Jobs at CVS Health

Analyzes healthcare claims and encounter data, writes SQL queries and reports, investigates data trends and anomalies, performs root cause analysis, and develops solutions and system enhancements. The role also supports testing, defect reporting, project prioritization, and stakeholder collaboration across teams. Candidates need experience with large datasets, data warehouses, healthcare claims or encounters, and complex SQL. Preferred experience includes QNXT, Edifecs, EDI files, test scripting, and Agile methodologies.

Partners with Enterprise Workforce Management and operational leaders to improve labor budgeting, forecasting, capacity planning, and reporting. Connects data from multiple sources, develops analytical models and visualizations, reconciles complex systems, and communicates business insights, risks, and investment outcomes. Collaborates cross-functionally with Operations, Finance, IT, HR, and Industrial Engineering while using SQL, Excel, Tableau, GCP, Snowflake, and related tools.

The RN Case Manager conducts in-home assessments, develops and manages care plans, coordinates with members, providers, and interdisciplinary teams, authorizes cost-effective services, supports safe discharges, documents care accurately in the EHR, and advocates for members with complex medical and behavioral health needs. The role serves MLTSS and D-SNP populations, may include pediatric cases, requires NJ Choice certification, and involves 50–75% travel across Burlington and surrounding counties.

Facilitates Scrum events, removes impediments, coaches Scrum Masters and Product Owners, and drives continuous improvement. Manages Scrum processes, backlog prioritization, capacity forecasting, resource planning, budgets, risk mitigation, delivery expectations, and team collaboration. The role promotes adaptability, transparency, experimentation, and effective project and product delivery.

Leads product vision, strategy, roadmap, backlog, and launch activities for Epic EHR and clinical informatics tools, particularly electronic fax and medical records workflows. Partners with engineering, data science, design, operations, training, and change management teams to improve adoption, quality, safety, and healthcare delivery. Defines requirements, governance, testing, executive reporting, and continuous product improvements through analytics and user feedback.

Manages broker and technology partner commission payments, calculation systems, reconciliations, agreements, payment accuracy, broker inquiries, and process improvements. Collaborates with Sales, Finance, and Technology teams to ensure compliant and efficient commission operations. Requires strong analytical, communication, Excel, Python, automation, and commission-process expertise, with knowledge of broker compensation structures and insurance-related payments preferred.

Facilitates Scrum events, removes impediments, supports Product Owners, and coaches Scrum teams on Agile principles. Tracks team productivity, velocity, quality, and progress through metrics and reporting. Develops process evaluation tools, actionable analytics, stakeholder communication strategies, and knowledge-sharing systems. Promotes collaboration, self-organization, continuous improvement, and Agile adoption across teams and stakeholders.

Owns the strategy, roadmap, and operational support for pharmacy drive-thru colleague experience. Defines POS integrations, hardware, software, workflows, staffing models, and AI triage procedures. Uses feedback and workflow data to identify friction, leads pilots and testing, supports stores, develops enablement materials, and partners with technology, pharmacy, workforce management, operations, field leadership, and vendors to improve productivity and adoption across the enterprise.

Manages HEDIS quality operations involving vendors, medical record abstraction, data integrity, compliance, reporting, and cross-functional project execution. Oversees vendor workflows, calibration, staffing coordination, documentation, audits, and record repositories while partnering with quality, market, and business teams. Supports Statements of Work, forecasting, process improvement, and successful HEDIS outcomes in a regulated healthcare environment.

Owns digital product capabilities supporting Medicare sales, enrollment, agent enablement, and customer journeys. Responsibilities include backlog prioritization, requirements definition, Agile delivery coordination, acceptance criteria, testing, release readiness, production support, and stakeholder alignment across business, technology, compliance, operations, and vendors. The role supports regulated enrollment cycles and drives measurable customer and business outcomes.

Design, develop, test, and maintain CVS Health’s SailPoint Identity Governance and Administration platform. Configure and troubleshoot connectors, rules, transforms, workflows, lifecycle automation, RBAC, provisioning, access certifications, and compliance reporting. Integrate HRIS, directories, and identity providers while diagnosing issues across connected systems. Collaborate with security, compliance, architecture, network operations, and business teams in an Agile environment, contributing to secure, auditable IAM services and mentoring or leading initiatives as needed.

Lead and contribute to Salesforce Service and Health Cloud development, including configuration, custom coding, integrations, deployments, debugging, performance tuning, and governance. Design solutions using Apex, Aura, LWC, Knowledge Base, Workflow, Service Cloud Voice, and Agentforce. Collaborate with business and IT teams, document technical solutions, support Agile delivery, and coordinate onshore/offshore development efforts.

Leads complex, cross-functional business and technology initiatives from intake through implementation. Responsibilities include requirements gathering, executive workshops, project delivery, risk and dependency management, stakeholder consulting, process improvement, and executive reporting. The role serves as a business owner and escalation point while mentoring analysts and improving delivery practices across the organization.

Leads engineering teams developing agentic AI and enterprise SMS/RCS messaging platforms on GCP. Owns architecture, delivery, engineering roadmaps, team growth, messaging orchestration, carrier integrations, conversational AI, TCPA compliance controls, and GCP infrastructure. Partners with Product, Legal, and Compliance to implement scalable regulatory controls for healthcare communications.

Develop and deploy SAP Fiori and UI5 applications using SAP BTP and HANA Cloud Platform. Consult with customers, support UX and Design Thinking workshops, build prototypes, configure roles and catalogs, and collaborate with distributed implementation teams. Ensure code quality through testing, root cause analysis, documentation, release standards, and regression prevention.

Leads product management and development for drug cost reduction initiatives within CVS Caremark. Develops and executes strategic initiatives, pilots, products, analyses, and proposals while coordinating cross-functional stakeholders across operations, formulary administration, medical affairs, legal, analytics, sales, and other teams. Builds relationships, manages ambiguity, influences senior audiences, and drives successful strategy and product launches.

Lead technical vision and architecture for a cloud-native, event-driven health platform. Guide teams from prototype to production, ensure reliability, security, performance, and strong engineering practices (testing, observability, CI/CD), mentor senior engineers, and collaborate with product and architecture stakeholders to drive platform roadmaps and execution.

Lead analytics and AI/ML product delivery for PBM member experience. Define requirements, manage backlog and Agile ceremonies, partner with data science and engineering, prioritize roadmaps, engage stakeholders, and introduce tools and methods to drive analytics-driven product outcomes and adoption.

Designs and implements scalable Java and cloud software solutions, modern microservices, APIs, and Generative AI capabilities. Leads architecture discussions, creates proofs of concept, optimizes performance, participates in code reviews, resolves complex issues, and mentors engineers. Collaborates with business and technical leaders to deliver high-quality products and improve platform capabilities.

Develop and manage strategically positioned proposal responses for RFPs, RFIs, questionnaires, and broker surveys. Write, edit, and proofread customer-focused content; research and gather supporting data; collaborate with sales teams and subject matter experts; tailor value propositions; manage multiple deadlines; maintain proposal databases; and improve proposal processes and content standards.