Care Management Specialist Jobs

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 Dental Network Relations Senior Analyst, is the liaison between Aetna and an assigned group of DSOs. This role acts as a resource for all dental products (DHMO, PPO, Medicare) to DSO leadership and staff, providers, sales, and marketing to aid in the achievement of Aetna Key Performance Measures. This person serves as a subject matter expert, demonstrating a strong understanding of Aetna’s Dental Products and market position. The Senior Analyst negotiates provider contract language and compensation. This role is also responsible to work cross functionally to resolve provider concerns, document resolution, and effectively communicate to all parties. Responsible for account management of DSOs and large dental groups to support network strategic initiatives. Negotiates contracts at all organizational levels. Strong emphasis on analysis to develop cost-of-care strategy. Solid focus on data analytics to identify cost savings opportunities Collaborates cross-functionally to resolve provider issues with the utmost urgency. Recruits providers as needed to attain network expansion and meet access needs. Communicates early warning signs of potential issues/risks to management. Required Qualifications: 2+ years of experience in provider relations, network management, healthcare contracting, dental insurance, o

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 Dental Network Relations Senior Analyst, is the liaison between Aetna and an assigned group of DSOs. This role acts as a resource for all dental products (DHMO, PPO, Medicare) to DSO leadership and staff, providers, sales, and marketing to aid in the achievement of Aetna Key Performance Measures. This person serves as a subject matter expert, demonstrating a strong understanding of Aetna’s Dental Products and market position. The Senior Analyst negotiates provider contract language and compensation. This role is also responsible to work cross functionally to resolve provider concerns, document resolution, and effectively communicate to all parties. Responsible for account management of DSOs and large dental groups to support network strategic initiatives. Negotiates contracts at all organizational levels. Strong emphasis on analysis to develop cost-of-care strategy. Solid focus on data analytics to identify cost savings opportunities Collaborates cross-functionally to resolve provider issues with the utmost urgency. Recruits providers as needed to attain network expansion and meet access needs. Communicates early warning signs of potential issues/risks to management. Required Qualifications: 2+ years of experience in provider relations, network management, healthcare contracting, dental insura

About Us: Paytm is India’s largest digital payments and financial services platform, leading the mobile QR revolution. We power millions of businesses and individuals, and we’re building scalable, resilient systems to serve half a billion Indians and beyond. Here at Paytm, technology isn't just about keeping up, it's about building the future. We believe the next generation of engineers must not only scale systems to billions but also leverage AI and GPT tools to accelerate innovation. Role Overview: We are seeking an experienced Senior Information Security Manager to lead our security initiatives and ensure the integrity, confidentiality, and availability of our systems and data. This role is crucial in safeguarding our digital assets and maintaining compliance with industry standards. 1. Should take care of Infosec functions by coordinating with various stakeholders 2. Lead and manage Vulnerability Assessment (VA) and Penetration Testing (PT) programs end to end. 3. Should have technical hands-on knowledge on different VAPT tools, like Qualys, Tenable, BurpSuite, Checkmarx etc. 4. Ensure all cyber security compliance and audits directions issued from time to time by the regulator like SEBI, RBI etc. 5. Coordination with SOC, Technology team to follow up the incidents till closure 6. Follow escalation matrix for delayed issues 7. Assist in Internal and External Audits (Regulatory) and work towards closure of observations if any 8. Should have project management espouse, to run the security PMO for ensuring the multiple initiatives with internal / external teams, vendors, and regulators. 9. Prepare and review new/existing policies, procedures, and secure configure/ hardening documents. 10. Should possess technical skills and knowledge to handle/manage security solutions if required 11. Should have understanding of data protection technologies & laws, including DLP, DSPM, DPDPA, IT Act and international regulations like GDPR 12. Exposure to Cloud Environment & Appl

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 Front End Operations Supervisor is responsible for leading a team of approximately 20 employees and overseeing the day-to-day operations of mail intake, document processing, and workflow management. This role provides direct supervision, coaching, and performance support through regular one-on-one meetings, team communications, and operational oversight to ensure service levels and business objectives are met. Key responsibilities include managing the daily workload associated with in-house printing, returned mail processing, document scanning, check handling, and mail indexing activities. The Supervisor is responsible for monitoring work queues, balancing resources, addressing operational issues, and ensuring timely and accurate processing of all incoming and outgoing work. This person serves as a primary liaison with the mailroom vendor, coordinating the receipt, processing, and distribution of incoming mail. The Supervisor partners with internal and external stakeholders to identify process improvement opportunities, resolve service issues, and ensure operational efficiency across all front-end mail operations. Additionally, this role supports departmental initiatives and special projects, assists with process documentation and workflow enhancements, and contributes to the implementation of operational improvements designed to increase productiv

Become a part of our caring community The Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Pre-Authorization Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Pre-Authorization Nurse completes medical necessity and level of care reviews for requested services using clinical judgment, and refers to team members for review depending on case findings. Educate providers on utilization and medical management processes. Enter and maintain relevant clinical information in various medical management systems. Understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Use your skills to make an impact Required Qualifications 2+ years of RN experience Active RN license in the state of Indiana Ability to be licensed in multiple states without restrictions Previous experience in utilization management, case management, discharge planning and/or home health or rehab Proficient with MS Office products including Word, Excel and Outlook Ability to work independently under general instructions and with a team Preferred Qualifications Bachelor's degree MCO experience Health Plan experience working with large carriers Previous Medicare/Medicaid experience Outpatient or home health experience in Utilization Manageme

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. The Release Engineer is responsible for implementing and supporting automated software delivery processes that enable reliable, secure, and repeatable deployments across development, test, non-production, and production environments. This role serves as a technical bridge between Software Engineering, Quality Engineering, Infrastructure, and Operations teams to improve deployment speed, stability, and operational efficiency. The Release Engineer is responsible for implementing and supporting automated software delivery processes that enable reliable, secure, and repeatable deployments across development, test, non-production, and production environments. This role serves as a technical bridge between Software Engineering, Quality Engineering, Infrastructure, and Operations teams to improve deployment speed, stability, and operational efficiency. Key Responsibilities Develop, support, and maintain automated CI/CD pipelines to streamline application delivery. Standardize build, release, and deployment processes across applications and platforms. Establish repeatable, auditable, and traceable release management practices to ensure deployment consistency and compliance. Manage and support Git-based source control, branching strategies, and release workflows. Integrate automated testing, quality gates, security controls, and compliance checks into deploym

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 Audit Manager leads audit projects, develops team members, and partners with business leaders to identify and manage risks. This role is responsible for overseeing audit execution, providing strategic insights, and strengthening internal controls across the organization. Key Responsibilities Leadership & Team Development Lead, coach, and support audit team members. Set priorities, assign work, and monitor project progress. Manage employee development, performance, and career growth. Assess team capabilities and staffing needs. Recruit, develop, and retain top talent while supporting succession planning. Audit Leadership & Risk Management Identify emerging risks, business changes, and opportunities to improve controls. Ensure audit projects are completed on time and aligned with the audit plan. Serve as a trusted advisor on risk assessments and control design. Communicate audit plan progress and findings to key stakeholders. Promote risk awareness and proactive risk management across the business. Support organizational transformation by evaluating impacts on processes and controls. Contribute to special projects and strategic initiatives while maintaining audit independence. Audit Execution Oversee and review audit

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 This position will be dedicated to one plan sponsor, in order to support their client locations, specifically related to understanding and promoting their Employee Assistance Program (EAP) benefits. This is a travel-based role, and will include approximately two-three weeks of travel (within the continental United States) per month. Job duties include: Supporting the plan sponsor through site visits to educate and promote EAP benefits. Ordering supplies/communications and regularly communicating with warehouse contacts. Coordinating with warehouse management team, employees, account team and HR executives. Creating engagement and employee inquiry tracking. Presenting to assigned locations and/or managers on benefits overview. Coordinating location trainings and other administrative duties as needed. Required Qualifications 2+ years of experience in a client-facing role. Ability to travel 50-75% of the time within the continental United States, averaging about 2-3 weeks per month. Demonstrated proficiency in Microsoft Office Suit (Excel, Word, PowerPoint, Teams, Outlook, etc.). Preferred Qualifications Previous experience working in EAP (Employee Assistance Program) or mental wellbeing. Growth mindset, including an agility f

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 Responsible for supporting the Nursing department by ensuring timely and accurate tracking of Plan of Treatment documents in medical records software. Individual will maximize contact with providers to obtain signatures. Team member will effectively execute the process that is consistent with the management and organizational goals. ESSENTIAL DUTIES AND RESPONSIBILITIES Contacting prescriber offices to obtain fax numbers or prescriber email addresses via phone call Faxing nursing Plan of Treatments to appropriate prescriber fax number or email address Tracking Plan of Treatment details within the patient's electronic medical record. Q and A of Plan of Treatment documents. Obtaining provider signatures on Plan of Treatments. Required Qualifications Minimum one year of related experience in coordinating activities, administrative support functions, and customer service. Effective verbal and written communications skills. Excellent detail orientation and time management skills. Proficiency with Microsoft business software. Preferred Qualifications Experience as a nursing assistant, pharmacy technician, home patient representative, or customer service representative preferred. Experience obtaining physician signatures on Pl

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 Senior Manager, Medicare Product Operations (NCOD) is responsible for providing leadership, operational oversight, and people management for the Non-Clinical Organization Determination (NCOD) team. This leader is accountable for ensuring accurate, timely, compliant, and member-centered coverage determinations while maintaining adherence to CMS regulations, and internal policies. The role oversees a team of managers and analysts responsible for evaluating member requests, issuing organization determinations, maintaining documentation, and supporting appeals- and grievance-related activities. This position serves as a key operational leader, driving quality, compliance, performance, process optimization, workforce development, and cross-functional collaboration. The Senior Manager partners with Compliance, Product, Appeals, Grievances, Eligibility, Technology, and vendor partners to ensure operational excellence and a best-in-class member experience. Responsibilities Include: Strategic Leadership Provides oversight for the NCOD operation, ensuring alignment with organizational goals, regulatory requirements, and member experience objectives. Establishes operational strategies, and performance standards that support long-term scalability and sustainability. Leads implementation of new NCOD workflo

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 As a Digital Analytics Senior Analyst, you will work closely with product teams to evolve and improve our digital experiences for customers and patients. You will use your analytical and problem-solving skills to define success metrics and measurement approaches to ensure our digital experiences stay healthy. You will collaborate with other motivated teammates across UX, Customer Experience Management, IT, Site Optimization, Marketing and Merchandising. Required Qualifications 1+ years of relevant experience for those in a CVSH leadership program (such as DAP, Leadership development, GMDP, etc.) OR 2+ years of relevant experience for others Preferred Qualifications Knowledge of online analytics tools such as Adobe, Coremetrics, Localytics, Webtrends, etc Experience in Tableau/Power BI, SQL (Teradata, Hadoop, Google Cloud Platform, etc.) Experience with highly quantitative analytics Project oriented, pro-active, and self-motivated work style with proven ability to manage effectively multiple projects and changing priorities in an extremely fast paced environment and constantly deliver superior results within given deadlines Strengths in structured and logical thinking, problem solving, issue resolution, and attention to detail Education - Bachelor’

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 Operations Manager is a member of the Store Management team, and as such, fulfills the company purpose of helping people on their path to better health by driving store execution and performance while building consumer loyalty to CVS/pharmacy through a focus on excellent customer service. Under the supervision of the Store Manager, the Operations Manager will maintain an engaged, productive store team through strong leadership, demonstrating initiative and leading by example. The Operations Manager is responsible for supporting the Store Manager in the total leadership and strategic operation of a CVS/pharmacy store including: Overall store management, supervision, and policy implementation Sales and inventory management Employee staffing, training, and development Financial management Customer service leadership Unlike the Store Manager in Training position, the Operations Manager position is not part of the CVS/pharmacy Retail Management Development Program. Operations Managers are not eligible for direct promotion to Store Manager. Candidates with a short-term goal of becoming a CVS Store Manager should instead apply for Store Manager in Training openings. Essential Functions: 1. Management Lead others and work effectively with store crews Supervise, assign and direct activities of

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 A Shift Supervisor is a key leader supporting the CVS Store Management team in driving store execution and performance while building consumer loyalty to CVS/pharmacy through a focus on excellent customer service. When there is no manager or Operations Supervisor onsite, the Shift Supervisor leads the store staff, ensures that store operations run smoothly, and is responsible for ensuring the completion of all opening and closing procedures. Essential Functions: 1. Management Work effectively with store management and store crews Supervise the store’s crew through assigning, directing and following up of all activities Effectively communicate information both to and from store management and crews 2. Customer Service Assist customers with their questions, problems and complaints Promote CVS customer service culture. (Greet, offer help, and thank) Handle all customer relations issues in accordance with company policy and promote a positive shopping experience for all CVS customers Maintain customer/patient confidentiality 3. Merchandise/Presentation Price merchandise Stock shelves Execute the displays, sign and inventory of weekly, promotional, and seasonal merchandise</

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 A Shift Supervisor is a key leader supporting the CVS Store Management team in driving store execution and performance while building consumer loyalty to CVS/pharmacy through a focus on excellent customer service. When there is no manager or Operations Supervisor onsite, the Shift Supervisor leads the store staff, ensures that store operations run smoothly, and is responsible for ensuring the completion of all opening and closing procedures. Essential Functions: 1. Management Work effectively with store management and store crews Supervise the store’s crew through assigning, directing and following up of all activities Effectively communicate information both to and from store management and crews 2. Customer Service Assist customers with their questions, problems and complaints Promote CVS customer service culture. (Greet, offer help, and thank) Handle all customer relations issues in accordance with company policy and promote a positive shopping experience for all CVS customers Maintain customer/patient confidentiality 3. Merchandise/Presentation Price merchandise Stock shelves Execute the displays, sign and inventory of weekly, promotional, and seasonal merchandise</

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 A Shift Supervisor is a key leader supporting the CVS Store Management team in driving store execution and performance while building consumer loyalty to CVS/pharmacy through a focus on excellent customer service. When there is no manager or Operations Supervisor onsite, the Shift Supervisor leads the store staff, ensures that store operations run smoothly, and is responsible for ensuring the completion of all opening and closing procedures. Essential Functions: 1. Management Work effectively with store management and store crews Supervise the store’s crew through assigning, directing and following up of all activities Effectively communicate information both to and from store management and crews 2. Customer Service Assist customers with their questions, problems and complaints Promote CVS customer service culture. (Greet, offer help, and thank) Handle all customer relations issues in accordance with company policy and promote a positive shopping experience for all CVS customers Maintain customer/patient confidentiality 3. Merchandise/Presentation Price merchandise Stock shelves Execute the displays, sign and inventory of weekly, promotional, and seasonal merchandise</