CVS Health

Manager

• serve as a liaison between members/clients, families, employers, providers, insurance carriers, and healthcare personnel as appropriate
• implement and coordinate case management activities for catastrophic and chronically ill members
• interact with members/clients both telephonically and in person while working on-site
• assess medical, functional, and vocational status to develop and implement individualized plans of care
• communicate effectively with stakeholders including medical providers, attorneys, employers, and insurance carriers
• prepare timely and accurate documentation of all case management activities
• collaborate with internal multidisciplinary teams
• conduct outreach to treating physicians and specialists
• provide education and preventive guidance to promote best clinical outcomes
• monitor member progress toward desired outcomes

Case Manager, Registered Nurse – Field

Platform Engineer

• Leading a team of engineers, including hiring, coaching, career development, and performance management
• Setting technical direction and driving architectural decisions for your team's domain, balancing innovation with reliability and maintainability
• Partnering with Product and Architecture to define roadmaps, decompose initiatives into deliverables, and ensure alignment across teams
• Driving operational excellence through investment in observability, incident response, SLOs, and production readiness practices
• Establishing and evolving engineering processes that enable your team to deliver high-quality software at pace — CI/CD, code review, testing strategies, and release management
• Building a culture of ownership, psychological safety, and continuous learning within your team
• Managing delivery across multiple workstreams, removing blockers, managing dependencies, and communicating status and risk to leadership
• Contributing to the broader engineering organization through participation in technical governance, architecture reviews, and cross-team initiatives
• Championing developer experience and engineering productivity improvements that benefit teams beyond your own
• Staying current with industry trends and technologies, evaluating their applicability to our platform and advocating for strategic adoption where appropriate

Senior Manager – Platform Engineering

Consultant

• Responsible for the review and resolution of clinical appeals.
• Reviews documentation and interprets data obtained from clinical records to apply appropriate clinical criteria and policies.
• Independently coordinates the clinical resolution with internal/external clinician support as required.
• This position may support UM, MPO, Coding, or Behavioral Health appeals.
• Full-time telework position with standard hours of Monday–Friday, 8:00 AM to 5:00 PM.

Appeals Nurse Consultant

Product Manager

• Own day-to-day product ownership for a server scrum team supporting the Care Path core train in a SAFe environment
• Lead agile team ceremonies, including backlog refinement, sprint planning, daily standups, sprint reviews, retrospectives, and PI planning preparation
• Translate business direction provided by Product Managers and technical solutions defined with Architecture into features, user stories, and acceptance criteria ready for engineering execution
• Maintain a healthy, prioritized backlog that aligns to portfolio goals, technical dependencies, and delivery timelines
• Partner closely with Engineering and Architecture to clarify requirements, sequence work appropriately, and ensure technical feasibility
• Organize the team around portfolio priorities by helping connect roadmap intent to sprint-level execution
• Support PI planning by driving pre-planning activities, identifying dependencies and timelines, clarifying scope, and surfacing risks early
• Ensure stories are complete and well formed, with strong acceptance criteria, quality expectations, and testing considerations before development begins
• Monitor execution progress, raise blockers quickly, and help drive decisions that keep delivery moving while protecting quality
• Contribute to testing efforts and ensure testing coverage is adequate and shipped product is defect free
• Communicate status, tradeoffs, risks, and readiness clearly across Product, Engineering, and partner teams
• Contribute to continuous improvement in team ways of working, delivery predictability, and backlog readiness

Digital Product Owner

• use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost effective outcomes.

Case Manager, RN

Analyst

• This position is for a Transition Coordinator for the Transition Team.
• The Transition Coordinator will be assigned to Central and North Cook County Nursing Home and SMHRF to meet with ABH-IL members, to assist with transition to the community.
• Transition Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources.
• As a Transition Coordinator, they will assist with transition of the members back to the community from the nursing home.
• Identify with members their needs and service needs that may impact member's outcomes.
• Coordinates with the RNCM, BHCM, and the rest of care team to ensure interventions are put into place to support members before and after discharge from the nursing home.
• Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.
• Identifies and escalates quality of care issues through established channels.
• Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs.
• Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
• Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
• Helps member actively and knowledgably participate with their provider in healthcare decision-making.
• Utilizes case management and quality management processes incompliance with regulatory and accreditation guidelines and company policies and procedures.

Case Management Analyst

Application Engineer

• Lead development and enforcement of application and AI security policies, standards, and guardrails
• Establish secure design patterns for AI agent frameworks
• Promote organization-wide awareness of AI-specific risks such as model misuse, prompt injection, data leakage, and unsafe agent behavior
• Serve as the principal SME for securing AI-enabled applications and agentic system architectures
• Architect and review secure designs for systems leveraging LLMs/foundation models, autonomous and semi-autonomous agents, RAG pipelines, and tool-using or decision-making workflows
• Define identity, authorization, data access, and observability controls specific to agentic environments
• Influence engineering and product teams to integrate secure engineering practices and align security with compliance, privacy, and responsible AI initiatives
• Advise senior leadership on AI security implications, architectural decisions, and long-term strategy
• Lead advanced security testing and risk assessments for AI-enabled systems
• Provide senior technical leadership during incidents involving application or AI systems
• Mentor senior and principal engineers to elevate security maturity across the organization

Principal Application Security Engineer – AI & Agentic Systems

• Dedicate 50-75% of the day to engaging with members and coordinating their care.
• Utilize all available resources to connect with and engage “hard-to-reach” members.
• Partner with members to develop individualized care plans that encompass goals and interventions to meet their identified needs.
• Maintain meticulous documentation of care management activities in the member’s electronic health record.
• Work with the Interdisciplinary Care Team to address barriers to care and develop strategies for maintaining the member’s stable health condition.
• Identify and connect members with health plan benefits and community resources.
• Meet regulatory requirements within specified timelines.
• Consult with the Care Manager RN within the Care Team for clinical knowledge, medication regimes, and supportive clinical decision making.
• Collaborate and leverage the Care Manager RN clinical expertise to ensure members’ needs are adequately addressed.
• Support team objectives, enhance operational efficiency, and ensure delivery of high-quality care to members. This may include participating in special projects, contributing to process improvement initiatives, or assisting with mentoring new team members.

Care Manager Specialist

• Coordinate care for members with chronic medical and behavioral health conditions
• Conduct comprehensive assessments to evaluate members’ needs
• Develop and implement individualized care plans
• Provide disease management education and support
• Ensure interdisciplinary team collaboration for optimal health outcomes
• Maintain meticulous documentation of care management activities

Care Manager – Registered Nurse

Data Scientist

• Build industry-leading analytics, data, and technology platforms to help re-imagine health care
• Engage business stakeholders to translate business problems into technical requirements
• Lead and guide junior data scientists
• Implement models, develop tools and algorithms for Claims, Appeals, and Grievances
• Leverage analytics for automation and efficiency improvement
• Develop, validate, and execute algorithms and predictive models
• Explore and interpret large data volumes
• Utilize advanced statistical techniques and develop data structures and pipelines
• Use data visualization to communicate analytical results
• Create and evaluate data needs of projects

Senior Data Scientist

Pharmacist

• Support the pharmacy team in delivering operational and service excellence within your store
• Assist the pharmacy team to ensure that pharmacy operations run smoothly, our patients’ prescriptions are filled promptly, safely, and accurately
• Provide caring service that exceeds patient expectations
• Operate as part of the pharmacy team through consistent application of Standard Operating Procedures (SOPs), best practices, and effective communication
• Complete a rigorous company training program and satisfy all registration, licensing, and certification requirements according to their State’s Board of Pharmacy guidelines
• Comply with CVS policies and procedures to ensure patient safety, compliance with controlled substance dispensing and recordkeeping, and to protect patient privacy and security
• Complete additional patient health care services (e.g., immunizations, point-of-care testing, and voluntarily staffing offsite clinics) where allowable by law and supported by required training and certification

Pharmacy Technician

• conducts oversight and management of clinical team processes
• communicates strategic plan and specific tactics to meet plan
• ensures implementation of tactics to meet strategic direction for cost and quality outcomes
• creates direction and communicates a business case for change
• identifies opportunities to implement best practice approaches and introduce innovations
• accountable for meeting the financial, operational and quality objectives of the department
• manages team(s) for adherence with established practices, policies and procedures
• collaborates with other functional area managers

Manager, Behavioral Health Utilization Management

Full-stack Engineer

• You'll design, build, and deploy infrastructure capabilities for database technologies in public, private, and hybrid cloud environments
• Drive the creation of automation for database infrastructure services to improve delivery and speed-to-market
• Collaborate with security, architecture, and engineering teams to establish and enforce standards and best practices
• Partner with product and program teams to define roadmaps and execution plans
• Build APIs to orchestrate automation exposing self-service capabilities to improve customer experiences
• Drive initiatives to incorporate open-source tools, cloud native services, and AI to increase efficiency