CVS Health

Analyst

• Administer and maintain HR systems, ensuring optimal performance, data integrity, and system availability.
• Configure system changes, including workflows, fields, and business rules, in alignment with organizational requirements.
• Manage system updates, releases, and enhancements in partnership with vendors and internal stakeholders.
• Troubleshoot system issues, coordinating resolution with IT and third-party providers as needed.
• Ensure accuracy, consistency, and security of employee data across HRIS, payroll, and related systems.
• Conduct regular audits of HR data to identify discrepancies and drive corrective actions.
• Establish and maintain data governance standards, documentation, and data management protocols.
• Develop and deliver standard and ad hoc HR reports to support operational and strategic needs.
• Partner with HR and business leaders to translate data into actionable recommendations.
• Serve as a cross-trained resource for payroll processes, supporting payroll execution as needed.

Senior Analyst, HRIS – Omnicare

QA Automation Engineer

• Design, develop and maintain automated solutions for relational database management systems (RDMS) using Database AI Ops
• Collaborate with software development teams to integrate database automation process into the software development cycle
• Implement and maintain database automation frameworks, tools, and scrips to streamline database operations and enhance efficiency
• Identify opportunities for process improvement and automation within the database environment and propose innovative solutions
• Troubleshooting automation pipeline failures
• Implementing Database DevOps
• Ensure high availability and optimal performance of production databases through effective automation strategies and monitoring techniques
• Document database automation process, procedures and configuration to ensure knowledge sharing and compliance with organization standards
• Keep up to date with the latest industry trends and advancement in database automation technologies

Database Automation Engineer

Manager

• Help elevate patient care through industry-leading support in serving dual eligible populations
• Collaborate with members, providers, and community organizations to address health care and social determinant needs
• Utilize a collaborative process of assessment, planning, facilitation, and care coordination
• Act as a liaison with member/client/family, employer, provider(s), insurance companies, and healthcare personnel
• Implement and coordinate all case management activities relating to catastrophic cases and chronically ill members/clients
• Communicate with members/clients and other stakeholders as appropriate
• Prepare all required documentation of case work activities as appropriate
• Consult with internal multidisciplinary team to help member/client maximize health outcomes
• Provide educational and prevention information for best medical outcomes
• Monitor member/client progress toward desired outcomes

Case Manager, Registered Nurse – Field

Customer Advocate

• Servicing your assigned book of business
• Acknowledge customer’s inquiry within 1 business day
• Create and maintain PDET cases as outlined in policy guidelines
• Acts as the single point of contact for client’s operational inquiries and escalated issues
• Resolutions to include but not limited to Claims, Enrollment, ID cards, COBRA, FSA, Network Ops, PBM, Customer Service, EDI Files and Finance
• Provides plan document interpretation and ensures the client’s questions are addressed
• Conduct client portal training
• Supports operational departments to enhance the member experience through improved workflows and process improvements
• Identify opportunities that support account owners in developing and delivering strategic plans

Client Advocate I

• Acts as a liaison with member/client /family, employer, provider(s), insurance companies, and healthcare personnel as appropriate.
• Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care.
• Interacts with members/clients telephonically or in person.
• May be required to meet with members/clients in their homes, worksites, or physician’s office to provide ongoing case management services.
• Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client’s appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determination of eligibility for benefits as appropriate.
• Communicates with member/client and other stakeholders as appropriate.
• Prepares all required documentation of case work activities as appropriate.
• Interacts and consults with internal multidisciplinary team as indicated to help member/client maximize best health outcomes.
• May make outreach to treating physician or specialists concerning course of care and treatment as appropriate.
• Provides educational and prevention information for best medical outcomes.
• Applies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by individual insurance carriers and referral sources.
• Conducts an evaluation of members/clients’ needs and benefit plan eligibility and facilitates integrative functions using clinical tools and information/data.
• Utilizes case management processes in compliance with regulatory and company policies and procedures.
• Facilitates appropriate condition management, optimize overall wellness and medical outcomes, appropriate and timely return to baseline, and optimal function or return to work.
• Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes, as well as opportunities to enhance a member’s/client’s overall wellness through integration.
• Monitors member/client progress toward desired outcomes through assessment and evaluation.

Case Manager, Registered Nurse

Pharmacist

• leverage strong organizational and interpersonal skills to lead and manage a team focused on Specialty Generics optimization
• oversee Pharmacy Service Representatives (PSRs), Benefits Verification (BV) representatives, Work-in-Progress (WIP) representatives, and technicians to ensure efficient and compliant operations
• participate in the hiring process
• provide ongoing guidance, coaching, and direction to staff
• manage team schedules
• ensure adherence to standard operating procedures (SOPs)
• responsible for staff training and development
• problem-solving and follow-up
• performance monitoring and evaluation

Supervisor, Specialty Pharmacy Services

Medical Director

• Support Medical Management staff ensuring timely and consistent responses to members and providers.
• Lead all aspects of utilization review/quality assurance, directing case management.
• Provide clinical expertise and business direction in support of medical management programs through participation in clinical team activities.
• Act as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams.
• Responsible for predetermination reviews and reviews of claim determinations, providing clinical, coding, and reimbursement expertise.

Medical Director – Ortho/Total Joint

• Lead enterprise Release Management coordination across teams, ensuring efficient, predictable, and low-risk delivery
• Establish and govern ITIL-aligned release processes adaptable to Agile, Waterfall, and hybrid delivery models
• Oversee release readiness, risk and dependency management, and Go/No-Go decision-making
• Manage release schedules, ServiceNow change records, and stakeholder communication across functions
• Drive continuous improvement through automation, analytics, and adoption of AI-enabled release capabilities

Manager, Enterprise Release Management

Consultant

• Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members
• Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care
• Communicates with providers and other parties to facilitate care/treatment
• Identifies members for referral opportunities to integrate with other products, services and/or programs
• Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization
• Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function

Utilization Management Nurse Consultant

• Support the pharmacy team in delivering operational and service excellence
• Ensure pharmacy operations run smoothly
• Fill patients’ prescriptions promptly, safely, and accurately
• Deliver caring service that exceeds patient expectations
• Complete basic inventory activities as directed

Pharmacy Technician

AI Engineer

• lead the product strategy, roadmap, and execution for a multi-agent AI decision intelligence platform
• serve as the bridge between business stakeholders, data science, engineering, and operations teams to deliver scalable AI-powered solutions
• define platform capabilities, prioritize investments, and drive the development of agentic AI workflows, predictive analytics solutions, and decision intelligence products
• translate complex business challenges into product requirements, manage cross-functional delivery teams, and ensure the platform delivers measurable value

Lead Decision Scientist – AI Product

Underwriter

• Provide analytical and operational support to Caremark Underwriting leadership
• Investigate drivers of change in pricing and forecasting outputs
• Identify root causes of anomalies
• Coordinate with internal stakeholders to obtain clarifications, data sources, and supporting documentation
• Respond to a broad range of ad hoc requests by gathering facts, performing targeted analyses, and producing clear, concise readouts for leadership and business partners
• Perform diagnostic reviews to explain changes in results across pricing and forecasting tools/models
• Partner with stakeholders across the underwriting ecosystem
• Build and maintain “side” analyses (primarily in Excel)
• Work with structured datasets and support extraction/validation of inputs and outputs using relational data concepts and SQL
• Maintain organized notes, assumptions, and reference materials

Senior Analyst, Executive Underwriting Priorities

Application Engineer

• Partner with stakeholders to identify, evaluate, document, and shape GenAI use cases (copilots, automation, decision support, and insight generation) with clear success metrics.
• Design solution architectures that integrate LLMs with enterprise systems, data sources, and tool/function calling while meeting latency and reliability expectations.
• Develop prototypes rapidly and validate them through evaluation, red-teaming, and user feedback; document tradeoffs and recommendations.
• Build production-grade services and full-stack experiences (APIs, UIs, workflows) with secure authentication/authorization, audit logging, and scalable deployment patterns.
• Implement safety, privacy, and compliance controls (e.g., PHI/PII protection, prompt injection defenses, data residency constraints, and policy-based filtering).
• Instrument solutions end-to-end with metrics, traces, logs, and model/app observability; contribute to SLOs, error budgets, and operational runbooks.
• Build and maintain evaluation harnesses for LLM quality, safety, and business outcomes (offline tests, golden sets, regression suites, and online experiments).
• Implement RAG pipelines (chunking, embedding, vector search, reranking) and optimize for accuracy, cost, and latency.
• Collaborate with platform teams on deployment, monitoring, drift/quality detection, and incident response for model-backed services.
• Contribute reusable libraries and patterns for prompt management, retrieval, tool calling, and policy enforcement.
• Participate in design reviews and code reviews; mentor senior and mid-level engineers on GenAI engineering practices.
• Continuously improve developer experience through templates, CI/CD automation, and documentation that accelerates safe adoption.

Staff Machine Learning Engineer – Generative AI, Full-Stack Applications

Business Analyst

• Collaborate and inform the case management process to facilitate appropriate healthcare outcomes for members
• Provide care coordination, support, and education for members using care management tools and resources
• Conduct comprehensive evaluations of member’s needs/eligibility
• Recommend approaches to case resolution and/or meeting needs
• Identify risk factors and service needs that may impact member outcomes
• Coordinate and implement assigned care plan activities and monitor care plan progress
• Consult with case managers and other health programs to overcome barriers
• Identify and escalate quality of care issues through established channels
• Utilize motivation interviewing skills to ensure maximum member engagement
• Provide coaching, information, and support to empower members

Case Management Analyst – Field

• Support the pharmacy team in delivering operational and service excellence within your store
• Assist patients and customers to deliver an exceptional experience
• Ensure pharmacy operations run smoothly, prescriptions are filled promptly, safely, and accurately
• Provide caring service that exceeds patient expectations
• Complete a rigorous company training program and satisfy all registration, licensing, and certification requirements according to state guidelines
• Follow all company SOPs at each workstation to help Pharmacists manage and improve patient health
• Complete basic inventory activities as permitted by law
• Contribute to a high-performing team, embracing a growth mindset and being receptive to feedback
• Remain flexible for both scheduling and business needs
• Comply with all relevant laws, regulations, professional standards, and CVS policies to ensure patient safety