Senior Manager jobs 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 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: 12/22/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Cardinal Health Sonexus Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient markers of success. We're continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the reach and impact of their products. **Together, we can get life-changing therapies to patients who need them-faster** Are you ready to lead change at the forefront of healthcare innovation in patient access and support? Sonexus is undergoing a major transformation-scaling rapidly, reimagining how we deliver patient services, integrating emerging technologies & AI, and collaborating across the specialty pharma ecosystem. We're looking for a Senior Change & Transformation Consultant who's not just experienced but energized by the opportunity to shape the future of patient care and a rapidly growing business division of Cardinal Health. This is a high-impact role reporting to the Director of Business Transformation and Change Management. This consultant will be responsible for driving adoption, inspiring stakeholders, and embedding lasting change across complex, regulated environments. Too often, patients forego or can't complete prescribed therapy because of complicated qualification processes, unmanageable costs, or uncertainty about their medications. Cardinal Health Sonexus Access and Patient Support combines best-in-class program and pharmacy operations with smart digital tools to streamline patient onboarding and increase adherence to prescribed care. If you thrive in fast-paced settings and want to make a real difference in the lives of patients, this is your moment. **Responsibilities** · Design and execute enterprise-level change strategies that support transformation across patient services, pharmacy operations, and digital/AI innovation. · Conduct impact assessments, stakeholder analyses, and readiness evaluations to guide successful implementation. · Build strong partnerships across Patient Access, Case Management, Specialty Hubs, Pharmacy Operations, IT, and executive leadership. · Develop and facilitate dynamic workshops to elevate organizational change capability and leadership transformation IQ to scale a rapidly growing business. · Design communication strategies, plans, and craft visually appealing and compelling communications (infographics, Veeva Engage posts, slides, manager huddle scripts) tailored to diverse audiences-from frontline teams to senior leaders. · Champion AI initiatives includes building use cases, managing barriers to change and adoption, and managing the complex people-side of change for adopting AI (must have prior experience). · Monitor adoption metrics, create surveys, feedback loops, and performance indicators to ensure long-term success. · Identify risks and lead proactive mitigation strategies to keep business and AI transformation momentum strong. Leverage data and insights to refine approaches. · Contribute to the evolution of our new Transformation and Change office. **Qualifications** · Bachelor's degree in Business, Organizational Development, Healthcare Administration, or related field, preferred · Strong consulting, communication, analysis, data gathering and organizational skills. · Microsoft Office 365 (Teams, Copilot) Proficiency preferred · Ability to work in a fast-paced, collaborative environment and deliver quality results within aggressive timeframes. · Willingness to travel up to 25%. · Must be willing to work Central Time Zone business hours. Prefer candidates located in Columbus, OH or Dallas, TX area. · 6+ years of experience in change management with AI, digital business transformation experience, preferred · Prosci certification required; CCMP certification preferred with advanced certifications in digital/AI transformation, coaching, training facilitation, lean six sigma, organizational development (ODCP), etc. · Deep understanding and application of Change Management methodology end-to-end from strategy and planning to change impact analysis, communications plans and messaging, stakeholder analysis and engagement, readiness assessments, training and facilitation, change reporting and metrics, and reinforcement and sustainability. · Must be comfortable and proficient delivering change and transformation workshops and courses. · Proven success managing change for AI-driven solutions, preferred within patient services or pharmacy operations. · Solid understanding of the specialty pharma ecosystem, with highly preferred experience in Payors, PBMs, Specialty Hubs, Patient Services, Patient Assistance Programs, Medicaid, and Pharmacy Operations. · Exceptional communication, executive presence, facilitation, and stakeholder management skills. · Experience with CRM platforms like Salesforce, patient support technologies, or specialty pharmacy systems is a plus. · Can identify the differences between change and transformation, and provide work/project examples, including knowledge of transformation methodologies, models, AI strategy/transformation models, frameworks, building roadmaps. Framework examples include SAP BTM2, USAII, and CXO Transform. · Knowledge of product, agile methodologies a plus. **Why Join Us?** · Be a catalyst for change in a mission-driven organization transforming patient care. · Work alongside passionate professionals in a collaborative, forward-thinking environment. · Lead initiatives that integrate cutting-edge technologies like AI to improve outcomes and efficiency. · Make a lasting impact on how specialty pharma supports patients across the care continuum. **TRAINING AND WORK SCHEDULES:** + Your new hire training will take place 8:00am-5:00pm CST, mandatory attendance is required. + This position is full-time (40 hours/week). + Employees are required to have flexibility to work any of our shift schedules during our normal business hours of Monday-Friday, 7:00am- 7:00pm CST. **REMOTE DETAILS:** + You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to highspeed internet. + We will provide you with the computer, technology and equipment needed to successfully perform your job. + You will be responsible for providing high-speed internet. + Internet requirements include the following: + Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. Dial-up, satellite, WIFI, Cellular connections are NOT acceptable. + Download speed of 15Mbps (megabyte per second) + Upload speed of 5Mbps (megabyte per second) + Ping Rate Maximum of 30ms (milliseconds) + Hardwired to the router + Surge protector with Network Line Protection for CAH issue **Anticipated salary range:** $105,100-$150,100 **Bonus eligible:** Yes **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:** 1/13/2026 *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 (***************************************************************************************************************************

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 SummaryAt 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. Job Description Summary: Senior Manager, Clinical Informatics you will help operationalize the Clinical Informatics program across the domains of population health, ambulatory quality, and safety. You will bridge clinical, operational, and technical teams to ensure the Informatics program drives efficient operations, excellent patient care, and measurable value across the enterprise. Key ResponsibilitiesCoordinate and oversee clinical informatics initiatives across population health, ambulatory, quality, and safety. Establish clear processes to ensure follow-up, documentation, and coordination of informatics initiatives to maintain a high-functioning, efficient informatics team. Collaborate with business and clinical stakeholders to identify opportunities for process redesign, translating operational needs into actionable technical requirements, and guiding clinical and IT teams toward scalable, value-driven solutions. Support workflow and build design decisions within Epic and related systems, as appropriate Conduct initial clinical validation of Epic build and reporting to confirm accuracy, logic, and alignment with clinical intent, as appropriate Work with Epic analysts and project managers to coordinate deliverables, track progress, and ensure timely implementation of products. Partner with analysts and communications teams to develop tip sheets, user guides, and other educational materials that promote adoption and effective use of digital tools. Partner with SMD and analysts to develop Epic dashboards and other reporting tools to measure clinical outcomes and drive continuous improvement Apply a positive, pragmatic, and solution-oriented approach to remove barriers, resolve issues, and sustain progress within a complex healthcare environment. Use data-driven insights to evaluate workflows, identify improvement opportunities, and design digital solutions to move the organization forward. Lead and moderate effective interdisciplinary meetings with clear agendas, follow-ups, and accountability. Prioritize clarity, problem solving, decision making and accountability. Prepare presentations for front-line care teams to scale optimal use of digital tools, as well as executive-level presentations to demonstrate key decision points and impact As part of a dynamic and quick moving team, be willing and able to adapt quickly and take on new responsibilities as priorities evolve. Qualifications:Clinical background preferred Prior healthcare experience required Experience in informatics required, Epic experience preferred Ability to connect clinical workflows with technical design and outcomes Strong organizational, facilitation, and communication skills; ability to coordinate across multiple stakeholder groups Experience working in primary care or population health models required Ability to apply a data-driven approach to evaluate workflows, quantify outcomes and support evidence-based decision making across informatics initiatives Ability to think operationally and pragmatically, focusing on program function and measurable value. Positive, pragmatic mindset focused on solving problems, finding solutions, and driving progress in complex environments Growth mindset and commitment to continuous improvement Required QualificationsExperience: Minimum of 7 years of related experience is required. Knowledge of ambulatory and population health workflows Experience working on large projects Strong knowledge of clinical applications and understanding of the healthcare IT industry Analytical, problem resolution and interpersonal skills Ability to bridge communication among technical and nontechnical project staff and customers Preferred Qualifications:Clinical background preferred Experience designing, and supporting an Epic solution Understanding of configurable applications and monitoring practices Education: Bachelor's degree is required or equivalent experience. Master's degree preferred Pay RangeThe typical pay range for this role is:$67,900. 00 - $199,144. 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: 03/02/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Cardinal Health Sonexus Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient markers of success. We're continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the reach and impact of their products. **Together, we can get life-changing therapies to patients who need them-faster** Are you ready to lead change at the forefront of healthcare innovation in patient access and support? Sonexus is undergoing a major transformation-scaling rapidly, reimagining how we deliver patient services, integrating emerging technologies & AI, and collaborating across the specialty pharma ecosystem. We're looking for a Senior Change & Transformation Consultant who's not just experienced but energized by the opportunity to shape the future of patient care and a rapidly growing business division of Cardinal Health. This is a high-impact role reporting to the Director of Business Transformation and Change Management. This consultant will be responsible for driving adoption, inspiring stakeholders, and embedding lasting change across complex, regulated environments. Too often, patients forego or can't complete prescribed therapy because of complicated qualification processes, unmanageable costs, or uncertainty about their medications. Cardinal Health Sonexus Access and Patient Support combines best-in-class program and pharmacy operations with smart digital tools to streamline patient onboarding and increase adherence to prescribed care. If you thrive in fast-paced settings and want to make a real difference in the lives of patients, this is your moment. **Responsibilities** · Design and execute enterprise-level change strategies that support transformation across patient services, pharmacy operations, and digital/AI innovation. · Conduct impact assessments, stakeholder analyses, and readiness evaluations to guide successful implementation. · Build strong partnerships across Patient Access, Case Management, Specialty Hubs, Pharmacy Operations, IT, and executive leadership. · Develop and facilitate dynamic workshops to elevate organizational change capability and leadership transformation IQ to scale a rapidly growing business. · Design communication strategies, plans, and craft visually appealing and compelling communications (infographics, Veeva Engage posts, slides, manager huddle scripts) tailored to diverse audiences-from frontline teams to senior leaders. · Champion AI initiatives includes building use cases, managing barriers to change and adoption, and managing the complex people-side of change for adopting AI (must have prior experience). · Monitor adoption metrics, create surveys, feedback loops, and performance indicators to ensure long-term success. · Identify risks and lead proactive mitigation strategies to keep business and AI transformation momentum strong. Leverage data and insights to refine approaches. · Contribute to the evolution of our new Transformation and Change office. **Qualifications** · Bachelor's degree in Business, Organizational Development, Healthcare Administration, or related field, preferred · Strong consulting, communication, analysis, data gathering and organizational skills. · Microsoft Office 365 (Teams, Copilot) Proficiency preferred · Ability to work in a fast-paced, collaborative environment and deliver quality results within aggressive timeframes. · Willingness to travel up to 25%. · Must be willing to work Central Time Zone business hours. Prefer candidates located in Columbus, OH or Dallas, TX area. · 6+ years of experience in change management with AI, digital business transformation experience, preferred · Prosci certification required; CCMP certification preferred with advanced certifications in digital/AI transformation, coaching, training facilitation, lean six sigma, organizational development (ODCP), etc. · Deep understanding and application of Change Management methodology end-to-end from strategy and planning to change impact analysis, communications plans and messaging, stakeholder analysis and engagement, readiness assessments, training and facilitation, change reporting and metrics, and reinforcement and sustainability. · Must be comfortable and proficient delivering change and transformation workshops and courses. · Proven success managing change for AI-driven solutions, preferred within patient services or pharmacy operations. · Solid understanding of the specialty pharma ecosystem, with highly preferred experience in Payors, PBMs, Specialty Hubs, Patient Services, Patient Assistance Programs, Medicaid, and Pharmacy Operations. · Exceptional communication, executive presence, facilitation, and stakeholder management skills. · Experience with CRM platforms like Salesforce, patient support technologies, or specialty pharmacy systems is a plus. · Can identify the differences between change and transformation, and provide work/project examples, including knowledge of transformation methodologies, models, AI strategy/transformation models, frameworks, building roadmaps. Framework examples include SAP BTM2, USAII, and CXO Transform. · Knowledge of product, agile methodologies a plus. **Why Join Us?** · Be a catalyst for change in a mission-driven organization transforming patient care. · Work alongside passionate professionals in a collaborative, forward-thinking environment. · Lead initiatives that integrate cutting-edge technologies like AI to improve outcomes and efficiency. · Make a lasting impact on how specialty pharma supports patients across the care continuum. **TRAINING AND WORK SCHEDULES:** + Your new hire training will take place 8:00am-5:00pm CST, mandatory attendance is required. + This position is full-time (40 hours/week). + Employees are required to have flexibility to work any of our shift schedules during our normal business hours of Monday-Friday, 7:00am- 7:00pm CST. **REMOTE DETAILS:** + You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to highspeed internet. + We will provide you with the computer, technology and equipment needed to successfully perform your job. + You will be responsible for providing high-speed internet. + Internet requirements include the following: + Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. Dial-up, satellite, WIFI, Cellular connections are NOT acceptable. + Download speed of 15Mbps (megabyte per second) + Upload speed of 5Mbps (megabyte per second) + Ping Rate Maximum of 30ms (milliseconds) + Hardwired to the router + Surge protector with Network Line Protection for CAH issue **Anticipated salary range:** $105,100-$150,100 **Bonus eligible:** Yes **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:** 1/13/2026 *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 (***************************************************************************************************************************

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 Senior Manager, Program Escalations & Defect Management for CVS Health, you will be a collaborative and results-oriented leader who will partner across the organization to triage and resolve the Payor solutions portfolio's complex technological and operational challenges. You'll need to be a strategic individual who can navigate complex technological and operational challenges with agility and precision in a fast-paced and dynamic corporate environment. This role requires strong partnership and engagement across all aspects of the Product Enablement team, as well as coordination with the partners within the larger Payor Solutions & Life Sciences Organization. As an ideal candidate you'll be a skilled communicator, capable of translating technical issues into clear, actionable insights for diverse audiences, including business stakeholders, product teams, and technical partners. You will lead cross-functional coordination efforts, ensuring timely and effective issue intake, prioritization, and resolution. You'll provide strategic leadership and direction to a team of managers, fostering a collaborative environment that drives performance and achieves organizational goals. Success in this role requires deep experience working across product, technical, and account management functions, as well as a strong ability to assess issues at both strategic and tactical levels. **Specific workstreams this individual is responsible for include:** Production defects intake and triage + Designing and implementing a scalable, end-to-end defect management process that enables efficient intake, triage, evaluation, analysis, and resolution of production defects. Individual should have experience building solutions for internal audiences that are able to scale. + Developing a thorough prioritization framework to handle a myriad of intakes but provide sound and strategic direction on rank order of production defects submitted. + Development of SLAs for defect intake, triage, and resolution and ensuring the team adheres to SLAs. Production defect resolution + Act as the point person for Payor Solutions to advocate on behalf of products, members, and clients for resolution when defects are identified. + Accountable for identifying the right partner to work with, the right processes to follow, with and ultimately accountable for driving issues to resolution as well as communicating impact, root cause, and remediation strategies to a Business audience. + Partner with, and advocate to, Product team leads when additional support or processes are needed to resolve issues, meet client commitments, and retain product integrity. + Partner with Product team leads to obtain deep subject matter knowledge on all products in the portfolio to be able to navigate all defects submitted. **Required Qualifications** + 7+ years of experience in Program or Product Management within the Healthcare field. + 4+ years of experience leading a team, either directly or indirectly. + 1 year of experience working with a geographically diverse team of primarily Work-from-Home colleagues. **Preferred Qualifications** + Experience working with varying levels of stakeholders, including senior leadership, department leadership, and technical partners. + Experience with product management and/or technical product management. + Experience with payor agnostic products, payers, and operations with the ability to solve complex problems through people in other functional organizations. + Extensive experience leading cross-functional initiatives and driving innovation. + Experience facilitating buy-in and engagement across diverse stakeholder groups. + Ability to anticipate risks and mitigate effectively. + Ability to develop and execute strategic and tactical business plans. + Ability to exercise sound business judgment to achieve proper balance between objectives and stakeholder engagement. + Excellent interpersonal communication skills, including active listening, self-management and awareness, emotional intelligence, and ability to flex interpersonal style. + Demonstrated success in the areas of collaboration, team work, and execution across multiple departments to deliver results. + Strong decision-making, analytical and organizational skills. **Education** + Bachelors degree required. + Masters degree preferred. **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: 01/10/2026 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. Position SummaryAt 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. Job Description Summary: Senior Manager, Clinical Informatics you will help operationalize the Clinical Informatics program across the domains of population health, ambulatory quality, and safety. You will bridge clinical, operational, and technical teams to ensure the Informatics program drives efficient operations, excellent patient care, and measurable value across the enterprise. Key ResponsibilitiesCoordinate and oversee clinical informatics initiatives across population health, ambulatory, quality, and safety. Establish clear processes to ensure follow-up, documentation, and coordination of informatics initiatives to maintain a high-functioning, efficient informatics team. Collaborate with business and clinical stakeholders to identify opportunities for process redesign, translating operational needs into actionable technical requirements, and guiding clinical and IT teams toward scalable, value-driven solutions. Support workflow and build design decisions within Epic and related systems, as appropriate Conduct initial clinical validation of Epic build and reporting to confirm accuracy, logic, and alignment with clinical intent, as appropriate Work with Epic analysts and project managers to coordinate deliverables, track progress, and ensure timely implementation of products. Partner with analysts and communications teams to develop tip sheets, user guides, and other educational materials that promote adoption and effective use of digital tools. Partner with SMD and analysts to develop Epic dashboards and other reporting tools to measure clinical outcomes and drive continuous improvement Apply a positive, pragmatic, and solution-oriented approach to remove barriers, resolve issues, and sustain progress within a complex healthcare environment. Use data-driven insights to evaluate workflows, identify improvement opportunities, and design digital solutions to move the organization forward. Lead and moderate effective interdisciplinary meetings with clear agendas, follow-ups, and accountability. Prioritize clarity, problem solving, decision making and accountability. Prepare presentations for front-line care teams to scale optimal use of digital tools, as well as executive-level presentations to demonstrate key decision points and impact As part of a dynamic and quick moving team, be willing and able to adapt quickly and take on new responsibilities as priorities evolve. Qualifications:Clinical background preferred Prior healthcare experience required Experience in informatics required, Epic experience preferred Ability to connect clinical workflows with technical design and outcomes Strong organizational, facilitation, and communication skills; ability to coordinate across multiple stakeholder groups Experience working in primary care or population health models required Ability to apply a data-driven approach to evaluate workflows, quantify outcomes and support evidence-based decision making across informatics initiatives Ability to think operationally and pragmatically, focusing on program function and measurable value. Positive, pragmatic mindset focused on solving problems, finding solutions, and driving progress in complex environments Growth mindset and commitment to continuous improvement Required QualificationsExperience: Minimum of 7 years of related experience is required. Knowledge of ambulatory and population health workflows Experience working on large projects Strong knowledge of clinical applications and understanding of the healthcare IT industry Analytical, problem resolution and interpersonal skills Ability to bridge communication among technical and nontechnical project staff and customers Preferred Qualifications:Clinical background preferred Experience designing, and supporting an Epic solution Understanding of configurable applications and monitoring practices Education: Bachelor's degree is required or equivalent experience. Master's degree preferred Pay RangeThe typical pay range for this role is:$67,900. 00 - $199,144. 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: 03/02/2026Qualified 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 SummaryAt 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. Job Description Summary: Senior Manager, Clinical Informatics you will help operationalize the Clinical Informatics program across the domains of population health, ambulatory quality, and safety. You will bridge clinical, operational, and technical teams to ensure the Informatics program drives efficient operations, excellent patient care, and measurable value across the enterprise. Key ResponsibilitiesCoordinate and oversee clinical informatics initiatives across population health, ambulatory, quality, and safety. Establish clear processes to ensure follow-up, documentation, and coordination of informatics initiatives to maintain a high-functioning, efficient informatics team. Collaborate with business and clinical stakeholders to identify opportunities for process redesign, translating operational needs into actionable technical requirements, and guiding clinical and IT teams toward scalable, value-driven solutions. Support workflow and build design decisions within Epic and related systems, as appropriate Conduct initial clinical validation of Epic build and reporting to confirm accuracy, logic, and alignment with clinical intent, as appropriate Work with Epic analysts and project managers to coordinate deliverables, track progress, and ensure timely implementation of products. Partner with analysts and communications teams to develop tip sheets, user guides, and other educational materials that promote adoption and effective use of digital tools. Partner with SMD and analysts to develop Epic dashboards and other reporting tools to measure clinical outcomes and drive continuous improvement Apply a positive, pragmatic, and solution-oriented approach to remove barriers, resolve issues, and sustain progress within a complex healthcare environment. Use data-driven insights to evaluate workflows, identify improvement opportunities, and design digital solutions to move the organization forward. Lead and moderate effective interdisciplinary meetings with clear agendas, follow-ups, and accountability. Prioritize clarity, problem solving, decision making and accountability. Prepare presentations for front-line care teams to scale optimal use of digital tools, as well as executive-level presentations to demonstrate key decision points and impact As part of a dynamic and quick moving team, be willing and able to adapt quickly and take on new responsibilities as priorities evolve. Qualifications:Clinical background preferred Prior healthcare experience required Experience in informatics required, Epic experience preferred Ability to connect clinical workflows with technical design and outcomes Strong organizational, facilitation, and communication skills; ability to coordinate across multiple stakeholder groups Experience working in primary care or population health models required Ability to apply a data-driven approach to evaluate workflows, quantify outcomes and support evidence-based decision making across informatics initiatives Ability to think operationally and pragmatically, focusing on program function and measurable value. Positive, pragmatic mindset focused on solving problems, finding solutions, and driving progress in complex environments Growth mindset and commitment to continuous improvement Required QualificationsExperience: Minimum of 7 years of related experience is required. Knowledge of ambulatory and population health workflows Experience working on large projects Strong knowledge of clinical applications and understanding of the healthcare IT industry Analytical, problem resolution and interpersonal skills Ability to bridge communication among technical and nontechnical project staff and customers Preferred Qualifications:Clinical background preferred Experience designing, and supporting an Epic solution Understanding of configurable applications and monitoring practices Education: Bachelor's degree is required or equivalent experience. Master's degree preferred Pay RangeThe typical pay range for this role is:$67,900. 00 - $199,144. 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: 03/02/2026Qualified 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. This is an Alternative Work Schedule weekend position. The role requires coverage of both Saturday and Sunday each week. Scheduling options may include four 10-hour shifts, five 8-hour shifts, three 12-hour shifts, or other approved configurations that meet operational needs. Specific schedules will be determined in collaboration with management to ensure adequate weekend coverage. This is a work-from-home position. During work hours, colleagues must be available by phone, videoconference, and email as required by their leader. Occasional on-site attendance at the office or client location may be required for meetings, training sessions, or other events as directed. **Position Summary** Utilize your clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor, and evaluate options to facilitate appropriate healthcare services and benefits for members. Key Responsibilities: * Gather clinical information and apply the appropriate clinical criteria, guidelines, policies, procedures, and clinical judgment to render coverage determinations and recommendations along the continuum of care. * Communicate with providers and other parties to facilitate care and treatment. Identify members for referral opportunities to integrate with other products, services, or benefit programs. * Identify opportunities to promote quality and effectiveness of healthcare services and benefit utilization. * Consult and lend expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function. * Meet set productivity and quality expectations as established by UMNC. **Required Qualifications** + Registered Nurse + 3+ years of experience as a Registered Nurse, 1+ years of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience + Must have active current and unrestricted RN licensure in state of residence. + May be required to obtain additional Nursing Licenses as business needs require. Key Responsibilities: * Gather clinical information and apply the appropriate clinical criteria, guidelines, policies, procedures, and clinical judgment to render coverage determinations and recommendations along the continuum of care. * Communicate with providers and other parties to facilitate care and treatment. Identify members for referral opportunities to integrate with other products, services, or benefit programs. * Identify opportunities to promote quality and effectiveness of healthcare services and benefit utilization. * Consult and lend expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function. * Meet set productivity and quality expectations as established by UMNC. Required Skills and Abilities: * Effective verbal and written communication skills. * Proficiency with computer skills, including navigating multiple systems and keyboarding. * Ability to multitask, prioritize, and adapt effectively to a fast-paced, changing environment. * Capacity to sit for extended periods, talk on the telephone, and type on the computer. **Preferred Qualifications** Utilization Management experience preferred **Education** Diploma RN acceptable; Associate degree/BSN preferred **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $26.01 - $56.14 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: 12/30/2025 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. Position SummaryAt 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. Job Description Summary: Senior Manager, Clinical Informatics you will help operationalize the Clinical Informatics program across the domains of population health, ambulatory quality, and safety. You will bridge clinical, operational, and technical teams to ensure the Informatics program drives efficient operations, excellent patient care, and measurable value across the enterprise. Key ResponsibilitiesCoordinate and oversee clinical informatics initiatives across population health, ambulatory, quality, and safety. Establish clear processes to ensure follow-up, documentation, and coordination of informatics initiatives to maintain a high-functioning, efficient informatics team. Collaborate with business and clinical stakeholders to identify opportunities for process redesign, translating operational needs into actionable technical requirements, and guiding clinical and IT teams toward scalable, value-driven solutions. Support workflow and build design decisions within Epic and related systems, as appropriate Conduct initial clinical validation of Epic build and reporting to confirm accuracy, logic, and alignment with clinical intent, as appropriate Work with Epic analysts and project managers to coordinate deliverables, track progress, and ensure timely implementation of products. Partner with analysts and communications teams to develop tip sheets, user guides, and other educational materials that promote adoption and effective use of digital tools. Partner with SMD and analysts to develop Epic dashboards and other reporting tools to measure clinical outcomes and drive continuous improvement Apply a positive, pragmatic, and solution-oriented approach to remove barriers, resolve issues, and sustain progress within a complex healthcare environment. Use data-driven insights to evaluate workflows, identify improvement opportunities, and design digital solutions to move the organization forward. Lead and moderate effective interdisciplinary meetings with clear agendas, follow-ups, and accountability. Prioritize clarity, problem solving, decision making and accountability. Prepare presentations for front-line care teams to scale optimal use of digital tools, as well as executive-level presentations to demonstrate key decision points and impact As part of a dynamic and quick moving team, be willing and able to adapt quickly and take on new responsibilities as priorities evolve. Qualifications:Clinical background preferred Prior healthcare experience required Experience in informatics required, Epic experience preferred Ability to connect clinical workflows with technical design and outcomes Strong organizational, facilitation, and communication skills; ability to coordinate across multiple stakeholder groups Experience working in primary care or population health models required Ability to apply a data-driven approach to evaluate workflows, quantify outcomes and support evidence-based decision making across informatics initiatives Ability to think operationally and pragmatically, focusing on program function and measurable value. Positive, pragmatic mindset focused on solving problems, finding solutions, and driving progress in complex environments Growth mindset and commitment to continuous improvement Required QualificationsExperience: Minimum of 7 years of related experience is required. Knowledge of ambulatory and population health workflows Experience working on large projects Strong knowledge of clinical applications and understanding of the healthcare IT industry Analytical, problem resolution and interpersonal skills Ability to bridge communication among technical and nontechnical project staff and customers Preferred Qualifications:Clinical background preferred Experience designing, and supporting an Epic solution Understanding of configurable applications and monitoring practices Education: Bachelor's degree is required or equivalent experience. Master's degree preferred Pay RangeThe typical pay range for this role is:$67,900. 00 - $199,144. 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: 03/02/2026Qualified 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 SummaryWith a focus on partnering with our internal and external constituents, this role will ensure clinical programs and workflows are delivered accurately and on time. Responsibilities will include evaluating population health programs within Value Based Contracting (VBC), identifying appropriate programs, and executing new programs, workflows and/or processes to meet the Aetna Clincal Solutions (ACS) business results. Drive or guide the development and evaluation of holistic solutions. The Clinical Consulatant provides consultative solutioning around the identification and implementation of care transformation initiatives within the client organization that will improve quality, increase efficiency, and drive cost savings and improve the member and provider experience. Identify opportunities for provider improvement and influence internal and external business leader(s) to change through negotiations and consultation that promote issue resolution. Communicates concise results to empower client groups and internal leadership in decision making regarding opportunities. Capture and elevate to Sr. Leadership feedback from the marketplace and the provider community that will shape the strategies going forward. LocationOne may live anywhere in the continental US. If outside of the Eastern Time Zone, need to be flexible to work Eastern Time Zone hours as needed. Required Qualifications5+ years of clinical program (understanding program design and impact of program) experience2+ years with clinical program delivery on the provider side2+ years experience in health care analysis methods and tools, Population health, care management including disease management, complex care, and end of life. 2+ years experienced working with clinical and claims data Ability to manage multiple customers and competing priorities that drive positive outcomes Experience in the following:5+ years experience introducing and implementing programs Outstanding verbal and written communication skills, including formal presentations for all levels of management combined with strong collaboration/influencing abilities Leadership: Anticipating and Innovating and Creating AccountabilityService: Working Across Boundaries2+ years ensuring project discipline/meeting deadlines Preferred QualificationsLicensed Clinical professional highly desired Specific experience within an ACO model is highly desired. Ability to collaborate with and understand the needs of C-level executives and help translate those needs to an actionable plan. Demonstrated ability to communicate technical concepts and implications to business and policy decision-makers and clients. 5+ years in either payer or provider settings highly preferred. Deep knowledge of health care industry, policy, research design, predictive modeling, ACO finance methods and tools. Strategic business acumen and proven organizational, management, and leadership skills. Demonstrated collaborative style, with ability to influence diverse teams and build strong relationships. Demonstrated strategic thinking, problem solving and critical thinking abilities. Demonstrated ability to negotiate complex and often contentious issues; reach consensus and work through people to achieve key goals. Acumen and experience with accountable care financial models. Experience working with clinicians, finance, and operational leaders to drive performance improvement experience. EducationBachelor's degree or equivalent experience Master's Degree in Business, Public Health, Health administration preferred but not required Pay RangeThe typical pay range for this role is:$67,900. 00 - $149,328. 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.

Cardinal Health Sonexus Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford, and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient markers of success. We are continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification, and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the reach and impact of their products. **Together, we can get life-changing therapies to patients who need them-faster.** **_Job Summary_** Access and Patient Support Senior Project Managers are responsible for managing the execution of programs and/or projects consisting of single or multiple projects and/or programs. They work within the constraints of budget, schedule and scope while managing risk and ensuring adherence to established processes and methodologies. This role enables the organization to drive complex and transformative patient support programs through disciplined project/program management and change management strategies to market. They must have advanced knowledge and skill to organize project teams, establish project/program schedules, assign individual responsibilities, integrate vendor tasks and deliverables into project plans and determine resource requirements while also ensuring adherence to internal and external client quality standards. **_Qualifications_** + BA, BS, or equivalent experience in related field preferred + 5-10 years' experience preferred + Provide overall management of projects/programs from concept to completion, including presentations, consultation, planning, estimating, project setup, project controls, procurement, administration, and closeout. + Excellent oral and written communication skills and people skills. Must have the ability to clearly and effectively present complex information to all levels of employees, management, and clients. + Proven ability to establish and maintain relationships with clients. + Report regularly on progress, cost and schedule metrics, procurement issues, safety or environmental concerns, design questions, potential impacts, and matters requiring support. + Working with business and IT leads for appropriate project staffing and development support. + Proficiency in Microsoft Office products is preferred. + Project Management Professional (PMP) or equivalent certification preferred. **_Responsibilities_** + Analyze and recommend solutions related to new product launches, product discontinuations, vendor integrations, and operational efficiencies among other potential services that provide value to our clients. + Manage to program budget, scope, client deliverables, timelines, and artifacts daily. + Anticipate client needs and proactively make program recommendations to enhance service value. + Present program readouts to clients and key leaders including, but not limited to, in-flight project status, issue tracking, risk mitigation and resolution. + Lead 3rd party vendor communication/coordination meeting. + Recommend changes/updates/enhancements to current platform and vendor integration landscape to further align with client's strategy and industry advancements. + Build relationships with internal business owners to help streamline processes. + Monitor team backlog and prioritize activities to deliver on time, on budget, on scope + Recommends new practices, processes, metrics, or models + Independently determine method for completion of new projects + Manage all aspects of project communications + Report regularly on progress, cost and schedule metrics, procurement issues, safety or environmental concerns, design questions, potential impacts, and matters requiring support. + Works with business and IT leads for appropriate project staffing and development support. **_What is expected of you and others at this level_** + Applies advanced knowledge and understanding of concepts, principles, and technical capabilities to manage a wide variety of programs + Participates in the development of policies and procedures to achieve specific goals + Recommends new practices, processes, metrics, or models + Works on, or may lead, complex projects or programs of large scale and scope + Decisions have a short-term impact on work processes, outcomes, and customers + Provides solutions which may set precedent + Interact with subordinates, peer customers and suppliers at various management levels and may interact with senior management + Gain consensus from various parties involved + Acts as a mentor to less experienced colleagues **TRAINING AND WORK SCHEDULES:** + Your new hire training will take place 8:00am-5:00pm CST, mandatory attendance is required. + This position is full-time (40 hours/week). + Employees are required to have flexibility to work any of our shift schedules during our normal business hours of Monday-Friday, 7:00am- 7:00pm CST. **REMOTE DETAILS:** + You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to highspeed internet. + We will provide you with the computer, technology and equipment needed to successfully perform your job. + You will be responsible for providing high-speed internet. + Internet requirements include the following: + Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. Dial-up, satellite, WIFI, Cellular connections are NOT acceptable. + Download speed of 15Mbps (megabyte per second) + Upload speed of 5Mbps (megabyte per second) + Ping Rate Maximum of 30ms (milliseconds) + Hardwired to the router + Surge protector with Network Line Protection for CAH issued equipment **Anticipated salary range:** $105,100 - $150,100 **Bonus eligible:** Yes **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:** 2/6/2026 *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 (***************************************************************************************************************************

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: 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. **Position Summary** **Fully remote role** **Must be able to work an Eastern Standard Time schedule** **Must be a licensed RN** + Utilization Management is a 24/7 operation and the work schedule may include weekends, holidays, and evening hours. + Applies critical thinking, evidenced based clinical criteria and clinical practice guidelines for services requiring precertification. + The majority of the time is spent at a desk and on the phone collecting and reviewing clinical information from providers. + Precertification nurses use specific criteria to authorize procedures/services or initiate a Medical Director referral as needed. **Required Qualifications** + Must have active, current and unrestricted RN licensure in New Jersey or Compact RN License + 3+ years of clinical experience + Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and evening hours. + 2+ years' experience using personal computer, keyboard navigation, navigating multiple systems and applications; and using MS Office Suite applications (Teams, Outlook, Word, Excel, etc.) **Preferred Qualifications** + Previous prior authorization experience + Prior experience working for a health plan **Education** + Associates degree required + BSN preferred **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $34.92 - $74.78 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: 12/31/2025 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. Position SummarySupports comprehensive coordination of medical services through composition and auditing of approval, extensions, and denial letters. Promotes and supports quality effectiveness of the healthcare services. Maintains accurate and complete documentation to meet risk management, regulatory, and accreditation requirements. Promotes communication, both internally and externally to enhance effectiveness of medical management services. This position will be for 11-8pm EST M-FRequired Qualifications1+ years experience as a Registered Nurse, with an unrestricted license in state of residence. 1+ years of clinical experience Preferred QualificationsUtilization Management experience Managed Care ExperienceProficiency in grammar and syntax Ability to multi-task EducationAssociates or bachelors degree 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: 12/12/2025Qualified 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 SummaryThe Aetna Pharmacy Health Plan Compliance team is seeking an experienced professional with Health Care compliance experience to join our team. Our mission is to assess the applicability of State and Federal regulations to our commercial Aetna pharmacy programs and benefit plans, to identify and track business and compliance risks and issues and to develop and implement action plans to become compliant. Our team collaborates with both the Aetna Health Plan business teams and with our CVS Caremark PBM colleagues to understand regulatory trends and to anticipate impacts. Our regulatory environment is ever-changing. Our team works with urgency to anticipate, understand and address new regulatory requirements which impact the Aetna Pharmacy Health Plan and to drive our organization to new levels of efficiency through continuous process improvement activities. Successful candidates for this position will be able to:Review and assess new state and Federal legislative requirements to determine applicability to the Aetna Pharmacy Health Plan. Research impacts of new legislation to our existing systems, processes, policies and technology platforms. Summarize and present new legislation and its applicability to the Aetna Pharmacy Health Plan to internal and external colleagues to make them aware of impacts to their business areas and to solicit their ideas and support for developing a solution to become compliant before the effective date of new mandates. Collaborate closely with internal Health Plan and PBM business teams in a fast-paced environment. Request reports and analyze data to understand the business impact of new legislation to fully insured Aetna commercial members and plan sponsors. Participate in or lead work group discussions to understand and document the interdependencies of business areas to become compliant, present information and complex data in a clear and concise manner. Develop project plans, document dependencies, engage resources and track project deliverables to completion. Manage multiple compliance projects from end-to-end at the same time. Adhere to team reporting metrics for mandate tracking. Take ownership and accountability and demonstrate leadership in pursuit of compliance. Join forces with team members to analyze and review incoming legislation. Required QualificationsA minimum of 5 years of experience in pharmacy benefit management, pharmacy operations or healthcare with regulatory experience. A minimum of 3 years project management experience. Strong organizational skills, problem solving skills and critical thinking capabilities. Able to communicate to multiple levels of leadership. Functions independently to meet deadlines while managing multiple competing priorities. Proficient in MS Office Suite, including MS Excel, MS Outlook, MS PowerPoint, MS SharePoint and MS Teams. Preferred QualificationsGeneral understanding of the legislative review process. Capable of building the trust and respect of internal and external constituents. EducationBachelor's degree preferred or a combination of professional work experience and education. Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$54,300. 00 - $159,120. 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. 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: 12/17/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Cardinal Health Sonexus™ Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford, and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient markers of success. We are continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification, and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the reach and impact of their products. Together, we can get life-changing therapies to patients who need them-faster. What IT Program & Project Management contributes to Sonexus Health Access and Patient Support Senior Project Managers are responsible for managing the execution of programs and/or projects consisting of single or multiple projects and/or programs. They work within the constraints of budget, schedule and scope while managing risk and ensuring adherence to established processes and methodologies. This role enables the organization to drive complex and transformative patient support programs through disciplined project/program management and change management strategies to market. They must have advanced knowledge and skill to organize project teams, establish project/program schedules, assign individual responsibilities, integrate vendor tasks and deliverables into project plans and determine resource requirements while also ensuring adherence to internal and external client quality standards. Qualifications BA, BS, or equivalent experience in related field preferred 5-10 years' experience preferred Provide overall management of projects/programs from concept to completion, including presentations, consultation, planning, estimating, project setup, project controls, procurement, administration, and closeout. Excellent oral and written communication skills and people skills. Must have the ability to clearly and effectively present complex information to all levels of employees, management, and clients. Proven ability to establish and maintain relationships with clients. Report regularly on progress, cost and schedule metrics, procurement issues, safety or environmental concerns, design questions, potential impacts, and matters requiring support. Working with business and IT leads for appropriate project staffing and development support. Proficiency in Microsoft Office products is preferred. Project Management Professional (PMP) or equivalent certification preferred. Responsibilities Analyze and recommend solutions related to new product launches, product discontinuations, vendor integrations, and operational efficiencies among other potential services that provide value to our clients. Manage to program budget, scope, client deliverables, timelines, and artifacts daily. Anticipate client needs and proactively make program recommendations to enhance service value. Present program readouts to clients and key leaders including, but not limited to, in-flight project status, issue tracking, risk mitigation and resolution. Lead 3rd party vendor communication/coordination meeting. Recommend changes/updates/enhancements to current platform and vendor integration landscape to further align with client's strategy and industry advancements. Build relationships with internal business owners to help streamline processes. Monitor team backlog and prioritize activities to deliver on time, on budget, on scope Recommends new practices, processes, metrics, or models Independently determine method for completion of new projects Manage all aspects of project communications Report regularly on progress, cost and schedule metrics, procurement issues, safety or environmental concerns, design questions, potential impacts, and matters requiring support. Works with business and IT leads for appropriate project staffing and development support. What is expected of you and others at this level Applies advanced knowledge and understanding of concepts, principles, and technical capabilities to manage a wide variety of programs Participates in the development of policies and procedures to achieve specific goals Recommends new practices, processes, metrics, or models Works on, or may lead, complex projects or programs of large scale and scope Decisions have a short-term impact on work processes, outcomes, and customers Provides solutions which may set precedent Interact with subordinates, peer customers and suppliers at various management levels and may interact with senior management Gain consensus from various parties involved Acts as a mentor to less experienced colleagues TRAINING AND WORK SCHEDULES: Your new hire training will take place 8:00am-5:00pm CST, mandatory attendance is required. This position is full-time (40 hours/week). Employees are required to have flexibility to work any of our shift schedules during our normal business hours of Monday-Friday, 7:00am- 7:00pm CST. REMOTE DETAILS: You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to highspeed internet. We will provide you with the computer, technology and equipment needed to successfully perform your job. You will be responsible for providing high-speed internet. Internet requirements include the following: Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. Dial-up, satellite, WIFI, Cellular connections are NOT acceptable. Download speed of 15Mbps (megabyte per second) Upload speed of 5Mbps (megabyte per second) Ping Rate Maximum of 30ms (milliseconds) Hardwired to the router Surge protector with Network Line Protection for CAH issued equipment Anticipated salary range: $105,100 - $150,100 Bonus eligible: Yes 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: 12/14/2025 *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

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 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 2-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, InterQual, 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:$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.

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 SummaryThe Aetna Pharmacy Health Plan Compliance team is seeking an experienced professional with Health Care compliance experience to join our team. Our mission is to assess the applicability of State and Federal regulations to our commercial Aetna pharmacy programs and benefit plans, to identify and track business and compliance risks and issues and to develop and implement action plans to become compliant. Our team collaborates with both the Aetna Health Plan business teams and with our CVS Caremark PBM colleagues to understand regulatory trends and to anticipate impacts. Our regulatory environment is ever-changing. Our team works with urgency to anticipate, understand and address new regulatory requirements which impact the Aetna Pharmacy Health Plan and to drive our organization to new levels of efficiency through continuous process improvement activities. Successful candidates for this position will be able to:Review and assess new state and Federal legislative requirements to determine applicability to the Aetna Pharmacy Health Plan. Research impacts of new legislation to our existing systems, processes, policies and technology platforms. Summarize and present new legislation and its applicability to the Aetna Pharmacy Health Plan to internal and external colleagues to make them aware of impacts to their business areas and to solicit their ideas and support for developing a solution to become compliant before the effective date of new mandates. Collaborate closely with internal Health Plan and PBM business teams in a fast-paced environment. Request reports and analyze data to understand the business impact of new legislation to fully insured Aetna commercial members and plan sponsors. Participate in or lead work group discussions to understand and document the interdependencies of business areas to become compliant, present information and complex data in a clear and concise manner. Develop project plans, document dependencies, engage resources and track project deliverables to completion. Manage multiple compliance projects from end-to-end at the same time. Adhere to team reporting metrics for mandate tracking. Take ownership and accountability and demonstrate leadership in pursuit of compliance. Join forces with team members to analyze and review incoming legislation. Required QualificationsA minimum of 5 years of experience in pharmacy benefit management, pharmacy operations or healthcare with regulatory experience. A minimum of 3 years project management experience. Strong organizational skills, problem solving skills and critical thinking capabilities. Able to communicate to multiple levels of leadership. Functions independently to meet deadlines while managing multiple competing priorities. Proficient in MS Office Suite, including MS Excel, MS Outlook, MS PowerPoint, MS SharePoint and MS Teams. Preferred QualificationsGeneral understanding of the legislative review process. Capable of building the trust and respect of internal and external constituents. EducationBachelor's degree preferred or a combination of professional work experience and education. Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$54,300. 00 - $159,120. 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. 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: 12/17/2025Qualified 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 SummaryThe Aetna Pharmacy Health Plan Compliance team is seeking an experienced professional with Health Care compliance experience to join our team. Our mission is to assess the applicability of State and Federal regulations to our commercial Aetna pharmacy programs and benefit plans, to identify and track business and compliance risks and issues and to develop and implement action plans to become compliant. Our team collaborates with both the Aetna Health Plan business teams and with our CVS Caremark PBM colleagues to understand regulatory trends and to anticipate impacts. Our regulatory environment is ever-changing. Our team works with urgency to anticipate, understand and address new regulatory requirements which impact the Aetna Pharmacy Health Plan and to drive our organization to new levels of efficiency through continuous process improvement activities. Successful candidates for this position will be able to:Review and assess new state and Federal legislative requirements to determine applicability to the Aetna Pharmacy Health Plan. Research impacts of new legislation to our existing systems, processes, policies and technology platforms. Summarize and present new legislation and its applicability to the Aetna Pharmacy Health Plan to internal and external colleagues to make them aware of impacts to their business areas and to solicit their ideas and support for developing a solution to become compliant before the effective date of new mandates. Collaborate closely with internal Health Plan and PBM business teams in a fast-paced environment. Request reports and analyze data to understand the business impact of new legislation to fully insured Aetna commercial members and plan sponsors. Participate in or lead work group discussions to understand and document the interdependencies of business areas to become compliant, present information and complex data in a clear and concise manner. Develop project plans, document dependencies, engage resources and track project deliverables to completion. Manage multiple compliance projects from end-to-end at the same time. Adhere to team reporting metrics for mandate tracking. Take ownership and accountability and demonstrate leadership in pursuit of compliance. Join forces with team members to analyze and review incoming legislation. Required QualificationsA minimum of 5 years of experience in pharmacy benefit management, pharmacy operations or healthcare with regulatory experience. A minimum of 3 years project management experience. Strong organizational skills, problem solving skills and critical thinking capabilities. Able to communicate to multiple levels of leadership. Functions independently to meet deadlines while managing multiple competing priorities. Proficient in MS Office Suite, including MS Excel, MS Outlook, MS PowerPoint, MS SharePoint and MS Teams. Preferred QualificationsGeneral understanding of the legislative review process. Capable of building the trust and respect of internal and external constituents. EducationBachelor's degree preferred or a combination of professional work experience and education. Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$54,300. 00 - $159,120. 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. 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: 12/17/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.