Lead Healthcare Analyst

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Analyst, Plan Sponsor Services Technician is responsible for entering and maintaining client and provider information within internal systems, ensuring data accuracy and completeness. This role supports ongoing updates for new, terminated, and modified client records, validates required documentation, participates in process and audit review meetings, and consistently meets monthly accuracy and quality standards. Required Qualifications 2-4 years of Health insurance industry experience. 2-4 years of experience maintaining client and provider data within healthcare or insurance systems. 2-4 years of experience supporting plan sponsors, or provider networks. Experience working in a fast-paced administrative or operational environment. Strong attention to detail with a proven ability to maintain data accuracy. Preferred Qualifications Managed Care experience Associate's degree preferred. Education High School Diploma or GED required. Anticipated Weekly Hours 40 Time Type Full time <p style="t

Opportunity Overview: We are seeking a Senior Integration Analyst to join our Integration Services team. In this role, you will lead the technical analysis and design of complex healthcare interoperability solutions that enable seamless integration between the Cohere platform and payer, provider, and third-party systems. You'll partner closely with Product, Engineering, Clinical, Analytics, and external stakeholders to deliver scalable, reliable integrations that improve the patient and provider experience. This is an opportunity to work with cutting-edge healthcare technology, solve complex interoperability challenges, and directly influence the evolution of Cohere's integration platform while contributing to better patient outcomes. This is a remote-first role that may require travel to Boston, MA for new hire onboarding and occasional in-person team meetings and company events. What you’ll do: Serve as a subject-matter expert for healthcare interoperability and payer prior authorization integrations, leading the analysis and definition of data exchanges between the Cohere platform and payer, provider, and third-party systems Lead client-facing integration discovery and requirements-gathering sessions, translating complex payer and provider workflows into clear technical specifications Design scalable, reusable integration workflows using APIs, HL7 FHIR, HL7 v2, X12 EDI, SFTP, flat files, and other data-exchange methods Produce source-to-target mappings, interface specifications, data-flow diagrams, field definitions, validation rules, and error-handling requirements Manage integration analysis across up to three concurrent client initiatives, tracking risks, dependencies, decisions, and open issues Investigate integration failures and coordinate root-cause analysis across technical teams; review payloads, files, logs, and system behavior to resolve data-quality issues Develop test scenarios and support unit, integration, end-to-end, regression, and producti

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Lead Director, Digital Product – Clinical Documentation & Care Delivery Products - Retail Health Location: Remote Massachusetts Department: Healthcare Technology & Product Management Reports To: Senior Medical Director, Clinical Informatics & Digital Product Role Overview As the Lead Director of Digital Product for Clinical Documentation & Care Delivery Products you will lead the technology product strategy and execution for core clinical care delivery products, including clinical documentation, core in-clinic and virtual care encounters, in-basket management, and coordination with the digital team to drive clinically sound asynchronous care. In this high-impact role, you will partner directly with clinical and business operational leaders to shape end-to-end technology pathways that support the delivery of safe, high quality outpatient care. You will lead a multidisciplinary team of product managers, Epic analysts, software engineers, data scientists, and UI/UX designers to translate clinical vision into scalable technology roadmaps that optimize patient outcomes, with an emphasis on safety, a delig

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Lead Director, Digital Product – Quality & STARS Location: Remote Department: Healthcare Delivery Technology & Product Management Reports To: Senior Medical Director, Clinical Informatics & Digital Product Role Overview As the Lead Director of Digital Product for Quality & Stars you will lead the technology product strategy and execution to drive performance in quality measures and programs, including technical leadership of Health Maintenance, dashboards to drive performance in Medicare Stars programs, and dashboards to drive performance in the ACO lead program. In this high-impact role, you will partner directly with clinical and business operational leaders to shape end-to-end technology pathways that support ambulatory quality performance measurement overall, as well as in payer programs, and that ultimately drive performance outcomes.You will lead a multidisciplinary team of product managers, Epic analysts, software engineers, data scientists, and UI/UX designers to translate clinical and program vision into scalable technology roadmaps that optimize patient outcomes, with an emphasis on safety

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Lead Director, Digital Product – Chronic Condition Management Location: Remote New York Department: Healthcare Technology & Product Management Reports To: Executive Director, Medical Cost Initiatives Role Overview As the Lead Director of Digital Product for Chronic Condition Management you will lead the technology product strategy and end-to-end execution for chronic condition programs, including primary responsibility for Compass Rose programs, and coordination with other business technology domains across HCD business, including Clinical Documentation, Clinic Operations, Quality & Stars, and Digital to ensure thoughtful, coordinated, and clinically meaningful technology products that support seamless care delivery pathways for chronic condition management. In this high-impact role, you will partner directly with clinical and business operational leaders to shape end-to-end technology pathways that support the delivery of safe, high quality outpatient care. You will lead a multidisciplinary team of product managers, Epic analysts, software engineers, data scientists, and UI/UX designers to translate clinica

Opportunity Overview: We are looking for a detail-oriented Senior Actuarial Support Analyst to join our Actuarial team. In this role, you will be responsible for evaluating cost-saving initiatives that enhance the efficiency and effectiveness of the prior authorization process. The ideal candidate will have extensive experience in healthcare analytics, financial modeling, and prior authorization, along with a strong strategic mindset and data-driven problem-solving skills. The work will be fast-paced and project-based, with evolving needs - requiring curiosity, flexibility, and grace under pressure. At a growing organization, this is a position that offers the ability to make a substantive mark on the company and its partners with exponential growth opportunities. You will be part of the Actuarial team and develop & maintain cost savings models. This is a remote-first role that may require travel to Boston, MA for new hire onboarding and occasional in-person team meetings and company events. What you’ll do: Design and maintain complex financial models to track and analyze cost-saving initiatives, providing regular updates and insights to senior leadership and stakeholders. Perform advanced data analysis to assess prior authorization & claims trends, decision patterns, and cost drivers. Lead the design and development of financial models to quantify the impact of proposed cost-saving initiatives and forecast cost reduction outcomes for business cases. Use statistical and data visualization tools to identify trends, patterns, and anomalies in claims data that may indicate areas for improvement on savings. Prepare detailed and executive-level reports and presentations that summarize cost-saving achievements, project performance, and future cost-saving potential. Act as a trusted advisor to leadership and key internal & external stakeholders, providing strategic insights, recommendations, and guidance on cost-saving strategies. Work closely with clinic