Jobs at CVS Health

Lead and deliver IBM i/AS400 application development across the SDLC, design technical direction, mentor teams, triage production incidents, perform RCA, and collaborate on cross-functional solutions while applying best practices and ITIL processes.

Lead manual and automated testing for enterprise healthcare applications, validating claims, member/provider data, EDI 837 transactions, APIs, and SQL Server backends. Develop test plans, execute test cases, log defects, support regression/integration/performance testing, and mentor junior QA engineers within Agile teams to ensure quality delivery.

Design, build, and deploy production-ready AI systems and agents using Python and LLMs. Implement RAG pipelines, vector embeddings, and semantic search. Integrate AI features via REST APIs and microservices, apply prompt engineering, monitor performance, and collaborate with cross-functional teams to deliver reliable, scalable AI-powered applications.

Support Medicare Advantage Sales & Acquisitions by owning team operations: onboarding/access, documentation, collaboration tools, and reporting. Coordinate user feedback into product roadmaps, maintain product and initiative documentation, enable engineers and product staff to deliver, and keep leadership informed on progress and readiness cycles.

Assess and manage member care using clinical judgment and guidelines to render coverage determinations. Communicate with providers, coordinate services, identify referrals and quality improvement opportunities, document decisions, and meet productivity and quality expectations in a remote, shift-based utilization management environment.

Design, develop, and enhance enterprise healthcare web applications and integrations. Provide technical leadership, establish coding standards, mentor engineers, optimize data/ETL workflows, and collaborate in Agile teams to deliver secure, high-performing solutions supporting claims, member/provider data, and EDI integrations.

Work-from-home case manager who conducts in-person member visits in Pima County to evaluate needs, develop and implement care plans, coordinate services, monitor outcomes, document per regulatory guidelines, escalate quality issues, and coach members. Focus on people with serious mental illness, elderly, or physical disabilities; travel up to 50% required.

Greet and check in patients, assist with forms, collect co-pays, update patient information and schedule appointments in the EMR, manage inbound/outbound phone and fax communications, maintain welcome area cleanliness, and occasionally float to other centers.

Greet patients and visitors, manage check-ins and required forms, collect co-pays, update patient records and schedule appointments in the EMR, handle inbound/outbound calls and faxes, maintain welcome area cleanliness, and support center operations including occasional float to other centers.

Drive Medicare patient acquisition through community outreach: research partners, prospect and cold call local organizations, build and manage stakeholder relationships, plan and execute events, track KPIs and collaborate with regional outreach teams to generate leads and new patients.

Greet patients and guests, perform visit check-in, collect co-pays, update patient records and schedule appointments in EMR, manage phone lines and faxes, maintain welcome area cleanliness, and support daily administrative workflows.

Design, build, and maintain large-scale data infrastructure and pipelines. Integrate data from multiple sources, ensure data quality and security, optimize performance, implement monitoring and governance, troubleshoot data issues, and collaborate with cross-functional teams to support analytics and BI workloads.

Support management by assigning and processing clinical non-adjudication offering requests submitted via eProject and Salesforce. Provide customer-service oriented coordination, work independently and cross-functionally, maintain quality and attention to detail, and follow a flexible schedule with regular attendance.

Serve as primary client contact for PBM operations, managing routine to complex requests, tracking issues to resolution, coordinating cross-functional teams, ensuring timely delivery, meeting client guarantees, and building strong client relationships through clear communication and problem-solving.

Pair with a primary care provider to document patient encounters in the EHR (HPI, exam, assessment, plan), assign CPT/ICD-10 codes, prepare after-visit summaries, support clinical documentation improvement and daily huddles, place orders/referrals, and perform related administrative tasks. Role requires in-person full-time clinic work and is ideal for pre-med or healthcare administration track candidates.

The role involves coordinating marketing campaigns, managing relationships with Provider groups and Brokers, and tracking ROI from activities in Central and North Florida.

Manage corporate cash, liquidity, and cash flow analysis; design liquidity strategies; ensure regulatory and policy compliance; maintain bank relationships; perform reconciliations, internal control audits, and process automation; act as backup liquidity analyst.

The Senior Analyst in Accounts Payable handles payment operations, maintains vendor data, ensures compliance, and supports ERP migrations while using automation tools.

Design, develop, test, deploy and maintain mainframe applications supporting claims processing. Collaborate with product, architecture, QA and offshore vendors in Agile teams. Monitor performance, troubleshoot issues, optimize applications, and produce related documentation.

Design, build, and ship enterprise AI applications using LLMs and agent frameworks. Own system architecture, write PRDs and design docs, build prototypes to production, integrate with enterprise platforms, coach architects and engineers, and ensure evaluation, testing, observability, security, and compliance.