CVS Health

Manager

• Lead and manage the QA team by setting strategic objectives
• Ensure implementation of effective quality assurance processes
• Collaborate with cross-functional teams to define testing requirements
• Develop test plans and ensure timely, thorough testing of software products
• Analyze testing metrics and provide reports to stakeholders
• Drive continuous improvement in QA practices
• Deliver high-quality and reliable software solutions

Manager, Quality Management

Account Manager

• Assess overall network composition and potential provider partners
• Identify and service partnerships that advance and differentiate the OhioRISE Network
• Execute, service, and potentially negotiate contracts with local market providers
• Establish and maintain productive relationships with assigned providers and internal business partners
• Partner in developing business strategy and programs supporting operational plans
• Resolve escalated issues and projects for assigned provider systems
• Monitor performance and adherence to scorecards and payout schedules
• Educate internal and external parties on contract policies, plan design, compensation processes, technology, and performance measurement
• Meet periodically with key providers to ensure service levels meet expectations
• Develop agendas, validate materials, and facilitate external provider meetings
• Collaborate on implementation of large provider systems, cost-driver management, data reports, and cost initiatives
• Drive provider engagement and recruit providers as needed to achieve network expansion and adequacy targets
• Assist with strategic network configuration and integration activities
• Serve as a subject matter expert for less experienced team members and internal partners

Provider Network Relationship Manager

Content Marketing Manager

• Translate complex concepts and processes into compelling, easy-to-follow designs with exceptional content
• Conduct UX research and champion data science to understand user behavior and uncover opportunities to reach customers with appropriate content and reduce friction
• Create content and design ecosystems across multiple channels, devices and touchpoints throughout user journeys
• Challenge existing design patterns and advocate for new approaches when appropriate
• Collaborate with designers, product managers and diverse business stakeholders to inform requirements and optimize content and user journeys
• Lead content strategists/designers in developing user stories and prioritizing work
• Facilitate workshops and design critiques
• Own content reviews and iterations across product, legal and other stakeholders
• Mentor junior colleagues as needed

Senior Content Designer

• Lead, coach, and develop Certified Coding Analysts and Senior Certified Coding Analysts
• Establish role expectations, performance goals, productivity standards, quality requirements, and accountability measures
• Oversee hiring, onboarding, training, succession planning, engagement, and retention
• Provide operational oversight for medical record reviews, coding audits, reconsiderations, appeals, and waste and error activities
• Assign priorities and manage work queues to meet production, turnaround time, quality, and service-level expectations
• Monitor workload, staffing capacity, inventory, aging, productivity, and resource allocation
• Ensure accurate application of CPT, HCPCS, ICD-10, modifier, CMS, state, federal, and organizational requirements
• Oversee escalations for complex coding questions, policy interpretation, Medical Director review, and case decisions
• Establish and monitor quality review processes; implement coaching, training, and corrective action plans
• Maintain compliance with state, federal, contractual, accreditation, and organizational requirements
• Support internal and external audits, regulatory reviews, and documentation requests
• Develop and monitor KPIs for productivity, quality, inventory, turnaround time, savings, and operational outcomes
• Analyze performance, coding trends, billing issues, and root causes to identify improvements
• Present operational updates, performance results, risks, decisions, and recommendations to leadership and business partners
• Drive process standardization, workflow improvements, automation, system enhancements, and resource optimization
• Participate in system implementations, upgrades, pilots, and new program launches
• Collaborate with Senior Leadership, Medical Directors, Legal, Compliance, Analytics, Operations, Technology, and Payment Integrity partners
• Serve as management escalation point for complex cases, operational barriers, coding disputes, and stakeholder concerns
• Represent the Waste & Error coding team in governance meetings, business reviews, implementations, and strategic initiatives

Manager, W&E Professional Coding

Full-stack Engineer

• Design, deliver, and operate business-critical distributed systems
• Build and sustain innovative solutions
• Develop a unified technology platform for value-based care
• Ship and operate large-scale systems using full-stack development
• Participate in distributed systems design, implementation, and operation at scale
• Collaborate as a key member of a technically strong, entrepreneurial, and collaborative team

Staff Software Development Engineer

• Design, develop, and implement AI solutions and systems
• Architect and code software applications
• Conduct system testing and debugging
• Collaborate with cross-functional teams
• Contribute to the technical direction and innovation of AI engineering projects
• Define and implement AI safety frameworks
• Lead engineering teams and drive technical roadmaps

Senior Software Development Engineer – AI Engineering

Accounting Manager

• Lead accounting operations across payroll, service operations, clinical accounting, and the financial close process
• Manage and develop accounting professionals, including offshore team members
• Improve efficiency through process standardization, automation, and continuous improvement initiatives
• Oversee month-end, quarter-end, and year-end close activities, ensuring accuracy and compliance
• Partner with Finance and business leaders to solve accounting issues and enhance processes
• Lead transformation projects, including workflow automation and SAP S/4HANA initiatives
• Use data and analytics to improve reporting, controls, and decision-making
• Coach and mentor team members to build a strong, high-performing organization
• Identify opportunities to simplify processes and implement scalable solutions

Senior Manager – Accounting Center of Excellence

General

• Provide primary care services in a regional field-based role
• Support CVS Health’s mission to deliver connected, convenient, and compassionate health care
• Help simplify health care for individuals, families, and communities

Regional Primary Care Provider

QA Automation Engineer

• Design, develop, test, and maintain automation solutions using Visual Basic (VB) scripting and related technologies
• Create, modify, and support complex Microsoft Excel macros and VBA-based automation tools
• Develop and maintain automations within Boston Workstation to improve operational performance and productivity
• Review claim data and quality assure claim examples in Athena Health
• Utilize Python and coding to implement automation via web-based platforms and applications
• Troubleshoot automation issues, identify root causes, and implement sustainable solutions
• Partner with revenue cycle leadership and operational teams to identify workflow automation and process improvement opportunities
• Provide technical support and customer service to call center representatives and other end users
• Collaborate with stakeholders to gather requirements and translate business needs into technical solutions
• Support insurance overpayment and patient refund check processing
• Manage and monitor file transfers using SFTP and related technologies
• Work with Cognizant and other revenue cycle platforms to support operational initiatives
• Maintain documentation for automation processes, workflows, and technical solutions
• Ensure compliance with organizational policies, data security standards, and healthcare regulations

Automation Developer, Revenue Cycle Systems Analyst

Data Analyst

• Own 837 file transmissions to the states
• Manage and act on state response files
• Ensure all transmitted transactions are complete and error free
• Manage and complete error corrections to meet state requirements

Encounter Data Analyst – DSNP

Therapist

• Provide mental health therapy and psychosocial support for individuals, couples, and families ages 13+
• Practice at the top of license with support from the clinical care team
• Build and grow the Minute Clinic practice
• Use assessment and treatment planning tools to support continuity of care
• Deliver evidence-based short-term counseling and treatment
• Collaborate on patient care and provide education addressing mental wellbeing
• Support clients in Washington state and/or California

Mental Health Therapist

Director

• Serve as the dedicated relationship owner and single point of accountability for stop loss carrier management, escalation resolution, governance, and operating discipline
• Establish decision rights, escalation pathways, and enterprise guardrails for stop loss funding decisions, risk acceptance, reimbursement issues, and carrier disputes
• Lead cross-functional coordination across operations, finance, claims, legal, underwriting, account management, compliance, and carrier partners
• Improve reimbursement performance by managing aged receivables, high-cost claim escalations, documentation requests, audit friction, and delayed carrier responses
• Develop and maintain a structured carrier management model
• Partner with senior leaders to identify financial and operational risk, assess exposure, recommend mitigation strategies, and support decision-making
• Create standardized reporting and executive visibility into stop loss performance, reimbursement delays, dispute trends, escalation status, carrier responsiveness, and financial exposure
• Identify process gaps and root causes; implement scalable solutions to reduce manual work, improve cycle time, and increase consistency
• Lead governance forums, carrier reviews, and internal stakeholder updates
• Translate complex operational, financial, and carrier issues into executive-ready summaries, recommendations, and decision points
• Build internal and external relationships to improve accountability, reduce friction, and support long-term business growth
• Promote ownership, disciplined execution, collaboration, and continuous improvement

Lead Director, Stop Loss Relationship Management

• Design, develop, and maintain backend services and APIs for the Health100 AI-native health technology platform
• Ensure releases are well-coordinated, fully prepared, and successfully deployed to production
• Partner with technical leaders and the open-source community on technical designs, frameworks, roadmap definition, and requirements gathering
• Provide domain knowledge and engineering insight to guide early designs and technical execution
• Maintain engineering excellence and build reliable distributed systems
• Execute the path from prototype to production for features
• Collaborate with business, product, architecture, security, digital, and engineering teams
• Contribute to automation initiatives and support high-performing remote teams
• Monitor production, triage issues, coordinate across teams, and drive operational excellence

Senior Software Engineer – Java Cloud

• Negotiate, execute, review, and analyze contracts and handle dispute resolution and settlement negotiations with providers
• Collaborate cross-functionally on provider compensation, pricing development, contractual information, negotiation, and reimbursement modeling
• Identify and manage cost issues and execute cost-saving initiatives
• Represent the company with customers and community groups
• Manage contract performance against network quality, availability, and financial goals
• Recruit providers to achieve network expansion and adequacy targets
• Contribute to provider compensation and pricing recommendations and analyze related reports
• Provide network development, maintenance, and refinement strategies for cross-market network management
• Assist with strategic network configuration design, development, management, and implementation, including integration activities
• Manage relationships with assigned providers and internal business partners
• Resolve escalated issues involving claims payment, contract interpretation, and provider contract or demographic information
• Interpret contractual requirements, including federal and state regulations and NCQA

Senior Contract Manager

• Negotiate, execute, review, and analyze contracts and handle dispute resolution and settlement negotiations with providers
• Manage contract performance in support of network quality, availability, and financial goals
• Recruit providers to achieve network expansion and adequacy targets
• Collaborate on provider compensation, pricing development, contractual information, negotiation, and reimbursement modeling activities
• Identify cost issues and recommend cost-saving initiatives and settlement activities
• Provide network development, maintenance, and refinement strategies for cross-market network management
• Assist with strategic network configuration, integration, and implementation activities
• Optimize interactions with assigned providers and internal business partners
• Resolve escalated issues involving claims payment, contract interpretation, and provider contract or demographic information
• Interpret contractual requirements, including federal and state regulations and NCQA