At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
POSITION SUMMARY
CVS HEALTH is seeking a highly skilled and motivated Senior Information Security Manager to lead our Cyber Defense Automation and Platform team. The ideal candidate will have a strong background in cybersecurity, excellent leadership abilities, and a passion for protecting our organization from cyber threats. This role involves managing a team of technical resources in charge of developing security strategies, and ensuring the effective implementation of security measures. They will closely collaborate with senior leaders across the organization to deliver security enhancement and design innovative solutions to enhance our security posture.
REQUIRED QUALIFICATIONS
7+ years of experience in leading and managing a team of cybersecurity professionals, providing guidance, mentorship, and support to enhance their skills and performance.
5+ year of experience in developing and implementing comprehensive cyber defense strategies to protect the organization's information assets and infrastructure.
3+ years of experience in overseeing the development of SOAR application
Minimum of 3 years of experience delivering large-scale solutions, preferably within the healthcare industry, with a proven track record of meeting compliance and regulatory requirements.
PREFERRED QUALIFICATIONS
5+ years hands-on experience with SDLC and agile processes to deliver complex projects.
2+ years of experience in work with implementing innovative AI capabilities in security use cases.
5+ year of hands-on Experience with a major cloud platform (GCP, AWS, Azure) services and architecture design.
Strong communication and interpersonal skills, with the ability to interact effectively with both technical and non-technical stakeholders.
EDUCATION
Bachelor degree from accredited university or equivalent work experience(HS diploma + 4 years relevant experience).
BUSINESS OVERVIEW
Bring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviorsâ„¢ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
Pay Range
The typical pay range for this role is:
$130,295.00 - $260,590.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit *****************************************
We anticipate the application window for this opening will close on: 01/31/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
$130.3k-260.6k yearly Auto-Apply 42d ago
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Sr. Manager, Clinical Innovation
CVS Health 4.6
Senior manager job at CVS Health
At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
Position Summary
A SeniorManager of Clinical Innovation is a critical contributor to managing and successfully driving use cases within the clinical innovation portfolio and initiatives that solve key business problems, and support development of new sources of value within Aetna's Clinical Solutions business unit.
Leads, partners, and collaborates with cross-functional teams, including key internal and external stakeholders, to develop, test, and implement innovative solutions. Define, rationalize and align priorities with clearly defined business rationale
Drives and manages innovation scope through all stages such as ideation/concept, solution development and pilot with an eye towards scaled, readiness, value realization and monitoring. Manages risk, develops interventions and facilitates working sessions as well as delivers all required analysis, reporting and presentation materials
Supports the evaluation of new concepts, emerging innovation trends and clinical operations/offerings benchmarking within the healthcare industry and subsequently develops these trends into new and innovative solutions that solve key business problems and deliver break through value
Foster a culture that accelerates our strategy through our Heart At Work Behaviors by keeping the customer and colleague as the central focus
Required Qualifications
7+ years Program Management experience leading complex initiatives within the payer clinical space such as utilization management.
5+ years successful experience in strategy, innovation and/or portfolio management within healthcare industry or equivalent industry
Strong interpersonal and communication skills, effectively communicate key messages across all levels of the organization including executive leaders and internal/external stake holders.
Strong verbal and written communication skills; proven ability to develop and deliver presentations to senior leadership team members.
Strong data and analytics skills to synthesize information and derive key insights.
High ability to consistently produce and create value and meet/exceed committed performance
High ability to drive new innovation in highly cross-functional environments
Demonstrated relationship management skills; capacity to quickly build and maintain credible relationships at varying levels of the organization.
Preferred Qualifications
Experience identifying value opportunities and creating new capabilities and/or project offerings that result in new value
Conceptual and structured thinker with proven ability to generate and translate concepts and ideas into effective strategies that achieve results
Ability to embrace & promote change, navigate uncertainty and shifting priorities and plans to accommodate broader changing objectives and demands
Experience with enterprise-wide and/or cross-functional large scale initiatives with high degree of complexity.
Experience with the following: Innovation, analytics, generative AI, business process optimization, enterprise business portfolio management/consulting, financial analysis, strategic planning, risk management, product strategy, regulatory policy
Broad understanding of the healthcare landscape with ability to synthesize multiple disparate data points into a structured perspective aligned to action
Education
Masters degree preferred, but not required.
College degree. Appropriate licensure or certification by discipline preferred
Pay Range
The typical pay range for this role is:
$82,940.00 - $182,549.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit *****************************************
We anticipate the application window for this opening will close on: 01/23/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
$82.9k-182.5k yearly Auto-Apply 17d ago
Pharmacy Operations Manager
Walgreens 4.4
Dublin, OH jobs
Where state and federal laws/regulations allow, accountable for performing day-to-day non-clinical pharmacy operations, administrative activities; Ensures efficient pharmacy workflow and a positive patient experience. Serves as a full-time certified pharmacy technician.
Responsible for operating pharmacy systems to obtain patient and drug information and process prescriptions. Under the supervision of a pharmacist, supervising pharmacy technicians and pharmacy cashiers within the guidelines of authorized company policies, laws, regulations and business ethics.
Responsible for the selection, scheduling, and development of pharmacy technician personnel. Leads training, coaching, and performance management of pharmacy technicians. Makes decisions regarding performance management including discipline and termination.
If you would like to know a bit more about this opportunity, or are considering applying, then please read the following job information.
Customer Experience
Engages customers and patients by greeting them and offering assistance with products and services. Resolves customer complaints, helps respond to customers' requests in a timely manner and answers non-clinical questions to ensure a positive customer experience. Models and shares customer service best practices.
Develops strong relationships with customers by anticipating customer needs and proactively offering services to provide the best experience possible when using the pharmacy. Enhances customer experience by increasing focus on healthcare services.
Operations
Responsible for assisting pharmacist in the delivery of patient care including patient registration, prescription data entry, preparation of medications for patients, counting, and verifying (where allowed by law). Completes patient and physician calls under the supervision of a pharmacist (where allowed by law). Under the supervision of a pharmacist assists with healthcare service offerings including administering vaccines, health screenings, and any health services allowed by law.
Within the guidelines of authorized company policies, state and federal laws/regulations, exercises independent judgment to delegate, direct, and assign non-clinical work in the pharmacy. Ensures tasks are completed on-time and holds others accountable for efficient workflow.
At the direction of the Pharmacy Manager or pharmacist, prepares, and files reports and records required by the company and various government agencies.
Manages core pharmacy workflow and drives excellence in pharmacy operations. Coordinates and organizes pharmacy daily schedule of activities. Recommends allocation of pharmacy hours. Assures the pharmacy is clean, neat, orderly, and stocked with adequate supplies.
Under the direction of the pharmacist, exercises independent judgment to ensure compliance and execution of all business administrative activities and pharmacy inventory management tasks that do not require pharmacist licensure. Manages annual inventory preparation.
Accountable for completion of non-clinical patient calls.
Drives new technology/ process roll out, champions change and engages team around action planning. Assures proper operation and maintenance of pharmacy department equipment. In collaboration with Pharmacy Manager, responsible for recordkeeping and ensuring security safeguards are in-place.
Under supervision of the pharmacist, strictly adheres to the Walgreen Co. policy regarding Good Faith Dispensing during all applicable prescription-dispensing activities and understands their role in ensuring that the elements of Good Faith Dispensing are met.
Maintains and applies knowledge of Company asset protection techniques. Supports Pharmacy Manager with diversion monitoring and reports any concerns that would compromise the security of the pharmacy to the Pharmacy Manager.
Communicates prescription errors to the accountable pharmacist, and adheres to Company policies and procedures in relation to pharmacy errors and the Continuous Quality Improvement Program.
Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follows-up with insurance companies as well as medical providers and conducts or participates in 3rd party audit.
Assists and supports Store Manager and Pharmacy Manager in analyzing and seeking to improve pharmacy financials, operational quality and customer service.
Manages Community Outreach Portal and coordinates and, at the direction of the Pharmacy Manager, assigns pharmacists to off-site immunization clinics and community events. Builds and sustains relationships with retail partnerships.
People & Performance Management
Leads performance management of technicians including making decisions and recommendations regarding discipline and termination. Follows constructive discipline policy to discipline, suspend, terminate or effectively recommend the same. Uses constructive discipline policy to ensure pharmacy technicians are compliant with state and federal laws. Holds technician accountable for attendance and timeliness. Maintains and improves performance of pharmacy through team member engagement and action planning.
Accountable for technician hiring, on-boarding, training, and scheduling. Monitors and holds pharmacy technicians accountable for timely training completion. Follows established policies and procedures set by the company for scheduling and training.
Accountable for identifying gaps in pharmacy operations knowledge among team members and supporting those team members in their training, either through hands-on training or assignment of learning modules.
Assists Pharmacy Manager in monitoring that all pharmacy and team member licensures, registrations and certifications are active and in good standing/ compliant with all regulatory and legal requirements. Leverages Walgreens resources such as Walgreens Online Verification System to assist in documenting licensure status.
Ensures proper procedures are followed for selection, recruitment, record retention, and training as required by Company policy and local, state and federal laws.
Training & Personal Development
Maintains PTCB certification through the designated PTCB training program and/or state required certification/registration.
Maintains and enhances current knowledge and skills related to pharmacy and healthcare.
Obtains necessary certifications, education credits and training such as LTMP e-modules as required by the Company. Follows performance improvement plans offered by Pharmacy Manager.
Seeks professional development by monitoring one's own performance, solicits for constructive feedback, and leverages Healthcare Supervisor as mentor and coach.
Communication
Communicates with pharmacy team, relaying messages from the support center or other key emails as required.
Participates in key store/pharmacy meetings, including 5-minute meetings and weekly check-ins with the Store Manager
Basic Qualifications
High School Diploma, GED, or equivalent.
PTCB or ExCPT certification (except in Puerto Rico).
Has one year of work experience as a pharmacy technician in a retail or hospital setting.
Must be fluent in reading, writing, and speaking English (except in Puerto Rico).
Requires willingness to work flexible schedule, including evening and weekend hours.
Willingness to obtain active immunization certification within 90 days of hire (except in Community Specialty Pharmacy and Health System Pharmacy locations)
Preferred Qualifications
Previous people management/ leadership experience.
Previous work experience with Walgreens with an Exceeding Expectation on last performance evaluation.
We will consider employment of qualified applicants with arrest and conviction records.
This information is being provided to promote pay transparency and equal employment opportunities at Walgreens. The current salary range for this position is $22.50 per hour - $31.00 per hour. The actual hourly salary within this range that you will be offered will depend on a variety of factors including geography, skills and abilities, education, experience and other relevant factors. This role will remain open until filled. xevrcyc To review benefits, please click here /benefits. If you are applying on a job board or unable to click on the link, please copy and paste this URL into your browser /benefits
Salary Range: Hourly
$22.5-31 hourly 1d ago
Pharmacy Operations Manager
Walgreens 4.4
Cleveland, OH jobs
Where state and federal laws/regulations allow, accountable for performing day-to-day non-clinical pharmacy operations, administrative activities; Ensures efficient pharmacy workflow and a positive patient experience. Serves as a full-time certified pharmacy technician.
Responsible for operating pharmacy systems to obtain patient and drug information and process prescriptions. Under the supervision of a pharmacist, supervising pharmacy technicians and pharmacy cashiers within the guidelines of authorized company policies, laws, regulations and business ethics.
Responsible for the selection, scheduling, and development of pharmacy technician personnel. Leads training, coaching, and performance management of pharmacy technicians. Makes decisions regarding performance management including discipline and termination.
Customer Experience
Engages customers and patients by greeting them and offering assistance with products and services. Resolves customer complaints, helps respond to customers' requests in a timely manner and answers non-clinical questions to ensure a positive customer experience. Models and shares customer service best practices.
Develops strong relationships with customers by anticipating customer needs and proactively offering services to provide the best experience possible when using the pharmacy. Enhances customer experience by increasing focus on healthcare services.
Operations
Responsible for assisting pharmacist in the delivery of patient care including patient registration, prescription data entry, preparation of medications for patients, counting, and verifying (where allowed by law). Completes patient and physician calls under the supervision of a pharmacist (where allowed by law). Under the supervision of a pharmacist assists with healthcare service offerings including administering vaccines, health screenings, and any health services allowed by law.
Within the guidelines of authorized company policies, state and federal laws/regulations, exercises independent judgment to delegate, direct, and assign non-clinical work in the pharmacy. Ensures tasks are completed on-time and holds others accountable for efficient workflow.
At the direction of the Pharmacy Manager or pharmacist, prepares, and files reports and records required by the company and various government agencies.
Manages core pharmacy workflow and drives excellence in pharmacy operations. Coordinates and organizes pharmacy daily schedule of activities. Recommends allocation of pharmacy hours. Assures the pharmacy is clean, neat, orderly, and stocked with adequate supplies.
Under the direction of the pharmacist, exercises independent judgment to ensure compliance and execution of all business administrative activities and pharmacy inventory management tasks that do not require pharmacist licensure. Manages annual inventory preparation.
Accountable for completion of non-clinical patient calls.
Drives new technology/ process roll out, champions change and engages team around action planning. Assures proper operation and maintenance of pharmacy department equipment. In collaboration with Pharmacy Manager, responsible for recordkeeping and ensuring security safeguards are in-place.
Under supervision of the pharmacist, strictly adheres to the Walgreen Co. policy regarding Good Faith Dispensing during all applicable prescription-dispensing activities and understands their role in ensuring that the elements of Good Faith Dispensing are met.
Maintains and applies knowledge of Company asset protection techniques. Supports Pharmacy Manager with diversion monitoring and reports any concerns that would compromise the security of the pharmacy to the Pharmacy Manager.
Communicates prescription errors to the accountable pharmacist, and adheres to Company policies and procedures in relation to pharmacy errors and the Continuous Quality Improvement Program.
Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follows-up with insurance companies as well as medical providers and conducts or participates in 3rd party audit.
Assists and supports Store Manager and Pharmacy Manager in analyzing and seeking to improve pharmacy financials, operational quality and customer service.
Manages Community Outreach Portal and coordinates and, at the direction of the Pharmacy Manager, assigns pharmacists to off-site immunization clinics and community events. Builds and sustains relationships with retail partnerships.
People & Performance Management
Leads performance management of technicians including making decisions and recommendations regarding discipline and termination. Follows constructive discipline policy to discipline, suspend, terminate or effectively recommend the same. Uses constructive discipline policy to ensure pharmacy technicians are compliant with state and federal laws. Holds technician accountable for attendance and timeliness. Maintains and improves performance of pharmacy through team member engagement and action planning.
Accountable for technician hiring, on-boarding, training, and scheduling. Monitors and holds pharmacy technicians accountable for timely training completion. Follows established policies and procedures set by the company for scheduling and training.
Accountable for identifying gaps in pharmacy operations knowledge among team members and supporting those team members in their training, either through hands-on training or assignment of learning modules.
Assists Pharmacy Manager in monitoring that all pharmacy and team member licensures, registrations and certifications are active and in good standing/ compliant with all regulatory and legal requirements. Leverages Walgreens resources such as Walgreens Online Verification System to assist in documenting licensure status.
Ensures proper procedures are followed for selection, recruitment, record retention, and training as required by Company policy and local, state and federal laws.
Training & Personal Development
Maintains PTCB certification through the designated PTCB training program and/or state required certification/registration.
Maintains and enhances current knowledge and skills related to pharmacy and healthcare.
Obtains necessary certifications, education credits and training such as LTMP e-modules as required by the Company. Follows performance improvement plans offered by Pharmacy Manager.
Seeks professional development by monitoring one's own performance, solicits for constructive feedback, and leverages Healthcare Supervisor as mentor and coach.
Communication
Communicates with pharmacy team, relaying messages from the support center or other key emails as required.
Participates in key store/pharmacy meetings, including 5-minute meetings and weekly check-ins with the Store Manager
Basic Qualifications
High School Diploma, GED, or equivalent.
PTCB or ExCPT certification (except in Puerto Rico).
Has one year of work experience as a pharmacy technician in a retail or hospital setting.
Must be fluent in reading, writing, and speaking English (except in Puerto Rico).
Requires willingness to work flexible schedule, including evening and weekend hours.
Willingness to obtain active immunization certification within 90 days of hire (except in Community Specialty Pharmacy and Health System Pharmacy locations)
Preferred Qualifications
Previous people management/ leadership experience.
Previous work experience with Walgreens with an Exceeding Expectation on last performance evaluation.
We will consider employment of qualified applicants with arrest and conviction records.
This information is being provided to promote pay transparency and equal employment opportunities at Walgreens. The current salary range for this position is $22.50 per hour - $31.00 per hour. The actual hourly salary within this range that you will be offered will depend on a variety of factors including geography, skills and abilities, education, experience and other relevant factors. This role will remain open until filled. To review benefits, please click here jobs.walgreens.com/benefits. If you are applying on a job board or unable to click on the link, please copy and paste this URL into your browser jobs.walgreens.com/benefits
Salary Range: Hourly
$22.5-31 hourly 1d ago
Senior Manager, Information Governance and Privacy
CVS Health 4.6
Senior manager job at CVS Health
At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
Position Summary
The SeniorManager, Information Governance and Privacy plays a critical leadership role in managing privacy operations and technology solutions that safeguard sensitive data across the enterprise. This position within our Pharmacy and Consumer Wellness (PCW) team applies in-depth knowledge to ensure compliance with data protection laws, regulations, and policies, and also conducts privacy risk assessments, reviews and drafts privacy policies. This individual collaborates with cross-functional teams to implement privacy programs, responds to data breaches, and ensures compliance with privacy, security, and data governance standards.
Key Responsibilities
Lead Technology & Control Operations: Oversee teams managing privacy tools and platforms such as Radar Incident Management, Archer, OneTrust, Tableau, and SharePoint. Drive system enhancements and backlog prioritization to optimize operational workflows.
Governance & Risk Management: Collaborate with Legal, IT, Assurance, Compliance, Enterprise Information Security, and Internal Audit to identify privacy risks, ensure adherence to regulatory requirements, and implement remediation strategies.
Operational Excellence: Serve as a thought leader on metrics, reporting, and process improvements. Develop and maintain privacy operations processes, including incident response and breach assessments under HIPAA and state laws.
Team Development: Manage and mentor team members, fostering a culture of accountability, collaboration, and continuous improvement; set clear performance expectations and conduct regular evaluations.
Incident and Breach Response: Lead a team of privacy compliance professionals responsible for handling privacy incidents/investigations, complaints, and providing advisory support to Retail Pharmacy Consumer Wellness business partners; ensure compliance with federal and state privacy laws, including incident reporting and breach documentation; review complex cases to ensure risk assessment, findings, and mitigation measures are appropriately documented.
Privacy Compliance: Lead privacy compliance initiatives for retail pharmacy operations, managing a centralized repository of policies, job aids, and best practices to support pharmacy teams; provide guidance and resources to ensure proper handling and reporting of authorized disclosures and privacy incidents; partner with Pharmacy Operations to promote privacy awareness, facilitate cross-training, and implement robust physical, technical, and administrative safeguards across stores.
Required Qualifications
7+ years of experience in privacy, information governance, or related fields with:
Strong knowledge of privacy laws, security standards, and data governance frameworks.
4+ years managing privacy tools (e.g., Archer, Radar, OneTrust) and operational reporting.
Preferred Qualifications
Proven ability to lead teams; adept at problem solving, decision-making, and collaboration/teamwork.
Experience with privacy tools (e.g., Radar) and advanced Excel features.
Familiarity with collaboration platforms (SharePoint, Teams, iManage).
Demonstrated success in driving compliance and operational efficiency in complex organizations.
Core Competencies
Strategic decision-making and prioritization.
Strong influencing and communication skills.
Excellent attention to detail and ability to keep track of deadlines.
Ability to balance compliance objectives with business needs.
Commitment to fostering a responsible data culture and ethical use of emerging technologies.
Education
Bachelor's degree required or equivalent years of related experience.
Pay Range
The typical pay range for this role is:
$75,400.00 - $182,549.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit *****************************************
We anticipate the application window for this opening will close on: 01/23/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
$75.4k-182.5k yearly Auto-Apply 38d ago
Senior Manager, National VBC Partner Optimization
CVS Health 4.6
Senior manager job at CVS Health
At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
Position Summary
At Aetna, our health benefits business, we are committed to helping our members achieve their best health in an affordable, convenient, and comprehensive manner. Combining the assets of our health insurance products and services with CVS Health's unrivaled presence in local communities and their pharmacy benefits management capabilities, we're joining members on their path to better health and transforming the health care landscape in new and exciting ways every day.
Aetna is recruiting for a SeniorManager, National Partner Optimization, who will support the design and execution of strategic and operational processes to improve National Value Based Care (VBC) Partner relationships and performance within and across Primary Care and Specialty partner verticals. This individual will work collaboratively with Aetna business and functional teams to support the successful implementation and operations of strategic VBC initiatives to advance business goals.
Major Responsibilities:
· Develop and implement optimized processes and workflows to achieve team efficiency and/or capacity gains
· Launch engagement structures and facilitate collaborations with cross-functional Aetna and CVSH teams (e.g., related to partnership ideation, communications strategy, opportunity assessments, and issue management)
· Coordinate intake of National VBC Partnerships project proposals
· Manage special projects through to execution
· Ongoing management of reporting and dashboards to monitor, measure and socialize comprehensive performance results
· Draw connections to internal initiatives, business impacts, and metrics driving business performance
· Support the National VBC Partnerships team in engagements with other core Aetna and CVSH stakeholders (e.g., Aetna Member Services, CVSH Ventures, select Case Management areas)
You will make an impact by:
Providing direct support to business leaders to coordinate strategic priorities within each workstream
Organizing and tracking priorities, aligned with identified business value
Driving work forward by tracking milestones, deliverables, and preparing presentations
Escalating issues as they arise to National Partner Optimization leaders
Required Qualifications
The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment. This position offers broad exposure to all aspects of the company's business, as well as significant interaction with all the business leaders. The candidate will be expected to have the following key attributes:
5+ years of experience in program and process management within the healthcare payer or provider space
Adept at execution and delivery (planning, delivering, and supporting) skills
Familiarity with the Value Based Care provider space
Experience working in a highly matrixed environment
Demonstrate a commitment to diversity, equity, and inclusion through continuous development, modeling inclusive behaviors, and proactively managing bias
Preferred Qualifications
Experience in assigned workstream area (Network, Medicare, Provider Operations, Service Operations, etc.)
Education
Bachelor's degree/specialized training/relevant professional qualification.
Pay Range
The typical pay range for this role is:
$82,940.00 - $182,549.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit *****************************************
We anticipate the application window for this opening will close on: 01/31/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
$82.9k-182.5k yearly Auto-Apply 8d ago
Senior Manager, Informatics
CVS Health 4.6
Senior manager job at CVS Health
At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
Position Summary
As a Sr. Manager, Informatics (Individual Contributor), you will play a pivotal role in supporting the Medicare Stars organization to better understand our members and reduce abrasion. Your primary responsibility is to engage with stakeholders, deeply understand their challenges and goals, and develop analyses and insights that drive meaningful action.
Why Join Us:
Directly impact the quality of care and satisfaction for our Medicare members
Work in a collaborative, innovative environment
Opportunity to see your insights shape organizational priorities and member outcomes
Key Responsibilities:
Partner with stakeholders to identify member experience challenges and define analytic needs
Develop and deliver actionable insights to improve Medicare member outcomes and reduce abrasion
Conduct advanced statistical analysis on key measures (CAHPS, NPS, Retention, etc.)
Translate complex data into clear, compelling narratives for business partners
Collaborate as needed with data scientists and dashboard designers to develop repeatable processes
[Optional] Insights that demonstrate high value may be incorporated into broader data science initiatives or dashboard visualizations
Required Qualifications
5+ years of experience in analytics, informatics, or related roles
Strong statistical analysis and data interpretation skills
Experience working with survey-based measures (e.g., CAHPS, NPS)
Proficiency in data analysis and visualization tools (e.g., SQL, Python, Tableau, Power BI)
Excellent communication skills for both technical and non-technical audiences
Ability to translate stakeholder needs into actionable analytic solutions
Preferred Qualifications
Experience in healthcare analytics, especially Medicare
Familiarity with member experience improvement strategies
Advanced degree or relevant certifications
Education
Bachelor's degree or equivalent work experience
Pay Range
The typical pay range for this role is:
$82,940.00 - $182,549.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit *****************************************
We anticipate the application window for this opening will close on: 01/22/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate.
And we do it all with heart, each and every day.
Position Summary: The Sr.
Manager is an experienced/career level compliance position that applies compliance, regulatory, business, analytical and communication skills to support, manage and develop and execute Medicare and Medicaid compliance programs and processes that promote compliant and ethical behavior, meet regulatory obligations, and prevent, detect and mitigate compliance risks.
The individual will work independently, as well as collaboratively, with internal senior level corporate compliance and business teams that operate Medicare Advantage in a highly complex regulatory environment and highly matrixed organization environment with a current focus on integrated special needs plans.
The Sr.
Manager Compliance maintains productive relationships and open lines of communication with internal and key external stakeholders to effectively communicate and influence compliant outcomes and ensure that processes are enhanced or implemented to effectively address compliance requirements.
Responsibilities include, but are not limited to:Serve as plan compliance officer for assigned Special Needs Plans (SNPs) Lead and implement an effective Compliance Program as described in CMS Medicare Managed Care Manuals/regulations, applicable Medicaid rules and government contracts, including risk assessment, auditing and monitoring and corrective action oversight Develop and manage compliance strategies, programs, and processes that promote compliant and ethical behavior, meet regulatory obligations, and prevent, detect, and mitigate compliance risks Track, analyze, research, interpret and monitor applicable CMS and state regulations and government contract requirements to develop recommendations, direction, and escalation ensuring Aetna's that implementation and integration of program requirements complies with federal and state specific program requirements and the CVS Code of ConductMaintain in-depth working knowledge and expertise in Medicare, Medicaid and State requirements, regulations and contracts with a focus on supporting special needs plans Facilitate compliance and contract related communications, deliverables and activities with regulators Manage to ensure timely and accurate responses and tracking of multiple complex regulatory interactions, including frequent meeting with regulators on compliance with laws and regulations, developing or assisting in the development of appropriate and strategic written responses to compliance-related regulatory inquiries requiring an understanding of business processes and regulatory requirements and positive relationships with regulators Leads and/or supports numerous external regulatory review and audit activities, including the preparation for and management of external audits conducted by state Medicaid and related agencies or partners in conjunction with health plan leadership through final report and corrective action plan closure Builds and maintains positive relationships with internal and external constituents at senior levels to drive decision-making and influence ethical and compliant outcomes Monitor and audit as outlined in Medicare Compliance Work Plan and direct other projects as assigned to evaluate compliance, propose remediation where necessary and monitor implementation of corrective action Utilize and maintain current information in systems unique to job functions, such as Microsoft products and compliance specific tools such as ArcherLead and support broader compliance initiatives and needs as assigned to ensure that effective compliance programs are achieved and maintained Work on other duties as assigned In order to be successful in this role you must exhibit the following:Extensive knowledge of Medicare and Medicaid compliance programs and rules, including rules applying to integrated duals plans Experience in validation, auditing and monitoring, root cause analysis and corrective action oversight Outstanding time management and project management Proficient in utilization of information systems Mastery of problem solving and decision-making skills Adept at execution and delivery (planning, delivering, and supporting) skills Adept at collaboration and teamwork Required Qualifications:7+ years' experience in Medicare or Medicare Advantage government healthcare program compliance or regulatory work2+ years of Project Management experience Ability to travel up to 10%Preferred Qualifications: Extensive knowledge of Medicare and Medicaid compliance programs and rules, including rules applying to integrated duals plans.
Education:Bachelor's Degree required Pay RangeThe typical pay range for this role is:$82,940.
00 - $182,549.
00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.
The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.
This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
This position also includes an award target in the company's equity award program.
Our people fuel our future.
Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be.
In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit *************
cvshealth.
com/us/en/benefits We anticipate the application window for this opening will close on: 01/31/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
$82.9k-182.5k yearly 14d ago
Project Manager, Strategic Accounts and Client Engagement
Cardinal Health 4.4
Columbus, OH jobs
_This position is remote and can be based anywhere in the United States. Candidates must be able to work EST of CST business hours._ **_What Strategic Account Solutions contributes to Cardinal Health_** The Commercial Strategic Solutions organization supports client engagement and project management within the context of nationally held summit events for the Specialty Networks business. The _Project Manager_ will assist in managing customer project deliverables, support the account management team with execution of initiatives, coordinate all aspects of assigned customer projects (includes planning, timing, and execution within the constraints of a budget, schedule, and scope) while minimizing risk, and adhering to established processes and methodologies.
**_Responsibilities_**
+ **Lead Project Lifecycle:** Drive the end-to-end project management for strategic account summit events across Oncology, Urology, Gastroenterology, and Rheumatology therapeutic areas, ensuring adherence to scope, timelines, and customer expectations.
+ **Stakeholder Engagement:** Conduct and lead internal and external project kick-off, implementation, and regular status meetings. Define customer requirements, track deliverables, and provide timely updates to account management and clients.
+ **Operational Planning & Oversight:** Collaborate with internal operations to develop and maintain project plans, work orders, and chronologies. Monitor milestone progress, identify and escalate project risks, and ensure timely project closeout.
+ **Strategic Partnership:** Serve as a primary resource for the account management team, managing projects within a matrixed organization and maintaining a strong customer service orientation.
+ **Financial & Process Management:** Partner with account management and accounting to ensure timely invoicing. Monitor and update Standard Operating Procedures (SOPs) and maintain accurate project documentation, reports, and spreadsheets.
+ **Travel:** Travel to summit events 8+ times annually (typically 1-3 nights per trip).
**_Qualifications_**
+ 4+ years in project management, account management, or customer service experience, preferred
+ Experience in client event coordination, management or planning, preferred
+ Experience working with therapeutic areas such as Oncology, Urology, Gastroenterology, Rheumatology, a plus
+ Strong written and verbal communication skills required
+ Ability to work with internal and external cross-functional stakeholders
+ A self-starter with a high attention to detail
+ Ability to problem solve and remain calm in a stressful situation
+ Successfully multi-tasking in a fast-paced, deadline-driven environment
+ Ability to travel domestically up to 10x per year with advance notice, depending on business needs
**Anticipated salary range:** $80,900 - $100,000
**Bonus eligible:** No
**Benefits:** Cardinal Health offers a wide variety of benefits and programs to support health and well-being.
+ Medical, dental and vision coverage
+ Paid time off plan
+ Health savings account (HSA)
+ 401k savings plan
+ Access to wages before pay day with my FlexPay
+ Flexible spending accounts (FSAs)
+ Short- and long-term disability coverage
+ Work-Life resources
+ Paid parental leave
+ Healthy lifestyle programs
**Application window anticipated to close:** **01/19/26** *if interested in opportunity, please submit application as soon as possible.
_** The salary range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity._
_Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply._
_Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal_ _Opportunity/Affirmative_ _Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law._
_To read and review this privacy notice click_ here (***************************************************************************************************************************
$80.9k-100k yearly 15d ago
Senior Manager, National Specialty Value Based Care Provider Performance
CVS Health 4.6
Senior manager job at CVS Health
At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
Implements Vale Based Care (VBC) National Specialty network strategies, monitors provider performance metrics, leads dispute resolution processes, and collaborates with key stakeholders to drive network growth and ensure high-quality provider relationships.
**What you will do**
+ Develops and implements internal and external strategies to effectively assess and advance the performance of healthcare providers within the company's network.
+ Develops and maintains provider scorecards and performance reports to track and communicate performance metrics to internal stakeholders, executives, and network providers.
+ Monitors and evaluates provider performance metrics, such as quality indicators, patient satisfaction scores, cost efficiency measures, and adherence to clinical guidelines.
+ Communicates with providers to develop and implement initiatives aimed at enhancing quality of care, patient outcomes, and operational efficiency.
+ Contributes to business objectives by collaborating with the network development team to identify providers that align with the company's strategic goals and objectives.
+ Manages operational aspects of the team, and implements workforce and succession plans to successfully achieve business goals.
+ Guides management for individual performance evaluations aimed to provide critical feedback for skills development and depth of work area experience.
**Required Qualifications:**
+ A minimum of 5 years related experience with provider engagement, relations, or account management.
+ Working knowledge of Medicare contracts.
+ An understanding of value based contracts, how they work, what is the value.
+ Strong presentation skills, the ability to communicate effectively.
+ Mastery of problem solving and decision making skills
+ Strong MS Office skills.
Preferred Qualifications:
+ The ability to use data to tell a story.
+ Mastery of growth mindset (agility and developing yourself and others) skills.
**Education:**
+ Bachelor's degree preferred or a combination of professional work experience and education.
**Pay Range**
The typical pay range for this role is:
$67,900.00 - $199,144.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
**Great benefits for great people**
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
+ **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** .
+ **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
+ **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit *****************************************
We anticipate the application window for this opening will close on: 01/31/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
We are looking for a dynamic and highly experienced SeniorManager, Strategic Financial Planning & Investments to join our team at Aetna/CVS. In this critical hybrid role, you will be responsible for developing and executing financial models, supporting multi-year capital planning, and driving strategic oversight for large-scale, high-impact initiatives. You'll play a central role in managing key relationships, presenting strategic insights to senior leadership, and influencing enterprise-wide decision-making.
Responsibilities:
Strategic Financial Modeling & Planning: Lead the design and development of financial, economic, and strategic frameworks for clinical services initiatives. Support the multi-year enterprise capital planning process, overseeing and driving high-value projects that shape product and service delivery.
Investment Planning & Capital Management: Manage the ACS capital planning process, securing $100M+ annually for strategic investments. Collaborate closely with ACS leadership, Finance, and other key stakeholders to ensure alignment with enterprise funding guidelines and organizational priorities.
Portfolio Management & Governance: Optimize the prioritization and utilization of resources across internal and external projects to maximize value. Provide portfolio governance, regular status updates, and key insights on ACS investment portfolio performance. Oversee scope management and backlog prioritization to ensure successful delivery of strategic goals.
Business Case Development & Value Realization: Lead the evaluation and development of business cases for new initiatives, ensuring alignment with strategic goals and performing cost-benefit analysis. Track value realization and develop methods to measure actual performance against expected benefits.
Leadership & Communication: Lead initiatives that require significant change management within large and complex organizations. Build and maintain strong senior-level relationships, influence strategic decision-making, and present key findings in a clear and impactful manner.
Required Qualifications:
7+ years of experience in management consulting, financial strategic analysis, business process consulting, mergers and acquisitions, or strategic business planning.
Proven leadership skills with the ability to manage relationships and influence stakeholders at senior levels.
Expertise in business process optimization, project management, and financial planning with a focus on enterprise-wide initiatives.
Extensive experience in financial analysis, modeling, and reporting. Advanced proficiency in Microsoft Excel, PowerPoint, and Word.
Excellent communication skills (both oral and written), with a track record of presenting to and influencing senior leadership.
Self-motivated, adaptable, and a proven individual contributor with a strategic mindset.
Preferred Qualifications:
Experiece working within healthcare, or healthcare insurance industry is a plus, but not required
Education:
Bachelor's degree, or equivilant experience
Master's degree preferred, but not required.
Certifications or licensure in relevant disciplines are a plus.
Pay Range
The typical pay range for this role is:
$75,400.00 - $199,144.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit *****************************************
We anticipate the application window for this opening will close on: 01/30/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
$75.4k-199.1k yearly Auto-Apply 36d ago
Senior Manager, Trade Strategic Planning
CVS Health 4.6
Senior manager job at CVS Health
At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
Position Summary
We are seeking a highly skilled and experienced individual with a strong background in the pharmacy benefit management industry to join our team. The SeniorManager, Trade Strategic Planning, will focus primarily on evaluating Trade initiatives and assessing financial value to identify opportunities, risks, and trends. In addition to working with colleagues in other Trade teams to size value drivers and align financial outcomes with strategic objectives, you will partner with other functions outside of the Trade organization to define and execute processes and strategies that support value creation and drive efficiencies. This is an outstanding opportunity with exposure to senior executives.
Additional responsibilities will be to:
Understand and evaluate revenue impacts of formulary strategies, pharma contract changes, and market events
Manage financial budgeting and forecasting process deliverables, analyzing Trade team submissions and summarizing business drivers behind the change
Develop and maintain monthly Trade revenue performance tracking, inclusive of risk and opportunity assessments
Assist in development of analyses & materials for executive-level audiences, including leading work with cross-functional partners to inform content and resolve data needs
Collaborate across Trade, Underwriting, and Finance partners to create/streamline processes and support cross-team rebate initiatives and future planning
Identify and implement process improvements/automation efforts to drive efficiencies and alignment, and manage documentation of process maps, guiding principles, and options analyses as needed
Provide project management support for key projects/initiatives
To be successful, you should possess:
Strong problem solving, analytical, oral and written communication skills
Experience leading conversations with cross-functional partners to understand CVS enterprise and PBM client financial impacts and to align on assumptions and deliverables
Experience developing analyses and presentations to explain business issues, quantify financial impact, and provide recommendations
Expertise in starting with raw data and transforming it into financial insights in an easy-to-understand way
Ability to work independently in a fast-paced environment and manage tight deadlines and competing priorities
Experience working through ambiguous projects, with ability to quickly identify business needs and conduct a thorough analysis
Required Qualifications
8+ years of experience in managed care, with a focus in pharmacy benefit management, pharmaceutical market access, formulary and rebate strategy setting, or financial strategy
Advanced capabilities using Microsoft Excel for data analytics and financial modeling/analysis
Experience manipulating and analyzing data from large databases using SQL or other appropriate software
Ability to make informed, data-driven decisions, with a strong emphasis on translating data insights into actionable strategies.
Demonstrated knowledge of corporate financial concepts (P&L management, budget development, variance analysis, etc.)
Preferred Qualifications
5+ years experience with pharmacy benefit management, prescription drug rebates, prescription drug spend, and/or formulary strategies
Experience leading process improvement exercises
Exposure and/or knowledge of the evolving pharmaceutical regulatory environment
Proficiency in Tableau or other data visualization software
Experience utilizing Google BigQuery to extract raw data
Education
Bachelor's degree in finance, healthcare, or related field required; or equivalent experience
MBA or Master's degree preferred
Pay Range
The typical pay range for this role is:
$67,900.00 - $182,549.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit *****************************************
We anticipate the application window for this opening will close on: 02/16/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
$67.9k-182.5k yearly Auto-Apply 7d ago
Senior Manager, Trade Strategic Planning
CVS Health 4.6
Senior manager job at CVS Health
At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
Position Summary
We are seeking a highly skilled and experienced individual with a strong background in the pharmacy benefit management industry to join our team. The SeniorManager, Trade Strategic Planning, will focus primarily on evaluating Trade initiatives and assessing financial value to identify opportunities, risks, and trends. In addition to working with colleagues in other Trade teams to size value drivers and align financial outcomes with strategic objectives, you will partner with other functions outside of the Trade organization to define and execute processes and strategies that support value creation and drive efficiencies. This is an outstanding opportunity with exposure to senior executives.
Additional responsibilities will be to:
Understand and evaluate revenue impacts of formulary strategies, pharma contract changes, and market events
Manage financial budgeting and forecasting process deliverables, analyzing Trade team submissions and summarizing business drivers behind the change
Develop and maintain monthly Trade revenue performance tracking, inclusive of risk and opportunity assessments
Assist in development of analyses & materials for executive-level audiences, including leading work with cross-functional partners to inform content and resolve data needs
Collaborate across Trade, Underwriting, and Finance partners to create/streamline processes and support cross-team rebate initiatives and future planning
Identify and implement process improvements/automation efforts to drive efficiencies and alignment, and manage documentation of process maps, guiding principles, and options analyses as needed
Provide project management support for key projects/initiatives
To be successful, you should possess:
Strong problem solving, analytical, oral and written communication skills
Experience leading conversations with cross-functional partners to understand CVS enterprise and PBM client financial impacts and to align on assumptions and deliverables
Experience developing analyses and presentations to explain business issues, quantify financial impact, and provide recommendations
Expertise in starting with raw data and transforming it into financial insights in an easy-to-understand way
Ability to work independently in a fast-paced environment and manage tight deadlines and competing priorities
Experience working through ambiguous projects, with ability to quickly identify business needs and conduct a thorough analysis
Required Qualifications
8+ years of experience in managed care, with a focus in pharmacy benefit management, pharmaceutical market access, formulary and rebate strategy setting, or financial strategy
Advanced capabilities using Microsoft Excel for data analytics and financial modeling/analysis
Experience manipulating and analyzing data from large databases using SQL or other appropriate software
Ability to make informed, data-driven decisions, with a strong emphasis on translating data insights into actionable strategies.
Demonstrated knowledge of corporate financial concepts (P&L management, budget development, variance analysis, etc.)
Preferred Qualifications
5+ years experience with pharmacy benefit management, prescription drug rebates, prescription drug spend, and/or formulary strategies
Experience leading process improvement exercises
Exposure and/or knowledge of the evolving pharmaceutical regulatory environment
Proficiency in Tableau or other data visualization software
Experience utilizing Google BigQuery to extract raw data
Education
Bachelor's degree in finance, healthcare, or related field required; or equivalent experience
MBA or Master's degree preferred
Pay Range
The typical pay range for this role is:
$67,900.00 - $182,549.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit *****************************************
We anticipate the application window for this opening will close on: 02/06/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
$67.9k-182.5k yearly Auto-Apply 16d ago
Utilization Management Nurse Consultant
CVS Health 4.6
Senior manager job at CVS Health
We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health , you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.
Position Summary
This is full time weekend position requiring 20 of the 40 hours are worked on the Saturday and Sunday.
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.
Typical office working environment with productivity and quality expectations.
Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.
Sedentary work involving periods of sitting, talking, listening.
Work requires sitting for extended periods, talking on the telephone and typing on the computer. Ability to multitask, prioritize and effectively adapt to a fast paced changing environment.
Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding.
Effective communication skills, both verbal and written
Required Qualifications
- 3+ years of experience as a Registered Nurse
- Must have active current and unrestricted RN licensure in state of residence
- Must possess 1+ years of clinical experience in acute or post acute setting
- Must be available to work four 10 hour shifts either Thursday-Sunday or Saturday through Tuesday in time zone of residence (Monday - Friday earliest start time of 7am
Saturday and Sunday earliest start time of 6am)
- Some holidays may be required
- Must obtain CA RN license within 6 months of hire
- 12.5% shift differential
Preferred Qualifications
- 3+ years of clinical experience preferred
- Managed Care experience preferred
Education
Associates Degree
BSN preferred
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$29.10 - $62.32
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit *****************************************
We anticipate the application window for this opening will close on: 01/21/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
$29.1-62.3 hourly Auto-Apply 3d ago
Group Manager Centralized Services
Walgreens 4.4
Canal Winchester, OH jobs
Responsible for managing a Centralized Services team through supervisors to ensure satisfactory, efficient and effective customer service. Ensures maximum utilization of resources to achieve customer satisfaction, productivity and financial goals while creating a highly engaged team
**Job Responsibilities:**
+ Manages a group of team members in a designated department in Centralized Services. Monitors team members to ensure quality of work and productivity, and manages performance using the tools provided.
+ Coordinates and controls the activities, plans and programs of the immediate staff.
+ Administers company and divisional operation policies, best practices, and standard operating procedures to facilitate performance that meets the business expectations. Responsible for ensuring compliance with Company policies, programs, and procedures. Follows the guidelines of authorized budgets, laws, and good business ethics.
+ Maintains good working relationships and actively cooperates with all levels and areas of management to ensure that the objectives of the department and company are met.
+ Creates a continuous improvement culture, actively participates in the LEAN initiatives in order to improve processes and continually drive out waste.
+ Maintains and improves performance of department through building team member morale, motivating team members, and using constructive coaching/discipline policies of the organization. Encourages participation in workplace events and activities.
+ Identifies areas and/or gaps where additional development is required. Makes recommendations to management on how to drive performance and achieve necessary results.
**About Walgreens**
Founded in 1901, Walgreens (****************** proudly serves nearly 9 million customers and patients each day across its approximately 8,500 stores throughout the U.S. and Puerto Rico. Walgreens has approximately 220,000 team members, including nearly 90,000 healthcare service providers, and is committed to being the first choice for pharmacy, retail and health services, building trusted relationships that create healthier futures for customers, patients, team members and communities.
**Job ID:** 1737929BR
**Title:** Group Manager Centralized Services
**Company Indicator:** Walgreens
**Employment Type:**
**Job Function:** Retail
**Full Store Address:** 6275 WINCHESTER BLVD,CANAL WINCHESTER,OH 43110
**Full District Office Address:** 6275 WINCHESTER BLVD,CANAL WINCHESTER,OH,43110-00000-01408-M
**External Basic Qualifications:**
+ Bachelor's degree and at least two years of related experience; or High School diploma/GED and at least five years related experience and/or training; or equivalent combination of education and experience.
+ Willing to be licensed as a Pharmacy Technician by state as granted by the state Board of Pharmacy and/or nationally recognized certification agency.
+ Experience in identifying operational issues and recommending and implementing strategies to resolve problems.
+ Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction.
+ Experience building and maintaining relationships within a team.
+ Intermediate level skill in Microsoft Office Suite (MS Excel, Word, for example: using SUM function, setting borders, setting column width, inserting charts, using text wrap, sorting, setting headers and footers and/or print scaling; inserting headers, page breaks, page numbers and tables and/or adjusting table columns.
+ Willing to travel up to/at least 10% of the time for business purposes (within state and out of state).
**Preferred Qualifications:**
+ Master's degree/MBA
+ Experience with a Lean Six Sigma environment.
+ Six Sigma Certification.
+ Experience applying knowledge of Workforce Management Systems (WMS)
+ Experience directly managing people, including hiring, developing, motivating, and directing people as they work.
+ Experience with project management (for example: planning, organizing, delegating, allocating, and managing resources to bring about a successful completion of specific project goals and objectives).
We will consider employment of qualified applicants with arrest and conviction records.
**Shift:**
**Store:**
$109k-169k yearly est. 9d ago
Utilization Management Nurse Consultant
CVS Health 4.6
Senior manager job at CVS Health
We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do.
Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.
SummaryAssesses and monitors patient health, administering medications and treatments, performing medical procedures, and collaborating with physicians and other healthcare professionals to develop and implement patient care plans.
Educates patients and their families about healthcare management and assists in maintaining a safe and supportive healthcare environment.
Primary Job Duties & ResponsibilitiesDrives effective utilization management practices by ensuring appropriate and cost-effective allocation of healthcare resources and facilitating appropriate healthcare services/benefits for members.
Conducts routine utilization reviews and assessments, applying evidence-based criteria and clinical knowledge to evaluate the medical necessity and appropriateness of requested healthcare services.
Collaborates with healthcare providers, multidisciplinary teams, and payers to develop and implement care plans that optimize patient outcomes while considering the efficient use of healthcare resources.
Applies clinical expertise and knowledge of utilization management principles to influence stakeholders and networks of healthcare professionals by promoting effective utilization management strategies.
Reviews and analyzes medical records, treatment plans, and documentation to ensure compliance with guidelines, policies, and regulatory requirements, subsequently providing recommendations for care coordination and resource optimization.
Consults with and provides expertise to other internal and external constituents throughout the coordination and administration of the utilization/benefit management function.
Communicates regularly with internal and external stakeholders to facilitate effective care coordination, address utilization management inquiries, and ensure optimal patient outcomes.
Provides IC-related coaching and guidance to nursing staff and other healthcare professionals, sharing knowledge and expertise to enhance their understanding of utilization management principles and improve their clinical decision-making.
Contributes to the development and implementation of utilization management strategies, policies, and procedures that aim to improve patient care quality, cost-effectiveness, and overall healthcare system performance.
EducationBachelor's degree preferred/specialized training/relevant professional qualification.
Prior Relevant Work Experience3-5 years Essential QualificationsWorking knowledge of problem solving and decision making skills.
Working knowledge of medical terminology.
Working knowledge of digital literacy skills.
Ability to deal tactfully with customers and community.
Ability to handle sensitive information ethically and responsibly.
Ability to consider the relative costs and benefits of potential actions to choose the most appropriate option.
Ability to function in clinical setting with diverse cultural dynamics of clinical staff and patients.
Registered Nurse (RN) required.
Licensed Clinical Social Worker (LCSW) preferred.
Requisition Job DescriptionPosition SummaryThis Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can live in any state.
Normal Working Hours: Monday through Friday 8:30am-5:00pm in the time zone of residence.
Shift times may vary occasionally per the need of the department.
Rotational late shift 9:30-6CST.
No travel is required.
As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program.
You would be responsible for ensuring the member is receiving the appropriate care at the appropriate time and at the appropriate location, while adhering to federal and state regulated turn-around times.
This includes reviewing written clinical records.
The UM Nurse Consultant job duties include (not all encompassing):Reviews services to assure medical necessity, applies clinical expertise to assure appropriate benefit utilization, facilitates safe and efficient discharge planning and works closely with facilities and providers to meet the complex needs of the member.
Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program.
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.
Required QualificationsRN with active and unrestricted state licensure in their state of residence2+ years of acute hospital clinical experience as an RN with preference for medical-surgical and ICU experience (team is not accepting applicants whose only acute care experience is in behavioral health) Preferred Qualifications1+ years' experience Utilization Review experience1+ years' experience Managed Care Strong telephonic communication skills1+ years' experience with Microsoft Office Suite (PowerPoint, Word, Excel, Outlook) Experience with computers toggling between screens while using a keyboard and speaking to customers.
Ability to exercise independent and sound judgment, strong decision-making skills, and well-developed interpersonal skills Ability to manage multiple priorities, effective organizational and time management skills required Ability use a computer station and sit for extended periods of time EducationAssociate Degree in Nursing is minimum required, BSN preferred.
Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$29.
10 - $62.
32This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.
The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.
This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future.
Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be.
In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit *************
cvshealth.
com/us/en/benefits We anticipate the application window for this opening will close on: 01/23/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
$29 hourly 2d ago
Utilization Management Nurse Consultant
CVS Health 4.6
Senior manager job at CVS Health
We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do.
Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.
Position SummaryThis Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can live in any state.
Normal Working Hours: Monday through Friday 8:30am-5:00pm in the time zone of residence.
Shift times may vary occasionally per the need of the department.
Rotational late shift 9:30-6CST.
No travel is required.
As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program.
You would be responsible for ensuring the member is receiving the appropriate care at the appropriate time and at the appropriate location, while adhering to federal and state regulated turn-around times.
This includes reviewing written clinical records.
The UM Nurse Consultant job duties include (not all encompassing):Reviews services to assure medical necessity, applies clinical expertise to assure appropriate benefit utilization, facilitates safe and efficient discharge planning and works closely with facilities and providers to meet the complex needs of the member.
Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program.
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.
Required QualificationsRN with active and unrestricted state licensure in their state of residence2+ years of acute hospital clinical experience as an RN with preference for medical-surgical and ICU experience (team is not accepting applicants whose only acute care experience is in behavioral health) Preferred Qualifications1+ years' experience Utilization Review experience1+ years' experience Managed Care Strong telephonic communication skills1+ years' experience with Microsoft Office Suite (PowerPoint, Word, Excel, Outlook) Experience with computers toggling between screens while using a keyboard and speaking to customers.
Ability to exercise independent and sound judgment, strong decision-making skills, and well-developed interpersonal skills Ability to manage multiple priorities, effective organizational and time management skills required Ability use a computer station and sit for extended periods of time EducationAssociate Degree in Nursing is minimum required, BSN preferred.
Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$29.
10 - $62.
32This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.
The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.
This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future.
Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be.
In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit *************
cvshealth.
com/us/en/benefits We anticipate the application window for this opening will close on: 01/31/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
$29 hourly 2d ago
Utilization Management Nurse Consultant - Medical Review (Remote)
CVS Health 4.6
Senior manager job at CVS Health
We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do.
Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.
Position InformationSchedule: Monday-Friday 8:00am-5:00pm ESTLocation: 100% Remote (U.
S.
only) About UsAmerican Health Holding, Inc.
(AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993.
We provide flexible, cost-effective care management solutions that promote high-quality healthcare for members.
Position SummaryJoin a team that's making a difference in the lives of patients facing complex medical journeys.
As a Utilization Management (UM) Nurse Consultant specializing in Medical Review, you'll play a vital role in ensuring members receive timely, medically necessary care through thoughtful clinical review and collaboration with providers.
This fully remote position offers the opportunity to apply your clinical expertise in a fast-paced, desk-based environment where precision, communication, and compassion intersect.
Key ResponsibilitiesUtilizes clinical experience and skills in a collaborative process to implement, coordinate, monitor and evaluate medical review cases.
Applies the appropriate clinical criteria/guideline and plan language or policy specifics to render a medical determination to the client.
Applies critical thinking, evidenced based clinical criteria and clinical practice guidelines.
Med Review nurses use specific criteria to authorize procedures/services or initiate a Medical Director referral as needed.
Assists management with training new nurse reviewers/business partners or vendors to include initial and ongoing mentoring and feedback.
Actively cross-trains to perform reviews of multiple case types to provide a flexible workforce to meet client needs.
Recommends, tests, and implements process improvements, new audit concepts, technology improvements, etc.
that enhance production, quality, and client satisfaction.
Must be able to work independently without personal distractions to meet quality and metric expectations.
Remote Work ExpectationsThis is a 100% remote role; candidates must have a dedicated workspace free of interruptions.
Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted.
Required QualificationsActive, unrestricted RN license in your state of residence with multistate/compact licensure privileges.
Ability to obtain licensure in non-compact states as needed.
Minimum 3 years of clinical experience.
5 years demonstrated to make thorough independent decisions using clinical judgement.
5 Years proficient use of equipment experience including phone, computer, etc.
and clinical documentation systems.
1+ Year of Utilization Review Management and/or Medical Management experience.
Commitment to attend a mandatory 3-week training (Monday-Friday, 8:30am-5:00pm EST) with 100% participation.
Preferred QualificationsExperience with interpreting Plan Language, Policies, and Benefits to determine medical necessity.
MCG Milliman, CPB or other criteria guideline application experience is preferred.
Education Associate's degree in nursing (RN) required, BSN preferred.
Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$26.
01 - $56.
14This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.
The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.
This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future.
Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be.
In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit *************
cvshealth.
com/us/en/benefits We anticipate the application window for this opening will close on: 01/26/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
$26 hourly 2d ago
Senior Manager, Systems Engineering - Change & Release Management
CVS Health 4.6
Senior manager job at CVS Health
At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
**POSITION SUMMARY**
We are seeking an experienced and strategic leader to oversee Change and Release Management for the Aetna Line of Business (LOB). This role is pivotal in ensuring the delivery of high-quality, reliable technology releases through close collaboration with Application Development, Infrastructure, Security, and other cross-functional teams. The ideal candidate will drive architectural alignment, risk mitigation, and process optimization championing automation and governance across the IT organization.
**_What we expect of you_**
+ Lead and own the Change & Release Management and Governance processes for Aetna LOB.
+ Evaluate architectural solutions & system integrations to identify dependencies & potential impacts.
+ Manage end-to-end enterprise change releases, including coordination with IT teams, checkout testing, severity assessment, business impact analysis, and executive-level reporting.
+ Represent Aetna LOB in Change Advisory Board (CAB) meetings; validate enterprise changes, drive risk analysis and support change releases including weekend on call schedule.
+ Review and certify change plans for clarity and completeness; ensure execution teams understand risks, timing, and implementation instructions.
+ Collaborate with development, QA, performance, and capacity teams to assess risks and define mitigation strategies, exercise authority to halt changes when necessary.
+ Partner with Infrastructure, Security, Problem Management, and other enterprise teams to develop SOPs, quality controls, and issue resolution strategies.
+ Drive continuous improvement initiatives and defect remediation in partnership with IT and business stakeholders.
**REQUIRED QUALIFICATIONS**
+ 7+ years in senior IT leadership roles managing complex teams and driving process improvement, standard operating procedure (SOP) development, and issue resolution.
+ 3+ years designing scalable, distributed applications using microservices & API-driven architecture.
+ 3+ years working with cloud platforms (AWS, Azure, GCP) and container technologies (Docker, Kubernetes).
+ 3+ years' experience implementing best practices in observability, monitoring, chaos engineering, incident/problem management, and performance optimization.
+ 3+ years' experience of network security, firewalls, virtualization, and remote access.
+ 3+ years' of experience in change validation, post-deployment verification, and defining success criteria.
+ 3+ years' experience in Release, Change, Incident & Service Management, with working knowledge of ITIL.
+ Exceptional communication and stakeholder management skills, including executive-level engagement, ability to lead cross-functional teams, including offshore/onshore vendor teams.
+ Strong innovation mindset with a focus on automation and customer service excellence.
**PREFERRED QUALIFICATIONS**
+ Experience with monitoring/logging tools such as Splunk, Grafana, New Relic, or AppDynamics.
+ Familiarity with IT security, compliance, operations, and application development.
+ Experience implementing and improving SRE metrics in distributed environments.
+ Proficiency with SharePoint, ServiceNow, and ITIL frameworks.
**EDUCATION**
Bachelor's degree from accredited university or equivalent work experience (HS diploma + 4 years relevant experience).
**BUSINESS OVERVIEW**
Bring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
**Pay Range**
The typical pay range for this role is:
$106,605.00 - $284,280.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
**Great benefits for great people**
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
+ **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** .
+ **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
+ **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit *****************************************
We anticipate the application window for this opening will close on: 03/31/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
$106.6k-284.3k yearly 7d ago
Group Manager Centralized Services
Walgreens 4.4
Canal Winchester, OH jobs
Responsible for managing a Centralized Services team through supervisors to ensure satisfactory, efficient and effective customer service. Ensures maximum utilization of resources to achieve customer satisfaction, productivity and financial goals while creating a highly engaged team
Job Responsibilities:
* Manages a group of team members in a designated department in Centralized Services. Monitors team members to ensure quality of work and productivity, and manages performance using the tools provided.
* Coordinates and controls the activities, plans and programs of the immediate staff.
* Administers company and divisional operation policies, best practices, and standard operating procedures to facilitate performance that meets the business expectations. Responsible for ensuring compliance with Company policies, programs, and procedures. Follows the guidelines of authorized budgets, laws, and good business ethics.
* Maintains good working relationships and actively cooperates with all levels and areas of management to ensure that the objectives of the department and company are met.
* Creates a continuous improvement culture, actively participates in the LEAN initiatives in order to improve processes and continually drive out waste.
* Maintains and improves performance of department through building team member morale, motivating team members, and using constructive coaching/discipline policies of the organization. Encourages participation in workplace events and activities.
* Identifies areas and/or gaps where additional development is required. Makes recommendations to management on how to drive performance and achieve necessary results.
About Walgreens
Founded in 1901, Walgreens (****************** proudly serves nearly 9 million customers and patients each day across its approximately 8,500 stores throughout the U.S. and Puerto Rico. Walgreens has approximately 220,000 team members, including nearly 90,000 healthcare service providers, and is committed to being the first choice for pharmacy, retail and health services, building trusted relationships that create healthier futures for customers, patients, team members and communities.
Basic Qualifications
* Bachelor's degree and at least two years of related experience; or High School diploma/GED and at least five years related experience and/or training; or equivalent combination of education and experience.
* Willing to be licensed as a Pharmacy Technician by state as granted by the state Board of Pharmacy and/or nationally recognized certification agency.
* Experience in identifying operational issues and recommending and implementing strategies to resolve problems.
* Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction.
* Experience building and maintaining relationships within a team.
* Intermediate level skill in Microsoft Office Suite (MS Excel, Word, for example: using SUM function, setting borders, setting column width, inserting charts, using text wrap, sorting, setting headers and footers and/or print scaling; inserting headers, page breaks, page numbers and tables and/or adjusting table columns.
* Willing to travel up to/at least 10% of the time for business purposes (within state and out of state).
Preferred Qualifications
* Master's degree/MBA
* Experience with a Lean Six Sigma environment.
* Six Sigma Certification.
* Experience applying knowledge of Workforce Management Systems (WMS)
* Experience directly managing people, including hiring, developing, motivating, and directing people as they work.
* Experience with project management (for example: planning, organizing, delegating, allocating, and managing resources to bring about a successful completion of specific project goals and objectives).
We will consider employment of qualified applicants with arrest and conviction records.
Salary Range: $77800 - $124400 / Salaried