CVS Health

General

• Provide in-home health evaluations in members’ private residences
• Engage with members and build trusted relationships
• Review medications and medical histories
• Perform physical evaluations
• Provide additional diagnostic and preventive services, including diabetic eye exams, spirometry, and bone density screening
• Conduct virtual visits as needed
• Travel locally and within licensed states as needed
• Help identify connections to appropriate care and bridge gaps in care
• Use an iPad and intuitive clinical workflow for each evaluation
• Avoid prescribing medication, ordering lab tests, or altering current treatment regimens

In Home NP/PA – Part Time

• Provide Part Time In-Home Health Evaluations in members’ homes
• Conduct approximately 45-minute visits including medication and medical history review and physical evaluation
• Perform additional diagnostic tests when ordered by the health plan, including diabetic eye exams, spirometry, and bone density screening
• Use an iPad and clinical workflow for each evaluation
• Answer health questions and provide health education
• Visit people nationwide to connect them with appropriate care
• Conduct virtual visits as needed
• Provide Signify Health services, including Diagnostic & Preventive Services products
• Travel locally and within licensed states as needed

Manager

• Coordinate effective resolution of member and/or provider/practitioner appeals, complaints, and grievances
• Manage staff day to day to ensure effective and timely resolution across all products
• Coordinate responses from multiple business units for complex issues
• Implement Aetna's appeals, complaints, and grievances policies and procedures
• Identify trends and issues; report on and recommend solutions
• Meet financial, operational, and quality objectives of the unit
• Manage team productivity, resources, workload, and customer satisfaction
• Serve as a content model expert and mentor on policies, procedures, regulatory, and accreditation requirements
• Manage performance measures and standards; coach team members
• Participate in staff selection using education, experience, technical, and performance requirements
• Build functional teams through training, assignments, coaching, and mentoring
• Assess developmental needs and implement team and individual development plans
• Ensure work meets federal and state requirements and quality measures for letter content and turnaround time
• Hold individuals and teams accountable for results and recognize or reward performance
• Lead change efforts and manage team transitions
• Research and route incoming electronic appeals, complaints, and grievances
• Research plan design or certification of coverage to assess benefit or administrative denials
• Research claim processing logic, eligibility data, and billing/payment status
• Identify and research all components of member or provider/practitioner appeals, complaints, and grievances
• Carry a modified case load and perform additional assigned duties

Medicaid Appeals & Grievance Associate Manager

Software Engineer

• Design, develop, and enhance automation solutions based on defined business requirements and processing rules
• Translate functional requirements into technical logic for scalable automation workflows
• Perform unit testing, system testing, and validation before deployment
• Support production deployments, including release readiness, implementation, and post-production monitoring
• Troubleshoot and resolve defects, errors, and performance issues in production automation processes
• Maintain and enhance existing automation solutions to improve efficiency, accuracy, and throughput
• Monitor automation performance and system health and identify optimization opportunities
• Ensure adherence to technical standards, coding practices, and control requirements
• Partner with Process/Governance teams to evaluate the technical feasibility of automation opportunities
• Collaborate with Supervisors and Operations teams to align solutions with execution needs
• Support First Pass and Rework automation lanes
• Execute technical solutions based on validated and approved designs rather than defining business processes or requirements

Senior Manager, Rocket Application Developer

• Facilitate delivery of appropriate benefits and healthcare information to determine benefit eligibility
• Promote wellness activities
• Develop, implement, and support health strategies, tactics, policies, and programs
• Support delivery of benefits, overall member wellness, and successful and timely return to work
• Perform assessment, planning, facilitation, care coordination, evaluation, and advocacy
• Coordinate options and services addressing individuals’ and families’ comprehensive health needs
• Communicate with members, providers, and community organizations
• Use available resources to promote quality and cost-effective outcomes
• Collaborate with Community Care teams in a member-centric, team-delivered, community-based care management model

Case Manager, RN – Compact License

Call Center Representative

• Contact Medicare Advantage and Medicaid health plan members by phone
• Offer, explain, and schedule free in-home or virtual healthcare evaluations
• Make an average of 50 outbound calls per hour using an automatic dialer
• Follow 20+ approved scripts and respond persuasively to rebuttals
• Meet department productivity, quality, customer service, appointment, dialing, shift, and attendance goals
• Adjust, reschedule, and cancel appointments with members and contracted providers
• Monitor appointments, calls, handle time, and productivity using reporting systems
• Report member complaints and escalations to Member Engagement Managers
• Participate in peer side-by-side coaching
• Follow HIPAA and security/privacy guidelines when handling protected health information
• Report to a Member Engagement Manager

Outbound Sales Call Center Representative

Customer Support

• Serve as the first point of contact for members seeking emotional support, behavioral health resources, and employee assistance services through Aetna's Resources for Living Employee Assistance Program
• Respond to member inquiries through phone, video, and live chat
• Assess member needs and connect individuals to appropriate behavioral health, employee assistance, and community resources
• Provide information, guidance, referrals, and benefit education
• Recognize warning signs, de-escalate challenging situations, and facilitate clinical transfers when appropriate
• Support members and their families while adhering to program policies and service standards
• Accurately document interactions and maintain confidentiality
• Navigate multiple systems simultaneously in a fast-paced, service-focused environment
• Work Saturday through Wednesday, 1:00 PM–9:30 PM EST

Employee Assistance Program Customer Support Associate

Procurement

• Lead strategic category partnerships across Merchandising, Marketing, Loyalty, Personalization, Analytics, Sales, Partner Management, and other enterprise teams
• Develop category growth strategies, integrated programs, tentpole strategies, and commercialization opportunities
• Create category stories, consumer insights, strategic points of view, sales engagements, and innovation roadmaps
• Lead complex cross-functional initiatives from concept through execution
• Establish best practices, facilitate knowledge sharing, and create scalable ways of working
• Evaluate emerging business opportunities, category trends, and market dynamics
• Develop business cases, strategic recommendations, and commercialization frameworks for new products and integrated solutions
• Navigate operational readiness, legal review, measurement strategy, and change management
• Create sales stories, multi-supplier campaign initiatives, programs, and collateral
• Translate market opportunities into innovative solutions that drive supplier investment, revenue, and measurable business outcomes
• Report to the Director of Core and Category Marketing

Senior Manager, Category Marketing – CVS Media Exchange

Operations

• Support relationships with health plan partners through prompt and accurate follow-up
• Respond to ad-hoc reporting and deliverables for internal and external stakeholders
• Pull data and conduct thorough analysis
• Maintain client marketing materials, recurring metrics, and support information
• Capture accurate notes and follow-up items for client calls
• Ensure deliverables are posted on time according to client requirements
• Support complex, high-volume, national clients
• Develop and implement strategic programs and projects aligned with healthcare business objectives
• Define program goals, scope, and success metrics with leadership
• Lead cross-functional project teams throughout the project lifecycle
• Partner with internal teams on client program objectives
• Meet regularly with stakeholders and clients regarding requirements and deadlines
• Organize and present KPIs
• Execute client SLAs for reports, deliverables, and member feedback
• Assist with reconciliation efforts to meet or exceed SOW requirements
• Document client meetings, including data entry, minutes, and action items
• Oversee client marketing materials and direct mail campaigns
• Monitor success and complete ad-hoc reporting projects
• Perform quality assurance and report manipulation based on client requirements
• Communicate updates and escalations
• Submit and track tickets for client requests
• Track, document, and formulate responses for member grievances
• Provide account coverage for the Client Success Executive or Manager

Senior Client Operations Analyst

• Respond to member inquiries through phone, video, and live chat
• Assess member needs and connect individuals to behavioral health, employee assistance, and community resources
• Provide information, guidance, referrals, and benefit education
• Recognize warning signs, de-escalate challenging situations, and facilitate clinical transfers when appropriate
• Support members and their families while adhering to program policies and service standards
• Accurately document interactions and maintain confidentiality
• Navigate multiple systems simultaneously in a fast-paced, service-focused environment

Employee Assistance Program – Work-life Customer Support Associate

Engineering Manager

• Provide strategic leadership and oversee the digital engineering function
• Manage a team of engineers and foster innovation and collaboration
• Define technical strategies and roadmaps aligned with business goals
• Oversee digital engineering projects and ensure delivery within scope, budget, and timeline
• Contribute to long-term plans, technology adoption strategies, and innovation initiatives
• Guide teams on best practices, optimize development processes, and resolve technical challenges
• Collaborate with senior leadership to define digital engineering strategy and roadmap
• Participate in the design and architecture of digital solutions
• Engage business leaders, clients, and partners to gather requirements and manage expectations
• Establish quality assurance processes and standards
• Drive continuous improvement and optimize development workflows
• Provide guidance, mentorship, and professional growth support to digital engineers

Senior Manager – Software Development Engineering

DevOps Engineer

• Lead technical implementation, migration, automation, mobile application security and standardization across the Health 100 portfolio
• Support application onboarding and security enablement for Health 100 initiatives
• Help development teams meet security requirements through standard tooling, pipeline integration and repeatable implementation patterns
• Translate release-readiness expectations into repeatable technical patterns and evidence
• Enable mobile application security testing, secure configuration validation and remediation guidance
• Lead DevSecOps implementation initiatives, including technical planning, architecture, delivery, issue resolution and implementation outcomes
• Coordinate across application, platform and security teams to remove blockers and sustain adoption
• Design, implement and improve CI/CD security controls, pipeline enforcement and automated scanning workflows
• Build self-service security solutions and reusable automation
• Automate secret-detection and CI/CD security workflows, including Gitleaks or comparable capabilities
• Lead security-tool migrations such as Checkmarx to Snyk through stable production operation
• Produce and validate post-migration scan results
• Standardize tooling configurations across development teams
• Drive remediation of critical and high-risk vulnerabilities and monitor remediation against SLAs
• Lead prioritization of open-source and software supply chain exposures
• Improve SBOM coverage and secure-by-default dependency usage
• Engineer controls for public cloud, containers, Kubernetes, Security-as-Code and Infrastructure-as-Code environments
• Apply network-security, cloud-architecture and mobile-security expertise to assess risks and guide remediation
• Track and report scan coverage, mobile testing coverage, vulnerability aging, SLA adherence, remediation effectiveness, automation adoption, tool coverage and pipeline compliance
• Provide executive-ready updates on implementation progress, delivery risk and measurable security outcomes
• Mentor engineers, establish reusable engineering patterns and create implementation guidance and education

Staff DevSecOps Engineer, Health

Consultant

• Review and assess clinical information to support utilization and coverage determinations
• Collaborate with providers, care teams, and internal partners to facilitate appropriate treatment and care plans
• Identify opportunities for care management referrals and member support programs
• Promote quality, cost-effective healthcare outcomes
• Serve as a clinical resource for utilization and benefit management activities
• Communicate with providers and apply evidence-based criteria and clinical judgment
• Support effective, high-quality healthcare services for members
• Work in a remote/office-based environment with extensive computer and telephone use
• Navigate multiple systems and multitask in a sedentary desk-based role

Utilization Management Nurse Consultant

Product Manager

• Lead the Pharmacy Services DDAT Product team and a team of product management professionals
• Advance the product management practice and build a high-performing team
• Shape the strategic direction and execution of multiple technology product lines
• Define desirable, viable, feasible, and sustainable technology solutions that meet customer needs and business objectives
• Facilitate cross-functional product leadership teams with business, technology, analytics, and other stakeholders
• Establish product portfolio visions, strategies, and roadmaps aligned with business objectives
• Make investment-priority decisions and develop business cases with business, value pool, and finance partners
• Align roadmaps, backlogs, capacity, timelines, and commitments across product areas
• Set and manage product-line and portfolio OKRs
• Ensure teams use OKRs, KPIs, and data to evaluate product health and performance
• Oversee new product launches, beta testing, user feedback collection, and product documentation
• Partner with business and customer insight teams to understand market trends, competitive landscapes, and customer needs
• Ensure technology product teams deliver final outputs to stakeholders
• Mature the product operations framework and promote product operations best practices
• Develop, mentor, and coach team members
• Conduct performance evaluations and identify competency and career-growth opportunities
• Champion product and agile mindsets and values
• Create a customer-centric culture focused on product performance, opportunities, north-star vision, and product health metrics

Associate Vice President – Technology Product Management

• Define the strategic approach for third-party vendor integrations across the portfolio
• Identify business requirements and operational considerations for new and existing vendor models
• Determine setup strategies and dependencies across pricing, claims, billing, and related processes
• Translate business needs into integration recommendations and execution direction
• Own and maintain the inventory of third-party vendors enabled for integration
• Maintain portfolio visibility as vendors, products, and business needs evolve
• Coordinate updates and assess implications of vendor changes across stakeholders
• Serve as the Sales organization’s point of contact for new vendor integration requests
• Assess intake requests and guide cross-functional evaluation of business need, feasibility, and setup approach
• Move new opportunities from intake through recommendation and readiness
• Create field communications and provide guidance on integration models, business rules, and plan sponsor nuances
• Serve as the central point of contact for production questions and plan sponsor requests
• Lead cross-functional production issue resolution and drive follow-through across product, operational, and support teams

In Home NP/PA – Part Time

In Home NP/PA – Part Time

Medicaid Appeals & Grievance Associate Manager

Senior Manager, Rocket Application Developer

Case Manager, RN – Compact License

Outbound Sales Call Center Representative

Employee Assistance Program Customer Support Associate

Senior Manager, Category Marketing – CVS Media Exchange

Senior Client Operations Analyst

Employee Assistance Program – Work-life Customer Support Associate

Senior Manager – Software Development Engineering

Staff DevSecOps Engineer, Health

Utilization Management Nurse Consultant

Associate Vice President – Technology Product Management

Senior Manager, Product Strategy and Management – Third Party Vendor Integrations