The Utilization Management Nurse Consultant assesses and coordinates appropriate healthcare services for members, applying clinical criteria and ensuring effective communication with providers to enhance care quality.

The Epic Cogito Administrator manages the Epic Cogito analytics ecosystem, ensuring the stability and performance of reporting databases and data pipelines while supporting reporting consumers and collaborating with multiple teams.

The Lead Director will oversee IBM zSystems strategy, platform modernization, team development, operational reliability, security compliance, and cross-functional collaboration at CVS Health.

Develop and implement analytic solutions, execute models and experiments, and communicate findings through reports and visualizations.

The Senior Manager, Corporate Compliance leads Medicare and Medicaid compliance programs, manages risks, and communicates with stakeholders. They oversee auditing, regulatory requirements, and compliance strategies, ensuring adherence to laws and ethical standards.

The Senior Software Development Engineer designs and implements digital solutions, codes applications, conducts testing, collaborates on architecture, and contributes to IBMi projects, ensuring performance and maintainability.

Responsible for reviewing prior authorizations for health services, utilizing clinical skills to assess coverage, document decisions, and communicate with providers and members.

Design and maintain healthcare software integrations, ensuring data flow between Epic EHR and systems while mentoring developers and ensuring quality standards.

The Sr. Analyst supports Network Pricing by ensuring compliance and accuracy in pharmacy network pricing implementations, performing quality assurance reviews, and managing operational tasks with a focus on detail and deadlines.

The Network Relations Manager ensures effective provider relationships, oversees Medicaid policies, resolves complex provider issues, and collaborates cross-functionally while educating providers on contracts and compliance.

Lead a team in end-to-end forecasting, budgeting, and reporting for financial planning in production support and clinical programs, ensuring accuracy and transparency in financial plans and processes.

The Contract Negotiation Manager recruits providers, negotiates contracts, manages relationships and performance, and ensures compliance with established guidelines while supporting cost-saving initiatives.

The Senior Investigator conducts complex investigations into healthcare fraud, prepares cases for review, documents activities, and collaborates with law enforcement, while providing guidance to new investigators.

As a Specialty Mail Service Pharmacist, you will provide exceptional patient care, monitor drug therapy, educate patients, and manage chronic diseases.

The Welcome Coordinator creates an inclusive environment for patients, managing appointments, handling calls, and ensuring a positive experience in the clinic.

The Case Manager RN coordinates and assesses healthcare needs of members, develops action plans, and advocates for patients to improve outcomes.

The Senior Analyst Informatics is responsible for analyzing business data, conducting root cause analysis, and creating reports to support business needs, particularly related to claim and encounter data.

Lead a finance team to prepare financial statements, ensure compliance with regulations, and oversee consolidation activities for accurate reporting.

The Employee Relations Case Manager advises leaders and employees on employee relations, manages workplace inquiries, and conducts investigations while ensuring compliance with policies and laws.

The Informatics Manager will support HEDIS reporting, perform analytics, and collaborate with stakeholders using healthcare data. Requires strong technical skills in SQL and data analysis.