CVS Health

Administration

• Support the loading of new and revised Medicaid participating provider data transactions into Aetna/CVS source systems
• Perform analytical work involving large data sets and data analysis
• Support provider data service administration for Medicaid participating providers

Provider Data Service Administrator

Analyst

• Serve as the primary point of contact for leaders and colleagues regarding performance, attendance, behavioral issues, policy interpretation, and application of CVS Health policies and Code of Conduct
• Handle a significant volume of colleague calls and emails concerning employment practices and policies
• Resolve colleague issues during initial outreach whenever possible
• Serve as first point of contact through a centralized phone system, up to 75% of the time
• Perform real-time issue spotting and document pertinent call details and consultation provided
• Assign cases to the appropriate team, including case categorization and priority
• Review and assess inquiries through email, self-serve portal, and Ethics Line reporting, typically 25% of the time
• Leverage resources to achieve first-contact resolution and provide proactive colleague support
• Assist with policy interpretation and application of CVS Health policies and Code of Conduct
• Consult with leaders regarding colleague discipline and performance issues
• Escalate inquiries to appropriate teams for further review and consultation when necessary
• Partner with Legal to retain and provide records upon request
• Respond to workforce-reduction inquiries and escalate concerns where appropriate
• Provide cross-functional support to other business areas as needed

Senior Analyst, Colleague Relations

Team Lead

• Serve as the first point of contact for clinical questions and support
• Mentor team members and promote quality, consistency, and best practices
• Assist with onboarding, quality monitoring, workflow management, and project initiatives
• Support achievement of performance and service goals
• Collaborate with leadership and contribute to team communications and meetings
• Help create a positive, engaged, and high-performing work environment
• Provide guidance on clinical issues
• Oversee workflow coordination
• Support operational excellence for a care management team
• Cover Florida, Pennsylvania and New Jersey health plans

Clinical Team Lead

General

• Provide care management services and evidence-based short-term psychotherapy to patients with behavioral health needs
• Serve as a key behavioral health resource for Care Teams across a region of Oak Street Health primary clinics
• Coordinate and support behavioral healthcare in collaboration with Care Teams and a psychiatric consultant
• Assess patient needs and make referrals to appropriate behavioral health resources and specialists
• Provide short-term counseling and evidence-based treatments
• Collaborate with primary care teams to identify appropriate patients for the Oak Street Behavioral Health Program
• Screen and assess patients for common mental health and substance use disorders
• Develop care plans and facilitate referrals to the psychiatric consultant and external resources
• Coordinate care with the psychiatric consultant, including warm handoffs for telehealth visits
• Develop relationships with primary care teams and communicate changes in behavioral health care plans
• Document patient encounters and counseling sessions accurately and promptly in Oak Street’s electronic medical record
• Participate in regional and organizational program efforts through workshops, feedback sessions, and surveys
• Potentially cover multiple clinics depending on clinic maturity and panel sizes
• Perform other duties as assigned

Behavioral Health Specialist – LSCSW, LCPC, LMFT

Medical Director

• Lead utilization management, including predetermination and UM reviews
• Apply clinical expertise to support accurate, consistent decisions
• Participate in developing, implementing, and evaluating clinical/medical programs
• Expand Aetna's medical management programs across the continuum of care
• Support Medical Management staff in delivering timely, consistent responses to members and providers
• Oversee utilization review and quality assurance activities
• Direct case management efforts
• Provide clinical expertise and business direction for medical management programs
• Serve as lead clinical and business liaison to network providers and facilities
• Represent Aetna One Advocate in external-facing presentations and plan sponsor meetings, approximately 15% of the time
• Provide clinical oversight for medical policy implementation

Medical Director – Aetna One Advocate

Pharmacist

• Support the pharmacy team in delivering operational and service excellence
• Serve as a first point of contact for patients and customers
• Follow company SOPs and pharmacy workflow procedures across production, pick-up, drive-thru, and drop-off workstations
• Ensure prescriptions are filled promptly, safely, and accurately
• Provide caring, empathetic, and personalized patient service
• Offer immunizations and other services at the register and over the phone, where permitted
• Solve or escalate patient problems
• Complete inventory activities such as putting away medication deliveries, cycle counts, returns-to-stocks, and waiting-bin inventories
• Contribute to a high-performing, safe, inclusive, and engaging team
• Expand clinical and technical knowledge and respond to feedback
• Remain flexible for scheduling and business needs, including voluntarily traveling to market stores for shifts
• Comply with applicable laws, regulations, professional standards, ethical principles, and CVS policies
• Deliver additional services such as immunizations, point-of-care testing, and offsite clinics where legally permitted and appropriately trained
• Where permitted, complete immunizer licensure and training, educate patients about vaccines, monitor adverse reactions, document patient information, and manage vaccine supplies
• Perform other tasks as directed by the Supervisor or Manager

Pharmacy Technician

Application Engineer

• Design, implement, and maintain defensive security controls across applications, cloud platforms, data systems, and network environments
• Develop and enforce enterprise-wide application and data security standards, policies, and best practices
• Embed security controls into SDLC processes, CI/CD pipelines, and deployment automation frameworks
• Lead security architecture reviews and establish security governance frameworks
• Partner with Engineering, Infrastructure, Architecture, and Business teams on secure-by-design practices
• Serve as a trusted advisor and technical leader for Application Security, Cloud Security, and Secure Development
• Monitor, detect, investigate, and respond to security events, vulnerabilities, threats, and incidents
• Lead vulnerability assessments, remediation planning, risk prioritization, and validation
• Conduct security assessments, threat modeling, and architecture reviews
• Implement advanced security solutions across multi-cloud, colocation, and enterprise environments
• Participate in a rotational 24x7 on-call schedule, including off-hours, nights, weekends, and holidays
• Lead incident response activities including investigation, containment, eradication, recovery, and post-incident reviews
• Develop and improve incident response, detection, escalation, and recovery playbooks
• Mentor and coach engineers on secure coding, security engineering, and defensive operations
• Research emerging threats, vulnerabilities, attack techniques, and security technologies
• Evaluate and recommend security tools, platforms, and defensive capabilities
• Automate security operations using code and Security-as-Code principles
• Contribute to long-term security strategy, architecture roadmaps, technology planning, and enterprise security objectives
• Partner with leadership to prioritize security investments and risk reduction activities

Staff Application Security Engineer – Blue Team

Nurse

• Conduct face-to-face visits in members’ homes using comprehensive assessment tools
• Evaluate medical needs of members enrolled in MLTSS, D-SNP/FIDE, and non-MLTSS programs
• Facilitate members’ overall wellness and help obtain needed services
• Address service requests including adult and pediatric medical daycare, personal care assistant, nursing facility custodial requests, personal preference program, and MLTSS enrollment
• Develop, implement, support, and promote health service strategies, policies, and programs
• Apply advanced clinical judgment and critical thinking to coordinate physical, behavioral health, and psychosocial wrap-around services
• Develop care plans with members and care teams
• Authorize services cost-effectively within the MLTSS/FIDE benefit
• Schedule and attend interdisciplinary meetings
• Advocate for members and ensure safe discharge with appropriate services in place
• Coordinate and collaborate with members, authorized representatives, PCPs, and other care team participants
• Document accurately and timely in members’ electronic health records
• Solve problems using critical thinking
• Mentor new hires after attaining proficiency

Case Manager Registered Nurse – Field

Actuary

• Support Medicaid-wide analyses and reporting as part of the Medicaid Strat team
• Work with Medicaid Plan actuaries to identify opportunities for new or refined analyses relevant to multiple markets
• Standardize current Plan-level reporting
• Automate existing Medicaid team reporting
• Support Medicaid Health Plans and Medicaid Finance in Requests for Proposals (RFPs) for new and renewing business
• Build skills necessary to become a well-rounded actuary
• Build models and clearly communicate analysis results to technical and non-technical audiences

Senior Analyst, Actuarial

Scrum Master

• Lead one or more medium to large projects and/or programs
• Collect, define, and document project requirements
• Define and communicate roles, responsibilities, and expectations for project team members
• Determine staffing requirements and form project teams
• Independently plan work to meet project goals
• Assess project performance and implement changes to maintain cost, schedule, scope, and quality objectives
• Develop metrics, procedures, objectives, and methods to assess project progress using established standards and quality objectives
• Manage complex programs and projects spanning multiple lines of business and/or with significant dependencies on other large projects

Manager, Scrum Master

Manager

• Partner with business and technology stakeholders to define objectives, outcomes, scope, and success measures
• Drive complex work from concept to execution
• Facilitate planning and delivery activities covering scope, milestones, financials, risks, dependencies, and team commitments
• Align priorities and execution plans to measurable business outcomes
• Identify and resolve or escalate obstacles, risks, dependencies, and opportunities
• Adapt delivery approaches while maintaining execution discipline and governance
• Build relationships across business, technology, product, and vendor teams
• Lead, coach, and motivate teams to deliver commitments and achieve objectives
• Facilitate discussions and decision-making around priorities, tradeoffs, risks, and outcomes
• Manage resource plans, financials, and delivery forecasts
• Manage scope, prioritization, and changes
• Monitor delivery performance, quality, progress, team effectiveness, and execution
• Communicate status, risks, decisions, and recommendations to stakeholders and leadership
• Conduct retrospectives, lessons learned, and post-implementation reviews
• Collaborate across product, project, engineering, architecture, operations, and business teams

Senior Manager, Technology Delivery

• Gain hands-on experience leading a retail team and engaging directly with customers
• Learn day-to-day store operations and retail management best practices
• Work alongside Store Managers and District Leaders
• Develop leadership skills and learn to motivate and manage a store team
• Analyze business performance and understand how operational and strategic decisions affect customer satisfaction and store results
• Support merchandise handling, inventory management, and stocking
• Help the store meet customer needs during busy periods, including evenings and weekends
• Gain exposure to staffing, talent development, customer engagement, and operational excellence
• Participate in leadership development with field and retail leaders
• Complete a business-focused project addressing an opportunity within the assigned store
• Present project findings and recommendations to leadership

Retail Store Management Internship

Claim Specialist

• Review and rework sensitive, complex medical and hospital claims for the rework project department.
• Work closely with Commercial Services Operations team members to perform root cause analysis and precisely resolve affected claims.
• Ensure rework project claims are resolved accurately and handled by the rework project due date.
• Serve as a medical/hospital claim processor for rework projects, compliance, and complex issues.
• Process claims for specific providers/networks or large-scale rework projects resulting from plan sponsor issues, release fallout, and legal, regulatory, or compliance concerns.
• Interface with appropriate areas to resolve claims.

Claim Benefit Specialist

• Manage and successfully drive use cases within the clinical innovation portfolio and initiatives
• Solve key business problems and support development of new sources of value within Aetna’s Clinical Solutions business unit
• Lead, partner, and collaborate with cross-functional teams and internal/external stakeholders
• Develop, test, and implement innovative solutions
• Define, rationalize, and align priorities with clearly defined business rationale
• Drive and manage innovation scope through ideation/concept, solution development, and pilot stages
• Manage readiness, scaled deployment, value realization, and monitoring
• Manage risk and develop interventions
• Facilitate working sessions
• Deliver required analysis, reporting, and presentation materials
• Evaluate new concepts, emerging innovation trends, and clinical operations/offerings benchmarking
• Develop trends into innovative solutions that solve key business problems and deliver breakthrough value
• Foster a culture that accelerates strategy through Heart At Work Behaviors

Senior Manager – Clinical Innovation

• Review and rework sensitive, complex medical and hospital claims for the rework project department
• Work closely with Commercial Services Operations team members to perform root cause analysis and precisely resolve affected claims
• Ensure rework project claims are resolved accurately
• Interface with appropriate areas to address claims
• Complete rework project claims by the due date
• Serve as a medical/hospital claim processor for rework projects, compliance, and complex issues
• Process claims for specific providers/networks or large-scale rework projects resulting from plan sponsor issues, release fallout, and legal, regulatory, or compliance concerns