelines
• Consult with and leverage the Care Manager RN’s clinical expertise
• Support team objectives, operational efficiency, high-quality care, special projects, process improvement, and mentoring

Care Management Specialist

Nurse

• Support members throughout Essex County and nearby areas
• Conduct in-home, face-to-face assessments for members enrolled in Managed Long-Term Services and Supports and Dual Special Needs Programs
• Evaluate member needs and coordinate adult/pediatric medical day care, personal care assistant services, nursing facility placement, and MLTSS program enrollment
• Partner with members, caregivers, PCPs, and interdisciplinary teams to develop and implement individualized care plans
• Authorize services in alignment with program guidelines
• Support safe transitions of care
• Document all case activity accurately and promptly in the electronic health record
• Apply clinical judgment and critical thinking to manage complex care needs
• Mentor new team members once proficiency is achieved

Registered Nurse Case Manager – Field

• Coordinate care for Special Needs Plan members, particularly those with social determinants of health needs and stable health conditions
• Complete annual Health Risk Assessment Surveys and address social determinants of health needs
• Close gaps in preventive and health maintenance care
• Engage members telephonically for 50–75% of the day
• Conduct outreach to hard-to-reach members
• Develop individualized care plans with members
• Document care management activities in members’ electronic health records
• Collaborate with the Interdisciplinary Care Team to address barriers to care
• Connect members with health plan benefits and community resources
• Meet regulatory requirements within specified timelines
• Consult with and leverage the Care Manager RN’s clinical expertise
• Support team objectives, operational efficiency, special projects, process improvement, and mentoring of new team members

Data Engineer

• Lead the design and implementation of a near real-time transactional cache platform supporting APIs, applications, and digital experiences
• Design and support CDC pipelines replicating data from UniVerse into PostgreSQL using vendor-supported replication technologies
• Develop and maintain transformation pipelines converting operational relational data into optimized MongoDB document structures
• Design and evolve MongoDB document models, indexing strategies, partitioning approaches, and query patterns for high-throughput, low-latency API consumption
• Partner with API and application development teams to define and deliver cache-ready domain models
• Establish data freshness, latency, monitoring, and availability standards
• Optimize PostgreSQL and MongoDB performance through schema design, indexing, query tuning, and capacity planning
• Own platform reliability, observability, troubleshooting, incident response, and operational support for production environments
• Develop operational runbooks, monitoring dashboards, alerting strategies, and support procedures
• Provide technical leadership across engineering teams and drive architecture and modernization initiatives
• Mentor engineers and establish engineering standards for CDC, operational data pipelines, and cloud-native data platforms

Staff Data Engineer

Operations

• Take inbound calls from providers, pharmacies, members, and other callers
• Provide professional and courteous phone assistance through the criteria-based prior authorization process
• Maintain complete, timely, and accurate documentation of reviews
• Transfer clinical questions, escalations, and judgment calls to the pharmacist team
• Make outbound calls as needed
• Review and process prior authorizations received via fax and ePA
• Monitor and respond to inquiries via department mailboxes
• Perform other duties assigned by the leadership team

Technician I, Prior Authorizations - Operations

• Leverage data, analytics, and business insights to support strategic decision-making and operational excellence across Retail Operations
• Partner with business stakeholders, product teams, and technical teams to translate complex business questions into analytical solutions and actionable recommendations
• Support data validation efforts
• Manage multiple initiatives and coordinate deliverables across stakeholders
• Develop executive-ready presentations and communications
• Communicate analytical findings to technical and non-technical audiences
• Bridge business and technical stakeholders while driving projects forward amid ambiguity
• Ensure data-driven products and insights are accurate, impactful, and aligned with business objectives

Senior Decision Scientist – Retail Operations

• Design, develop, and support a near real-time transactional cache platform supporting APIs, applications, and digital experiences
• Build and maintain CDC pipelines replicating data from UniVerse into PostgreSQL using vendor-supported replication technologies
• Develop and support transformation pipelines converting operational relational data into optimized MongoDB document structures
• Implement and support MongoDB document models, indexing strategies, partitioning approaches, and query patterns for high-throughput, low-latency API consumption
• Partner with API and application development teams to define and deliver cache-ready domain models
• Monitor and improve data freshness, latency, availability, and reliability of transactional cache workloads
• Optimize PostgreSQL and MongoDB performance through schema design, indexing, query tuning, and capacity planning
• Troubleshoot production issues and participate in operational support, incident response, and root cause analysis
• Develop and maintain operational runbooks, monitoring dashboards, alerting strategies, and support procedures
• Collaborate with architects, senior engineers, and cross-functional teams on scalable data platform solutions
• Contribute to engineering best practices, code reviews, documentation, and continuous improvement
• Mentor junior engineers and share knowledge related to CDC, data pipelines, and cloud-native data engineering

Senior Data Engineer

Business Intelligence Analyst

• Prepare quarterly, annual and audited statutory financial statements
• Prepare related supplementary filings for regulatory agencies
• Perform financial analytics on legal entities’ financial results
• Investigate unexpected fluctuations and understand underlying drivers and future expectations
• Network with business partners
• Assist in transforming CVS Health’s financial reporting processes into an automated, streamlined state
• Work across various company business units

Pharmacy Technician

Care Coordinator, Utilization Management

Manager, Provider Relations – National Health Systems

Pharmacy Technician

Case Management Analyst – Field

Senior Software Development Engineer

Pharmacy Technician

Care Management Specialist

Registered Nurse Case Manager – Field

Care Management Specialist

Staff Data Engineer

Technician I, Prior Authorizations - Operations

Senior Decision Scientist – Retail Operations

Senior Data Engineer

Analyst, Financial Reporting & Analysis – Statutory Reporting