CVS Health

Analyst

• Managing all phases of our PBM proposals process including: Formatting proposals to meet internal marketing specifications.
• Responding to RFP questions using a database of internal Subject Matter Expert reviewed content.
• Organizing, attending, and leading strategy calls with key stakeholders across the organization.
• Customizing and modifying responses to create client-specific content.
• Creating timelines and ensuring RFP milestones are met by all involved individuals in a timely manner.
• Preparing and reviewing final documents and submitting in accordance with client driven deadlines.

Proposals Analyst

Medical Director

• Lead, develop, direct, and implement clinical and non-clinical activities that impact health care quality, cost, and outcomes.
• Direct the utilization review process and oversee the quality of utilization determinations, including case reviews, peer to peer provider discussions, and appeals.
• Ensure compliance with clinical goals through monitoring of care management performance.
• Oversee application of medical policies to ensure the appropriate and most cost-effective medical care is received, and for the day-to-day management of medical management staff.
• Recommend changes and enhancements to current managed care, review guidelines, and clinical criteria based on extensive knowledge of health care delivery systems, utilization methods, reimbursement methods, and treatment protocols.
• Develop, implement, and interpret medical policy including medical necessity criteria, clinical practice guidelines, and new technology assessments.
• Lead clinical staff in the coordination of quality care.
• Provide clinical expertise and business direction in support of medical management programs through participation in clinical team activities.
• Analyze policy/procedure/workflows on case management and utilization management for redesign and efficiency opportunities.
• Act as lead clinical liaison to select plan sponsors including reviewing clinical trends, exploring new clinical strategies, handling escalations, and supporting sales and renewal activities as needed.
• Support and train SMDs and MDs on such activities.
• Identify and advance new affordability initiatives for the Commercial line of business, not limited to medical policy and utilization review activities.
• Monitor KPIs and trends to understand value and opportunities and expand Aetna's medical management programs to address member needs across the continuum of care.
• Provide clinical support for UM/CM/Appeals complex or escalated cases as appropriate.
• Participate in an on‑call rotation, including occasional weekend coverage.

Executive Medical Director, Commercial

Financial Planning and Analysis

• Partner closely with VBS leadership, National and Local market VBS teams, VBC Analytics, and operational stakeholders to drive the end-to-end execution of VBC initiatives
• Lead structured problem-solving efforts and implement sustainable solutions
• Drive execution of VBC initiatives from problem identification through implementation and performance tracking
• Monitor progress against plans and ensure delivery of measurable results
• Identify risks, gaps, and inefficiencies across initiatives and processes
• Support and enhance VBC governance routines
• Develop clear, structured updates on initiative progress, risks, and outcomes
• Serve as a conduit between strategy and execution, ensuring leadership alignment and informed decision-making
• Translate complex concepts into concise, executive-ready messaging
• Develop and deliver presentations, proposals, and strategic materials for senior leadership
• Enable effective decision-making through clear storytelling and structured insights

Senior Manager, Strategic Planning – Governance, Value-Based Services

Supply Chain

• shape the future of technology products that enable Supply Chain Transformation & Modernization
• manage the development and rollout of new technology applications
• partner with users to be expert on user experience across all applications within your portfolio
• work with various DC leaders, vendor partners and IT to understand our process and challenges
• drive improvements to our processes and technology products
• balance business viability, technology feasibility and user/customer desirability for the CVS Supply Chain technology portfolio.

Lead Director, Supply Chain Systems

Security Engineer

• independently execute cybersecurity audit testing, including performing detailed test procedures, evaluating control design and operating effectiveness, and documenting results in accordance with audit standards and methodology
• own assigned audit areas end-to-end, including walkthroughs, evidence collection, validation, and workpaper documentation, ensuring accuracy, completeness, and audit defensibility
• perform testing procedures to assess key cybersecurity domains, including cloud security (Azure & GCP), network security, data protection, application security, and third-party/vendor risk management
• identify control gaps, document exceptions, and contribute to the development of audit findings and recommendations
• collaborate with Audit Managers and team members to support audit execution, validate control effectiveness, and ensure timely completion of deliverables
• leverage data analytics and emerging technologies (e.g., AI tools) to enhance audit testing procedures, coverage, and efficiency
• develop clear, concise, and well-supported workpapers and documentation
• effectively communicate audit results, issues, and risks to audit team members and management
• stay current on cybersecurity risks, trends, tools, and techniques and apply insights to audit testing and risk identification

Senior Analyst, IT Corporate Audit – Cybersecurity

Manager

• Manage the end-to-end reasonable accommodation process to include, individualized case assessment, interactive discussions, documentation, and implementation.
• Conduct individualized assessments to determine the essential functions of roles and identify reasonable accommodations that do not create undue hardship.
• Partner with colleagues, managers, HR, and Legal to facilitate timely and appropriate accommodations.
• Provide expert guidance and coaching to HR and business leaders on ADA/ADAAA compliance and best practices.
• Review and analyze medical documentation to determine functional limitations and job-related restrictions.
• Champion and promote a positive employee relations climate, providing appropriate counsel and support to ensure that any Reasonable Accommodation processes are delivered to maximize the colleague and manager experience.
• Ensure compliance with federal, state, and local disability laws, and maintain thorough, accurate, and confidential case documentation.

Reasonable Accommodations Case Manager

• Implements a quality management strategy that meets internal and external expectations
• Works to achieve day-to-day objectives for the Health Care Quality Management function
• Condenses complex data into a clear picture
• Assists in the development and implementation of QM projects
• Documents QM activities to demonstrate compliance
• Makes outbound calls to assist members in obtaining services
• Performs quantitative and qualitative data analysis to achieve operational targets
• Reports business information and consults on solutions for emergent issues

Analyst, Health Care Quality Management

• coordinate the identification of potential claim editing & clinical program enhancements to ensure compliance with Medicare NCDs and LCDs as well as Federal and State Legislation
• collaborate and partner with functional leads and other business areas to ensure quality and end-to-end payment accuracy functions in the Medicare NCD/LCD and Federal/State legislation policy space
• provide support and management of savings opportunities and provider/customer deviation implementation

Manager – Health Services

• Perform customer care duties to provide high levels of service
• Execute merchandising strategies to support store sales growth
• Manage the store inventory and assets to maintain profitability
• Support your store as management team member and lead in a manner that is consistent with CVS values and policies
• Actively engage with your leader in Key Learning Experiences to support you on your path to promotion during the structured program

Store Manager – In Training

• Provide analytical support to Specialty Trade Relations
• Design, build, and/or maintain models to aid the trade organization
• Extract and analyze drug utilization data from multiple databases
• Assist with the production of recurring reports such as the annual BOB file, quarterly dashboards, etc.
• Prepare ad-hoc requests such as benchmarking and P&L tables
• Create/modify PowerPoint presentations for senior management
• Assist team members with tasks, timelines, and deliverables, including collaborating on projects, sharing information, and ensuring effective communication within the team
• Interact with various departments, members of management, and internal stakeholders
• A small amount of travel may be required

Specialty Trade Finance Analyst

• Negotiates, executes, and analyzes contracts with larger and more complex healthcare providers
• Manages and facilitates dispute resolution processes
• Leverages negotiation skills to optimize contracts with large hospitals and health systems
• Implements strategies to enhance and expand the provider network
• Aligns provider contracts with financial goals
• Conducts comprehensive reviews and analyses of provider contracts
• Ensures compliance with healthcare regulations
• Facilitates leadership, guidance and mentorship to a team of professionals

Senior Manager, Provider Contract Negotiations

• model the highest levels of clinical integrity, knowledge and cross functional thinking and decision making
• transacts Utilization Management (UM) activities (prior authorization and appeals)
• responds to prescriber inquiries related to UM transactions and CVS Health coverage policies
• report to a Senior Medical Director in the Medical Affairs Department
• provide consultative clinical support to Account Management in support of Key Clients as assigned
• complete assigned medication utilization reviews and/or medical necessity appeals for commercial clients, governmental (Medicare/Medicaid) programs and individual client requested coverage determinations or appeals when appropriate
• participate in inter-rater review activities and other quality oversight processes for internal Director UM decisions
• provide oversight of a portion of CVS Health's clinical programs and commercial client program support
• perform special clinical investigations and research as requested by the Senior Medical Director

• Provides leadership of medical management activities in Aetna’s Northeast region (Maryland, New Jersey, New York, Pennsylvania, and Virginia)
• Lead a team of Medical Directors
• Collaborate with health plan chief medical officers
• Implement medical management programs/policies
• Direct the utilization review process and oversee the quality of utilization determinations

Senior Medical Director – Medicaid

Sales

• Manage assigned work in shared sales intake mailbox
• Assist Assigned Sales RVP on pre-sales needs
• Administratively assist with the new quote to confirm Sales process
• Backup colleagues based on workload during time-off
• Manage pre-sales Salesforce data integrity
• Ongoing management of Task Dash and review and resolution of Monthly Audit

Sales Associate

Growth Marketing

• Partner with product owner(s) and other key stakeholders to support growth initiatives for priority products within the PID portfolio
• Lead small team (1-2 direct reports) of junior level product growth enablement roles in pursuit of overall product growth strategy
• Help identify and support growth opportunities across target segments
• Lead product launches, pilots, enhancements and adoption initiatives through structured enablement efforts, working across stakeholders to ensure new and evolving offerings are operationally feasible, scalable and launch-ready
• Provide hands-on support for strategic client engagements and complex deals, including representing the product at finalist meetings and other client forums
• Partner with product owner(s), sales and marketing to develop client-specific product narratives and value propositions
• Identify gaps, risks and dependencies early, enabling proactive solutions that protect growth timelines and product credibility
• Develop and maintain product-specific enablement collateral such as product playbooks, FAQs, pitch decks and use case documentation
• Partner with Analytics to lead development of case studies and overall integration of metrics and quantifiable outcomes into collateral that enables data-driven storytelling
• Lead development of product-specific sales training for new products and features, and coordinate with sales enablement team to ensure timely delivery
• Manage client-facing materials and updates; translate product roadmaps into client-ready messaging and materials
• Gather and synthesize client and field feedback to inform product improvements
• Implement organizational policies, goals, and objectives based on best practices in the field and in accordance with accreditation standards, when applicable
• Develop methodology to evaluate market conditions and adapt business models to meet emerging market needs.
• Contribute to top-level decision making of market pricing strategies to optimize sales, member retention, and earnings.
• Design the allocation of resources, including staffing ratios, to support key performance metrics.
• Control negotiations with clients in complex financial situations.
• Determine improvement opportunities for sales management processes and systems.