CVS Health

Counselor

• Deliver on-demand, single-session consultations
• Conduct clinical assessments, action and safety planning, triage, and informational services
• Provide support through phone, video, and chat
• Use advanced technology platforms to connect members with appropriate solutions
• Type and document information accurately in real time
• Navigate intranet systems and tools to support call handling
• Use chat and instant messaging tools for team support
• Review email communications regarding plan sponsor information, process changes, and department information
• Multitask while engaging with members
• Protect member confidentiality under enterprise and EAP policies
• Maintain accurate, complete, and timely documentation meeting regulatory and risk management requirements

Clinical Counselor – Employee Assistance Program

Risk

• Support Inventory, Data Analytics, DC, and Merchandising partners through inventory initiatives from concept and pilot through testing, implementation, and benefit realization
• Own and maintain the rubric for evaluating inventory changes, including evidence standards, financial thresholds, and approval criteria
• Maintain audit trails for inventory parameter changes, policy decisions, and test outcomes
• Ensure Blue Yonder settings, WOS targets, safety stock, and other planning parameter changes follow governance protocols
• Scope problems, design tests or pilots, define measurement methodologies, track results, and synthesize recommendations
• Evaluate financial impacts including working capital, inventory investment, write-off risk, and in-stock performance
• Build and maintain analytical frameworks and models for repeatable inventory policy and system-change decisions
• Track inventory investment implications against expected outcomes
• Translate inventory decisions into financial language concerning working capital, margin, and service levels
• Connect internally developed applications with enterprise planning platforms such as Blue Yonder
• Advise partners on applicable tools, workflows, and data and decision flows
• Provide governance and analytics input into tool development and enhancement
• Identify tool connectivity gaps and recommend improvements
• Develop and maintain SOPs, process documentation, and decision frameworks
• Facilitate training on self-service tools and analytical resources
• Define and communicate when partners can work independently versus when F&R involvement is required

Inventory Analytics, Governance Manager

Nurse

• Conduct comprehensive in-home LTSS assessments to determine eligibility for waiver and community-based services
• Complete and submit required waiver documentation in accordance with state Medicaid and health plan guidelines
• Develop and implement individualized, person-centered plans of care addressing medical, behavioral, functional, and social determinant needs
• Apply clinical judgment to identify risk factors, prevent avoidable hospitalizations, and reduce barriers to care
• Coordinate services across interdisciplinary teams including providers, home health agencies, behavioral health, and community organizations
• Review claims data, clinical records, and assessment tools to evaluate member needs and benefit utilization
• Monitor member progress and reassess needs based on changes in condition or level of care
• Present cases at interdisciplinary team (ICT) meetings and collaborate with supervisors and stakeholders to ensure goal attainment
• Ensure compliance with Medicaid waiver requirements, CMS regulations, state LTSS guidelines, and company policies
• Document all case management activities in accordance with regulatory and accreditation standards
• Educate members and caregivers regarding benefits, services, and available community resources
• Serve as a frontline advocate for members and coordinate case management activities to support overall wellness

Case Manager, Registered Nurse – LTSS

Pharmacist

• Work in a leading retail pharmacy company serving patients and customers
• Manage assigned pharmacy workstations and tasks
• Promptly, safely, and accurately fill patient prescriptions
• Provide caring service that exceeds customer expectations
• Ensure medication needs and regulatory compliance standards are met
• Maintain professional and ethical standards and comply with Federal, State, and Local laws and regulations
• Demonstrate ethical conduct and maintain patient confidentiality
• Complete the CVS Pharmacy Technician Training Program
• Expand Pharmacy Technician duties after completing registration, licensing, and certification requirements
• Build clinical, technical, and insurance knowledge through available tools and training
• Support the pharmacy team in a fast-paced environment

Pharmacy Technician

Security Engineer

• Establish and maintain operational governance frameworks supporting Health100 and PCW Security & Infrastructure strategic priorities
• Define, document, and enforce operational standards, reporting processes, and organizational best practices
• Develop and maintain SOPs, operational playbooks, and governance documentation
• Own executive dashboards, KPI frameworks, scorecards, MORs, QBRs, and leadership reporting frameworks
• Define, track, analyze, and report KPIs covering organizational health, operational effectiveness, security performance, infrastructure reliability, delivery execution, risk management, and strategic objectives
• Partner with security, infrastructure, engineering, program management, business operations, data, and leadership teams on strategic initiatives
• Facilitate executive business reviews, operational reviews, leadership discussions, planning cycles, and strategic initiatives
• Analyze operational and business data, perform trend analysis, forecasting, benchmarking, scenario modeling, and performance assessments
• Leverage Power BI, Microsoft Fabric, Excel, SharePoint, and related technologies to provide data-driven visibility and decision support
• Manage action-item tracking, dependencies, risk mitigation, executive follow-through, communications, and information flow
• Maintain SharePoint sites, collaboration platforms, and knowledge management systems
• Provide mentorship, onboarding resources, operational documentation, and training materials
• Evaluate emerging security technologies, operational tools, automation opportunities, and AI-enabled solutions
• Support annual and quarterly planning, organizational goal setting, OKRs, strategic priorities, investment decisions, and operational roadmaps
• Create executive presentations, business cases, strategic narratives, and leadership communications
• Monitor strategic commitments and provide leadership visibility into performance, risks, and outcomes

Staff Security Engineer, Strategy & Operations

Analyst

• Support the daily processing of appeals in the Par Provider Dental Appeals
• Complete appeals determination letters
• Prepare dental requests
• Update systems
• Complete reporting as necessary
• Collaborate with clinical support staff, including Medical Directors, Nurses, and Providers
• Move cases in the MedHok system
• Manage complaint and appeal scenarios for dental products through resolution
• Coordinate responses from multiple business units
• Ensure timely, provider-focused responses to complaints and appeals
• Identify trends and emerging issues
• Report findings and recommend solutions

Dental Healthcare Analyst

AI Engineer

• Design, develop, and deploy AI and Generative AI applications using cloud-native services and modern software engineering practices
• Build and maintain AI-powered solutions using AWS Bedrock, GCP Vertex AI, large language models, and machine learning frameworks
• Develop Retrieval-Augmented Generation systems involving document ingestion, vector search, embeddings, and retrieval pipelines
• Create, test, and optimize prompts, workflows, and agentic AI solutions
• Develop APIs, microservices, and event-driven integrations for scalable and secure AI capabilities
• Collaborate with product owners, engineers, data teams, security teams, and business stakeholders to gather requirements and deliver AI capabilities
• Write and execute test cases, debug, conduct code reviews, monitor production performance, and resolve issues
• Participate in model evaluation, deployment, monitoring, and optimization to improve performance, accuracy, latency, scalability, and cost efficiency
• Implement AI solutions meeting security, privacy, governance, Responsible AI, HIPAA, and enterprise data protection requirements
• Create and maintain technical documentation, solution designs, architecture diagrams, implementation guides, and operational runbooks
• Participate in Agile or SAFe planning, sprint activities, estimation, and continuous improvement
• Evaluate AI technologies, frameworks, and cloud services and recommend improvements

Senior AI Engineer

• Design, build, and operationalize scalable, secure, and responsible Generative AI solutions across the affiliate line of business
• Develop and implement advanced machine learning models and algorithms for complex healthcare problems
• Collaborate with data scientists, clinicians, and IT professionals to define requirements and prioritize machine learning initiatives
• Define model performance metrics and evaluation methodologies
• Design and implement scalable machine learning systems, data pipelines, preprocessing, feature engineering, and model training
• Optimize data pipelines, model training processes, and infrastructure
• Present technical findings, insights, and recommendations to technical and non-technical stakeholders
• Ensure compliance with data privacy regulations, ethical guidelines, HIPAA, and industry standards
• Manage team performance through feedback and formal performance reviews
• Evaluate new machine learning algorithms and methodologies
• Build and deploy production-grade LLM and GenAI applications using AWS Bedrock and GCP Vertex AI
• Build cloud-native AI systems with serverless, event-driven, microservices, and API architectures
• Architect agentic AI systems and deliver multi-step reasoning, tool-use, and workflow orchestration
• Develop AI agents using Copilot Studio and Power Automate Cloud flows
• Develop RAG systems and secure document ingestion, embedding, chunking, grounding, and retrieval pipelines
• Lead model experimentation, fine-tuning, evaluation, deployment, and monitoring
• Optimize cost, performance, token usage, latency, and scaling
• Partner with product, engineering, data, security, and compliance teams
• Mentor engineers and contribute reusable patterns, frameworks, and platform accelerators

Staff AI Engineer

• Build, lead, mentor, and develop a high-performing team of AI and software engineers
• Establish the technical vision, engineering standards, and architectural roadmap for enterprise AI platforms and solutions
• Serve as senior technical leader for AI initiatives, providing architectural guidance, conducting design reviews, and driving engineering decisions
• Partner with executive leadership to align AI investments, technology strategy, and delivery priorities with business objectives
• Define and execute strategy for enterprise AI, Generative AI, Agentic AI, and intelligent automation initiatives
• Lead end-to-end solution delivery across the software development lifecycle
• Evaluate emerging AI technologies, platforms, and industry trends and recommend adoption strategies
• Lead production support, incident response, and operational risk management for critical AI platforms and applications
• Provide technical leadership for cloud-native AI platforms and applications across AWS, GCP, and enterprise ecosystems
• Guide design and implementation of LLM and Generative AI solutions, RAG architectures, agentic AI platforms, serverless architectures, APIs, microservices, and AI observability frameworks
• Establish reusable engineering patterns, frameworks, and platform accelerators
• Ensure AI solutions align with Responsible AI principles, technology standards, security controls, and regulatory requirements
• Partner with security, privacy, legal, compliance, and risk teams on AI governance
• Promote model evaluation, explainability, auditability, data protection, and operational risk management
• Partner with product, engineering, data, security, compliance, and business stakeholders to define roadmaps and prioritize initiatives
• Communicate complex technical concepts to executives, technical teams, and business partners
• Serve as a trusted advisor and thought leader on enterprise AI strategy and adoption

• Design, develop, and deploy AI and Generative AI applications using cloud-native services and modern software engineering practices
• Build and maintain AI-powered solutions using AWS Bedrock, GCP Vertex AI, large language models, and machine learning frameworks
• Develop Retrieval-Augmented Generation systems, including document ingestion, vector search, embeddings, and retrieval pipelines
• Create, test, and optimize prompts, workflows, and agentic AI solutions using Bedrock Agents, Vertex AI Agent Builder, LangChain, LangGraph, LlamaIndex, or similar frameworks
• Develop APIs, microservices, and event-driven integrations for scalable and secure AI capabilities
• Collaborate with product owners, engineers, data teams, security teams, and business stakeholders to gather requirements and deliver AI capabilities
• Write and execute test cases, debug, conduct code reviews, monitor production performance, and resolve issues
• Participate in model evaluation, deployment, monitoring, and optimization to improve performance, accuracy, latency, scalability, and cost efficiency
• Implement AI solutions in compliance with security, privacy, governance, Responsible AI, HIPAA, and enterprise data protection requirements
• Create and maintain technical documentation, solution designs, architecture diagrams, implementation guides, and operational runbooks
• Participate in Agile or SAFe planning, sprint activities, estimation, and continuous improvement
• Evaluate new AI technologies, frameworks, and cloud services and recommend improvements

• Collaborate with technicians and prior authorization team members to process referrals, answer clinical questions, and collect clinical/medical data for assessments and reviews
• Evaluate and review prior authorization requests and render coverage determinations based on clinical criteria and plan design
• Verify insurance coverage and eligibility and interpret clinical guideline criteria
• Consult physicians and other healthcare providers while applying clinical knowledge and department protocols
• Communicate case decisions promptly to healthcare providers, health plans/employers, patients, and other healthcare professionals
• Perform inbound and outbound calls to facilitate prior authorization requests, answer inquiries, and resolve escalations
• Maintain communication among CVS Caremark, health plan, and employer group staff
• Maintain professional and technical knowledge of drug and disease states for Specialty and Non-Specialty Pharmacy programs
• Attend training sessions and development meetings
• Provide on-call and after-hours pharmacist availability as needed
• Perform other related projects and duties as assigned

Clinical Pharmacist – Prior Authorization

Strategy

• Analyze, build, and maintain financial and operational tools supporting understanding of network value and its flow into underwriting modeling
• Deploy capabilities to increase automation and data accuracy
• Perform ad-hoc analyses in response to specific business questions
• Present to and collaborate with Network Development, Pricing/Underwriting, Operations, and Finance
• Create and maintain BigQuery/SQL processes integrating with master claims tables for cost of goods modeling
• Create standard data summary outputs to understand trends
• Develop and support Excel- and Tableau-based financial impact reports and dashboards for leadership decision-making and strategy
• Build Excel models to answer business questions and model and quantify network value
• Perform other ad hoc financial modeling and assigned duties

Network Strategy Analyst

Director

• Lead development, implementation, and oversight of reporting solutions supporting strategic Medicaid programs and state-directed initiatives
• Translate complex business objectives into actionable analytics, dashboards, and executive reporting
• Identify opportunities to improve program performance through data-driven insights and operational recommendations
• Advise executive leadership on program outcomes, emerging risks, and performance trends
• Establish governance and reporting structures for state-sponsored Medicaid initiatives, financial performance and ROI, provider partnerships, community-based organization engagement, and vendor performance
• Develop executive-level scorecards, KPIs, dashboards, and performance monitoring frameworks
• Analyze claims, encounter, utilization, quality, and financial data
• Partner with provider organizations, value-based care partners, and community-based organizations to evaluate effectiveness and outcomes
• Support innovative partnerships addressing health-related social needs
• Monitor partnership performance and recommend corrective actions or expansion opportunities
• Establish vendor cohorts and performance segmentation strategies
• Develop methodologies evaluating vendors against operational, financial, quality, and member outcome metrics
• Drive accountability through performance reviews and improvement plans
• Lead, mentor, and develop Senior Managers and business consultants
• Build relationships with executives and senior leaders across matrixed organizations
• Present results, insights, recommendations, and strategic analyses to senior leadership
• Navigate complex organizational structures and lead large-scale cross-functional initiatives
• Align program goals with corporate objectives, state requirements, and member needs

Lead Director, Business Performance – Medicaid

• Support the pharmacy team in delivering operational and service excellence
• Assist patients and customers as a first point of contact
• Follow pharmacy SOPs and workflow procedures across production, pick-up, drive-thru, and drop-off
• Ensure prescriptions are filled promptly, safely, and accurately
• Provide empathetic and personalized patient service and resolve or escalate patient problems
• Offer immunizations and other services at the register and over the phone where permitted
• Complete inventory activities, including medication deliveries, cycle counts, returns-to-stock, and waiting-bin inventories
• Expand clinical and technical knowledge to better assist patients
• Maintain flexibility for scheduling and business needs, including voluntarily traveling to other market stores
• Comply with federal, state, and local laws, regulations, professional standards, ethical principles, and CVS policies
• Deliver additional health care services, including immunizations, point-of-care testing, and offsite clinics, where permitted and appropriately trained
• Where permitted, obtain Technician Immunizer status and support vaccine preparation and administration
• Educate patients about vaccines and refer vaccination questions to the Pharmacist-on-duty
• Monitor and respond to adverse reactions and report events
• Review and collect patient information and document applicable patients
• Monitor and manage vaccine supplies
• Perform additional tasks as directed by the Supervisor or Manager

• Support the team in promptly, safely, and accurately filling patient prescriptions
• Deliver compassionate care and service to patients and customers
• Manage assigned pharmacy workstations and tasks
• Ensure medication needs and regulatory compliance standards are met
• Maintain professional and ethical standards and comply with Federal, State, and Local laws and regulations
• Maintain patient confidentiality and demonstrate ethical conduct
• Complete the CVS Pharmacy Technician Training Program if new to the role
• Build clinical, technical, and insurance knowledge through available tools and training
• Work in a fast-paced retail pharmacy environment