CVS Health

Pharmacist

• Deliver compassionate care to pharmacy patients and customers
• Manage assigned pharmacy workstations and tasks
• Support the team in promptly, safely, and accurately filling patient prescriptions
• Maintain compliance with Federal, State, and Local laws and regulations
• Ensure medication needs and regulatory compliance standards are met
• Demonstrate ethical conduct and maintain patient confidentiality
• Provide caring service that exceeds customer expectations
• Complete the CVS Pharmacy Technician Training Program when newly hired
• Build clinical, technical, and insurance knowledge through available tools and training

Pharmacy Technician

Representative

• Handle incoming customer inquiries by phone, fax, and email in a contact center environment
• Provide prescription records and status updates to customers by phone
• Process prescription records in a data entry system in response to fax, mail, and email requests
• Respond to requests from regulatory agencies, courts, law enforcement, attorneys, insurance agencies, patients, and other third parties
• Maintain strict confidentiality when handling Protected Health Information
• Comply with regulatory and subpoena demands in accordance with state and federal HIPAA/Privacy requirements
• Work in a high-volume, production-oriented, time-sensitive call center environment

Rx Records Representative II

Associate

• Support comprehensive coordination of medical services, including intake, screening, and referrals to Aetna Better Health
• Promote and support quality effectiveness of Healthcare Services
• Perform intake of member and provider calls regarding services via telephone, fax, and EDI
• Use Aetna systems to build, research, and enter member information
• Screen requests for appropriate referral to medical services staff
• Approve services that do not require medical review according to the benefit plan
• Perform non-medical research, including eligibility, COB, and benefits verification
• Maintain accurate documentation meeting risk management, regulatory, and accreditation requirements
• Promote internal and external communication with claim administrators, Plan Sponsors, third-party payers, members, families, and healthcare team members
• Protect member confidentiality and follow company confidentiality policies
• Communicate with Aetna Case Managers, Nurses, and Medical Directors when processing member transactions
• Support precertification administration in compliance with laws, regulations, NCQA standards, and company procedures
• Place outbound calls to providers to provide information or obtain clinical information for medical authorization approval
• Use MedCompass, QNXT, ProFAX, and ProPAT systems

Inbound/Outbound Queue Associate

Nurse

• Conduct comprehensive in-home LTSS assessments to determine eligibility for waiver and community-based services
• Complete and submit required waiver documentation according to 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, 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 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 case management activities according to regulatory and accreditation standards
• Educate members and caregivers about benefits, services, and community resources
• Travel 25–50% within assigned counties for in-home field visits
• Work remotely with a dedicated workspace free of interruptions during standard business hours

Case Manager, Registered Nurse – LTSS

Consultant

• Assess, plan, implement, coordinate, monitor, and evaluate options to facilitate appropriate healthcare services and benefits for members
• Gather clinical information and apply clinical criteria, guidelines, policies, procedures, and clinical judgment to render coverage determinations or recommendations
• Communicate with providers and other parties to facilitate care and treatment
• Identify members for referral opportunities involving other products, services, or programs
• Identify opportunities to promote healthcare service quality and effective benefit utilization
• Consult with and provide expertise to internal and external constituents regarding utilization and benefit management
• Work in a typical office environment with productivity and quality expectations
• Perform close inspection of handwritten and computer-generated documents and PC monitors
• Sit for extended periods, talk on the telephone, and type on a computer
• Multitask, prioritize, and adapt to a fast-paced, changing environment

Utilization Management Nurse Consultant

Case Coordinator

• Conduct comprehensive evaluations of members’ needs and eligibility using care management tools and information/data review
• Recommend approaches to case resolution and meeting member needs by evaluating benefit plans and available programs/services
• Identify high-risk factors and service needs and refer members to clinical case management or crisis intervention as appropriate
• Coordinate and implement assigned care plan activities and monitor progress
• Consult with case managers, supervisors, Medical Directors, and other health programs to overcome barriers
• Present cases at case conferences for multidisciplinary review
• Identify and escalate quality-of-care issues through established channels
• Negotiate appropriate options and services for members’ benefits and healthcare needs
• Use influencing and motivational interviewing skills to engage members and promote lifestyle/behavior changes
• Provide coaching, information, and support to empower independent medical and healthy lifestyle choices
• Engage in team meetings and provide peer mentoring/training
• Help members participate knowledgeably with providers in healthcare decision-making
• Apply case management and quality management processes in compliance with regulatory, accreditation, and company requirements

Case Management Coordinator – Field

Nurse Practitioner

• Deliver evidence‑based primary and family care, including assessment, diagnosis, treatment, and management of acute and chronic conditions
• Provide both in-person and virtual visits from the clinic to support positive patient health outcomes
• Perform diagnostic testing, preventive counseling, treatment of injuries and illnesses, and coordination of care with other healthcare professionals
• Engage patients in wellness services, chronic disease management, and preventive health screenings
• Complete clinic operations including inventory management, clinic opening/closing, patient follow‑up, insurance verification, and payment collection
• Support a safe and efficient care environment through routine examinations and timely patient appointment management

Data Engineer

• Own the data foundation supporting the Medicare revenue engine
• Design, build, and operate data pipelines and analytic tables for Medicare revenue projection models
• Ingest, normalize, and reconcile claims, encounters, eligibility/enrollment, EMR/chart extracts, vendor/program files, and CMS artifacts
• Implement HCC / ICD-10 mapping, model-year versioning, and diagnosis-year versus payment-year constructs
• Own data quality, reconciliation, lineage, and snapshot/freeze processes for accruals, AtoE, and audit
• Partner with enterprise data/IT on Databricks or equivalent lakehouse standards, Spark/PySpark, orchestration, CI/CD, access control, and cost/performance
• Provide documented datasets to Modeling, Finance, Actuarial, and Revenue Integrity
• Define freshness and completeness SLAs and monitor data drift and source-system changes
• Lead and mentor data engineers and establish engineering practices for a regulated, financially sensitive environment
• Support modular revenue, membership/mix, and related outputs

Senior Manager, Data Engineering – Medicare Revenue

Manager

• Oversee healthcare management staff and develop high-performing teams
• Oversee implementation of healthcare management services for the assigned functional area
• Maintain policies and procedures in accordance with regulatory and accreditation standards
• Implement and monitor best-practice approaches and innovations across the continuum of care
• Manage resources responsible for member identification, care-plan development, quality-of-care monitoring, evaluation, and documentation
• Serve as a liaison with key business areas and support customer implementations
• Participate in customer meetings and oversee customer cultural requirements
• Assess developmental needs and implement action plans supporting high-performing teams
• Promote teamwork, cross-product integration, and continuum-of-care thinking
• Lead change efforts and collaborate with licensed staff overseeing clinical activities
• Mentor the team on practice standards, intervention quality, problem resolution, and critical thinking
• Meet financial, operational, and quality objectives of the unit

Associate Manager, Health Services

• Support the pharmacy team in delivering operational and service excellence within the store
• Serve as an initial point of contact for patients and customers
• Follow standard operating procedures 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 in person and over the phone
• Offer immunizations and other services at the register and over the phone where permitted
• Solve or escalate patient problems
• Complete inventory activities, including putting away medication deliveries, cycle counts, returns-to-stocks, and waiting-bin inventories
• Maintain compliance with federal, state, and local laws, regulations, professional standards, ethical principles, and CVS policies
• Support controlled-substance dispensing and recordkeeping and protect patient privacy and security
• Deliver additional health care services such as immunizations, point-of-care testing, and staffing offsite clinics where allowable and trained
• Where permissible, 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 reactions and report events as required
• Review and collect patient information and document applicable patient records
• Monitor and manage vaccine supplies
• Travel voluntarily to stores in the market to work shifts as needed
• Perform additional tasks as directed by a Supervisor or Manager

• Support the pharmacy team in delivering operational and service excellence
• Assist patients and customers as a first point of contact
• 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 empathetic, 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-stocks, and waiting-bin inventories
• Contribute to a high-performing, safe, inclusive, and engaging team
• Travel voluntarily to other stores in the market to work shifts as needed
• Comply with applicable laws, regulations, professional standards, ethical principles, and CVS policies
• Deliver additional health care services such as immunizations, point-of-care testing, and offsite clinic staffing where permitted and trained
• Complete additional licensure and training to obtain Technician Immunizer status where applicable
• Educate patients about vaccines and refer vaccination questions to the Pharmacist-on-duty
• Monitor and respond to adverse reactions and report events
• Review, collect, track, and document patient information
• Monitor and manage vaccine supplies
• Perform other tasks directed by the Supervisor or Manager

Marketing

• Own and manage the Front Store strategic marketing calendar, aligning campaigns, promotions, and priorities across Rx, MinuteClinic, Front Store, and other business partners
• Lead enterprise planning and prioritization processes, including PCW and new initiative intake
• Identify and resolve scheduling conflicts, resource constraints, message overlap, and execution risks
• Establish and lead management routines, governance processes, and decision-making frameworks
• Drive alignment, accelerate decision-making, and provide clear escalation paths across stakeholders and leadership teams
• Own executive communications, reporting, and planning infrastructure
• Deliver actionable insights and decision-ready materials on priorities, performance, dependencies, and work in progress
• Improve cross-functional ways of working, reduce duplication, streamline reporting, coordinate strategic planning activities, and create a consistent view of Front Store marketing performance

Senior Manager, Strategic Marketing

• Deliver evidence‑based primary and family care, including assessment, diagnosis, treatment, and management of acute and chronic conditions
• Provide both in-person and virtual visits from the clinic to support positive patient health outcomes
• Perform diagnostic testing, preventive counseling, treatment of injuries and illnesses, and coordination of care with other healthcare professionals
• Engage patients in wellness services, chronic disease management, and preventive health screenings
• Complete clinic operations including inventory management, clinic opening/closing, patient follow‑up, insurance verification, and payment collection
• Support a safe and efficient care environment through routine examinations and timely patient appointment management
• Work as a Full Time Regional Provider at Overland Park, Kansas and surrounding HealthHub locations

• Collaborate and inform the case management process
• Facilitate appropriate healthcare outcomes for members
• Assist with appointment scheduling
• Identify and assist members with accessing benefits and education using care management tools and resources
• Evaluate members' needs, eligibility, benefit plans, and available programs or services
• Identify high-risk factors and service needs and refer to clinical case management or crisis intervention as appropriate
• Coordinate and implement assigned care plan activities and monitor progress
• Consult with case managers, supervisors, Medical Directors, and other health programs to overcome barriers
• Present cases at case conferences for multidisciplinary review
• Identify and escalate quality-of-care issues
• Negotiate appropriate options and services for members' benefits and healthcare needs
• Use influencing and motivational interviewing skills to promote member engagement and behavior changes
• Provide coaching, information, and support for independent medical and healthy lifestyle choices
• Engage in team meetings and provide peer mentoring/training
• Help members participate knowledgeably in healthcare decision-making
• Use case management and quality management processes in compliance with regulatory, accreditation, and company requirements

• Support the pharmacy team in delivering operational and service excellence
• Serve as an initial point of contact for patients and customers
• Follow Standard Operating Procedures and pharmacy workflow procedures
• Support safe, prompt, and accurate prescription fulfillment
• Provide caring service at pickup, drive-thru, over the phone, and at the register
• Offer immunizations and other patient health care services where allowable by law and supported by training and certification
• Solve or escalate patient problems
• Complete inventory activities, including medication deliveries, cycle counts, returns-to-stocks, and waiting bin inventories
• Expand clinical and technical knowledge to better assist patients
• Remain flexible for scheduling and business needs, including voluntarily traveling to market stores for shifts
• Comply with federal, state, and local laws, regulations, professional standards, ethical principles, and CVS policies
• Support Technician Immunizer duties where permissible, including vaccine preparation and administration, patient education, adverse-reaction monitoring, documentation, and vaccine supply management
• Perform additional tasks as directed by the Supervisor or Manager