CVS Health

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

Nurse

• Facilitate the case management process using critical thinking and judgment
• Collaborate with members, providers, and community organizations
• Facilitate appropriate healthcare outcomes for members
• Assist with appointment scheduling
• Identify and assist members with accessing benefits and education
• Use care management tools and resources
• Address members' health care and social determinant needs across the continuum of care
• Travel throughout the West Suburbs of Illinois, including DuPage, Kane, DeKalb, Kendall and surrounding areas
• Work independently from a designated home office while collaborating virtually with teams

Care Manager Registered Nurse – Field, DuPage, Kane, DeKalb, Kendall Counties

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

• Collaborate with members, providers, and community organizations to address health care and social determinant needs
• Facilitate appropriate healthcare outcomes for members
• Assist with appointment scheduling
• Identify and assist members with accessing benefits and education
• Use care management tools and resources
• Utilize critical thinking and judgment in the case management process
• Travel throughout Western Illinois/Quad Cities for field-based work, up to 75% of the time
• Communicate and collaborate with teams virtually
• Navigate multiple systems and applications to streamline tasks and improve efficiency
• Use digital communication channels, Teams, virtual meetings, VPN, and EHR portals
• Resolve common technical issues and contact IT for unresolved issues
• Learn new skills as the workplace environment evolves

Care Manager, Registered Nurse – Field

Director

• Oversee scaled initiatives and capabilities to improve patient experience (NPS), engaged Oak Street Health membership, and STARs performance through payer CAHPS programs
• Own the strategic agenda for improving patient experience at Oak Street Health
• Partner with cross-functional business leaders to achieve organizational performance goals and foster member engagement
• Lead opportunity identification through execution to deliver year-over-year improvements in patient experience
• Serve as primary liaison with payer partners on CAHPS strategy and performance
• Oversee a growing team of approximately 2-5 team members focused on corporate strategy functions
• Work with central service operations, field operations, patient engagement, technology, product, population health, learning, human resources, managed care operations, and other teams
• Lead major patient experience strategic initiatives
• Deploy Senior Managers and Analysts to improve NPS, net membership, and/or CAHPS performance
• Translate initiative impact into primary KPIs and economic value for the business
• Own organizational NPS performance against annual targets
• Develop, organize, and execute the patient experience strategic plan
• Support Field and Central operational partners with identifying and deploying experiential best practices
• Partner with the Enterprise CX team to identify trends and thematic patient experience opportunities and synthesize them into strategies
• Serve as patient experience subject-matter expert for payer QBRs and dedicated CAHPS performance sessions
• Develop CAHPS strategic plans for high-priority payer quality ladders
• Oversee the strategic roadmap for patient portal enrollment and portal experience
• Report to the AVP, Patient Experience & Field Execution

Lead Director, Patient Experience

Health Coordinator

• Interact with Medicare members via digital and telephone channels
• Conduct inbound and outbound outreach regarding healthcare visits, screenings, vaccinations, and medication refills
• Capture barriers and collect data using motivational interviewing to help close gaps in care
• Provide professional, empathetic support and answer or triage member questions
• Advocate for Medicare members and coordinate care among health plans, doctors, and pharmacies
• Collect member-reported data in the CRM to support HEDIS medical-record documentation
• Educate members based on their needs, preferences, and understanding
• Serve as a single point of contact, resolving issues and escalating to leadership when needed
• Build trusting relationships and connect members with appropriate services
• Explain programs, Aetna tools, and healthcare resources
• Document and track member contacts, events, and outcomes in applicable systems
• Produce business communications, including letters and spreadsheets
• Handle multiple functions and products while meeting performance standards
• Identify issues requiring escalation and suggest resolutions
• Support individual, team, and business goals and initiatives

Health Advocate, Call Coordinator

Pharmacist

• Support Medicaid Prior Authorization as a Clinical Pharmacist for Aetna
• Apply evidence-based clinical guidelines and criteria in clinical decision-making
• Utilize formularies and preferred drug lists
• Review medical records and clinical literature
• Compose SOAP notes
• Work in a high-production team environment
• Work the assigned AZ-time shift, scheduled Saturdays, and occasional holidays

Clinical Pharmacist – Aetna Medicaid Prior Authorization

Operations

• Lead technology product strategy and execution for core clinical care delivery products, including in-clinic and virtual care encounters, in-basket management, and inventory management
• Partner with clinical and business operational leaders to shape end-to-end technology pathways supporting safe, high-quality outpatient care
• Lead multidisciplinary teams of product managers, Epic analysts, software engineers, data scientists, and UI/UX designers
• Translate clinical vision into scalable technology roadmaps focused on patient outcomes, safety, care-team experience, and cost reduction
• Collaborate with healthcare delivery leadership on efficient and safe outpatient care models
• Serve as a strategic thought partner for CVS HCD business stakeholders defining care model strategy
• Drive cross-functional technology teams to deliver care-model technology solutions
• Establish shared outcome metrics tied to clinical quality, patient experience, and financial performance
• Transform clinical ideas into problem statements, product specifications, and Epic/technology architectures
• Oversee end-to-end technology design, technical requirements, and technology build
• Integrate external data sources, including claims data, remote monitoring, and health plan feeds, with internal Epic workflows
• Own the technology lifecycle from discovery and solutioning through build, deployment, and outcome realization
• Establish feedback loops and iterative improvement cycles
• Lead, mentor, and build high-performing product and cross-functional technology teams
• Support CVS HCD admissions prevention efforts and foster a high-trust, resilient team culture

Lead Director – Digital Product, Clinic Operations and Ambulatory Workflows

Backend Engineer

• Design, build, and deploy scalable AI/GenAI applications leveraging LLMs, RAG architectures, and agentic frameworks
• Develop and optimize AI prompts, evaluation frameworks, and model pipelines
• Architect and implement end-to-end solutions, including Angular/React frontend applications and backend APIs/services
• Integrate AI capabilities into enterprise systems using cloud-native and microservices architectures
• Lead technical design discussions and drive scalable, secure, high-performance architecture decisions
• Collaborate with product, business, and engineering teams
• Build reusable frameworks and tooling for LLM evaluation, monitoring, and observability
• Ensure software engineering best practices, including CI/CD, testing, code reviews, and security
• Mentor and guide engineers
• Stay current with emerging AI/ML, LLM ecosystem, and modern web technology trends

Staff Backend Engineer – AI Platforms

Clinician

• Complete In-home Evaluations, Focused Visits, and Video Visits
• Exemplify Signify Health operational, clinical, and member experience KPIs
• Complete up to 80% of the week in visits and reserve one assigned day per week for coaching and mentorship
• Provide 40 hours of weekly availability, 128+ capacity units per month, and 88+ completed visits per month
• Provide dedicated guidance to new hire clinicians during their first 90 days
• Facilitate virtual and in-person shadowing opportunities
• Provide best-practice guidance on clinical workflows and diagnostic and preventive services
• Offer group support to active clinicians through webinars and office hours
• Provide real-time support to in-field clinicians
• Serve as the first line of response for clinical inquiries and escalate issues to Clinical Leaders when needed
• Test new diagnostic and preventive services and clinical workflow changes and provide feedback
• Meet regularly with Clinical Leaders for support and training
• Participate in manager, team, clinical, and special-event meetings as needed
• Provide rotating evening and weekend mentoring and coaching support
• Maintain required supplies and diagnostic equipment
• Report to the Operations Manager with a dotted line to the Clinical Success team

Clinician Field Mentor

• Lead end-to-end, large-scale enterprise-wide transformations
• Lead highly complex initiatives and influence senior leadership
• Coach Managers and Senior Analysts to elevate team capability
• Lead large-scale, cross-functional transformation initiatives
• Design process improvement plans using DMAIC, DMADV, DFSS and LEAN
• Facilitate matrixed projects, Kaizen Events, Rapid Process Improvement Events, and current/future state design events
• Establish governance, KPIs and sustainability models
• Perform quantitative and qualitative analyses using Excel, Minitab and other tools
• Keep project teams on track and provide updates to key stakeholders
• Design and execute change management plans using ADKAR, Kotter’s 8-Step Model, Lewin’s Model and other methods
• Enable adoption, behavior change and sustained outcomes across operational teams
• Assess change readiness, stakeholder impacts and resistance risks
• Develop communications, training materials, job aids and reinforcement plans
• Monitor adoption metrics and feedback loops and adjust change strategies
• Drive business adoption plans and smooth transition of ownership
• Advance enterprise methodologies and standards
• Scale best practices across the enterprise
• Coach experienced process and change practitioners
• Pull resources from varied teams and skill sets to design, build, test and deploy solutions

Senior Manager, Process Excellence

Physician

• Provide In-Home Health Evaluations in members’ homes
• Travel primarily up to 100% of the time across a defined coverage area
• Conduct approximately 45-minute visits
• Review medications and medical history
• Perform physical evaluations
• Provide additional diagnostic tests when ordered, including diabetic eye exams and spirometry
• Use an iPad and clinical workflow for each evaluation
• Conduct virtual visits as needed
• Provide Diagnostic & Preventive Services, including spirometry, diabetic eye exams and bone density screening
• Build trusted relationships and help improve health outcomes
• Make referrals to health plans and encourage participation of members’ loved ones
• Ensure primary care physicians are aware of members’ health and quality of life

In-Home Traveler Physician

Nurse Practitioner

• Provide In-Home Health Evaluations in members’ homes
• Engage with people and help bridge gaps in care
• Conduct approximately 45-minute visits, including medication and medical history review and physical evaluation
• Perform additional diagnostic tests when ordered by the person’s health plan, including diabetic eye exams and spirometry
• Use an iPad and clinical workflow for each evaluation
• Build trusted relationships and help improve health outcomes
• Visit people nationwide and connect them to appropriate care
• Fulfill the requirements of the specified clinician role with Signify Health
• Travel locally and within licensed states, with coverage across all counties as needed
• Conduct virtual visits as needed
• Provide Diagnostic & Preventive Services, including spirometry, diabetic eye exams and bone density screening

In-Home Traveler Nurse Practitioner, Physician Assistant

• Provide in-home health evaluations in members’ homes
• Engage with people one-on-one and answer health questions
• Review medications and medical history
• Perform physical evaluations
• Conduct additional diagnostic tests when ordered, including diabetic eye exams, spirometry and bone density screening
• Use an iPad and clinical workflow for each evaluation
• Conduct virtual visits as needed
• Provide Signify Health services, including Diagnostic & Preventive Services
• Travel locally and within licensed states
• Build trusted relationships and help improve health outcomes
• Identify care gaps and connect people to appropriate care

• Provide in-home health evaluations in members’ homes
• Engage with people one-on-one and help bridge gaps in care
• Review medications and medical history
• Perform physical evaluations
• Conduct additional diagnostic tests when ordered, including diabetic eye exams, spirometry and bone density screening
• Use an iPad and clinical workflow for each evaluation
• Conduct virtual visits as needed
• Provide Signify Health services, including Diagnostic & Preventive Services products
• Travel locally and within licensed states
• Build trusted relationships and support improved health outcomes
• Make referrals to health plans and encourage participation of members’ loved ones
• Ensure primary care physicians are aware of members’ health and quality of life

Senior Manager, Data Engineering – Medicare Revenue

Care Manager Registered Nurse – Field, DuPage, Kane, DeKalb, Kendall Counties

Case Management Coordinator – Field

Care Manager, Registered Nurse – Field

Lead Director, Patient Experience

Health Advocate, Call Coordinator

Clinical Pharmacist – Aetna Medicaid Prior Authorization

Lead Director – Digital Product, Clinic Operations and Ambulatory Workflows

Staff Backend Engineer – AI Platforms

Clinician Field Mentor

Senior Manager, Process Excellence

In-Home Traveler Physician

In-Home Traveler Nurse Practitioner, Physician Assistant

In-Home Traveler Physician

In-Home Traveler Physician, Full Time