Compliance Engineer 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. Health is everything. At CVS Health, we are committed to increasing patient access to care, lowering costs and improving the quality of care. Millions of times a day, we're helping people on their path to better health- from advising patients on their prescriptions to helping them manage their chronic and specialty conditions. Because we're present in so many moments, big and small, we have an active, supportive role in shaping the future of health care. Pharmacy Technicians are at the forefront of our purpose as they deliver compassionate care to our millions of patients every day. Come join our team of dedicated and caring Pharmacy Technicians who demonstrate our core values of Accountability, Caring, Collaboration,Innovation and Integrity in everything they do in our pharmacies every day. Whether you are new to working in pharmacies or are an experienced Pharmacy Technician, we have a place for you on our team to use your skills and talents to serve and care for our patients and customers. The Pharmacy Technician position provides individuals with an opportunity to work in a leading retail pharmacy company and in a role that positively impacts the lives and health of others. You will work in an environment where the highest professional and ethical standards are maintained as well as full compliance with all Federal, State and Local laws and regulations. Pharmacy Technicians take important steps to

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 Health is everything. At CVS Health, we are committed to increasing patient access to care, lowering costs and improving the quality of care. Millions of times a day, we’re helping people on their path to better health— from advising patients on their prescriptions to helping them manage their chronic and specialty conditions. Because we’re present in so many moments, big and small, we have an active, supportive role in shaping the future of health care. Pharmacy Technicians are at the forefront of our purpose as they deliver compassionate care to our millions of patients every day. Come join our team of dedicated and caring Pharmacy Technicians who demonstrate our core values of Accountability, Caring, Collaboration,Innovation and Integrity in everything they do in our pharmacies every day. Whether you are new to working in pharmacies or are an experienced Pharmacy Technician, we have a place for you on our team to use your skills and talents to serve and care for our patients and customers. The Pharmacy Technician position provides individuals with an opportunity to work in a leading retail pharmacy company and in a role that positively impacts the lives and health of others. You will work in an environment where the highest professional and ethical standards are maintained as well as full compliance with all Federal, State and Local laws and regulations. Pharmac

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. A Brief Overview Performs claim documentation review, verifies policy coverage, assesses claim validity, communicates with healthcare providers and policyholders, and ensures accurate and timely claims processing. Contributes to the efficient and accurate handling of medical claims for reimbursement through knowledge of medical coding and billing practices and effective communication skills. What you will do Handles and processes Benefits claims submitted by healthcare providers, ensuring accuracy, efficiency, and strict adherence to policies and guidelines. Determines the eligibility and coverage of benefits for each claim based on the patient's insurance plan and policy guidelines and scope. Assesses claims for accuracy and compliance with coding guidelines, medical necessity, and documentation requirements. Documents claim information in the company system, assigning appropriate codes, modifiers, and other necessary data elements to ensure accurate tracking, reporting, and processing of claims. Conducts reviews and investigations of claims that require additional scrutiny or validation to ensure proper claim resolution. Communicates with healthcare providers, patients, or other stakeholders to resolve any discrepancies or issues related to claims.</sp

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. Job Purpose and Summary: Accountable for Commercial, Medicare, Exchange and Medicaid NCQA Accreditation quality projects and initiatives through design, development, and implementation. This role focuses primarily on Delegated Credentialling and Oversight of the delegated Credentialling organizations, per contract. Proactively builds strong business relationships with internal and external business partners. Participates in presentation to business partners on accreditation requirements to achieve results and ensure accreditation readiness. Proven experience as a subject matter expert on NCQA accreditation standards, analysis, Delegated Credentialing file reviews and supporting quality functions. Primary Job Duties & Responsibilities: Utilizes statistical analysis, data visualization tools, and database queries to identify trends, patterns, and opportunities for quality improvement. Develops and maintains performance metrics and dashboards to track and report on patient safety, clinical effectiveness, patient experience, and compliance with quality standards. Contributes to quality improvement projects and initiatives by providing data-driven insights and recommendations. Collaborates with cross-functional teams to design and implement evidence-based practices, care protocols, and process improvements. Assists in conducting audits and performing chart review

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 Location: Work From Home – Flexible, Travel Required: 25 – 50% (Wayne and Macomb Counties) Schedule: Standard business hours Monday-Friday 8:00am-5:00pm EST No evenings, weekends, or major holidays 4 day/10-hour schedule available after training ​ Our Mission The LTSS RN Case Manager is responsible for comprehensive assessment, care planning, coordination, implementation, and monitoring of Long-Term Services and Supports (LTSS) for dual-eligible Medicare and Medicaid members. This role ensures members receive appropriate waiver and community-based services to promote safety, independence, and improved health outcomes while maintaining regulatory compliance. This position includes in-home visits to complete functional assessments, evaluate eligibility for waiver services, and develop person-centered service plans. Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and

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 Health is everything. At CVS Health, we are committed to increasing patient access to care, lowering costs and improving the quality of care. Millions of times a day, we’re helping people on their path to better health— from advising patients on their prescriptions to helping them manage their chronic and specialty conditions. Because we’re present in so many moments, big and small, we have an active, supportive role in shaping the future of health care. Pharmacy Technicians are at the forefront of our purpose as they deliver compassionate care to our millions of patients every day. Come join our team of dedicated and caring Pharmacy Technicians who demonstrate our core values of Accountability, Caring, Collaboration,Innovation and Integrity in everything they do in our pharmacies every day. Whether you are new to working in pharmacies or are an experienced Pharmacy Technician, we have a place for you on our team to use your skills and talents to serve and care for our patients and customers. The Pharmacy Technician position provides individuals with an opportunity to work in a leading retail pharmacy company and in a role that positively impacts the lives and health of others. You will work in an environment where the highest professional and ethical standards are maintained as well as full compliance with all Federal, State and Local laws and regulations. Pharmac

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. Omnicare is a leading provider of pharmacy services to long-term care facilities nationwide, supporting skilled nursing facilities, assisted living communities, and other institutional care settings. Following the sale of Omnicare by CVS Health, this role will support Omnicare and its continued operations as an independent, standalone organization. Candidates should be aware that this role will not remain within CVS Health following the transaction. The individual hired into this role will be employed by Omnicare and will contribute to shaping the future of our organization during this exciting period of growth and transformation. Delivery Driver - Full Time Requisition Job Description The road to a Fortune 4 career starts here As a Delivery Driver for Omnicare Pharmacy, you will deliver prescription orders and/or products to customers on a predetermined route and schedule in a company provided vehicle. Delivery Drivers take important steps to ensure all medication needs and regulatory compliance standards are met for our patients and they demonstrate ethical conduct and always maintain patient confidentiality. Successful Delivery Drivers will utilize a customer service mindset to manage all assigned pharmacy workstations and tasks to support the team’s ability to fill patient prescriptions promptly, safely and accurately. Provide timely and accura

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 Health is everything. At CVS Health, we are committed to increasing patient access to care, lowering costs and improving the quality of care. Millions of times a day, we’re helping people on their path to better health— from advising patients on their prescriptions to helping them manage their chronic and specialty conditions. Because we’re present in so many moments, big and small, we have an active, supportive role in shaping the future of health care. Pharmacy Technicians are at the forefront of our purpose as they deliver compassionate care to our millions of patients every day. Come join our team of dedicated and caring Pharmacy Technicians who demonstrate our core values of Accountability, Caring, Collaboration,Innovation and Integrity in everything they do in our pharmacies every day. Whether you are new to working in pharmacies or are an experienced Pharmacy Technician, we have a place for you on our team to use your skills and talents to serve and care for our patients and customers. The Pharmacy Technician position provides individuals with an opportunity to work in a leading retail pharmacy company and in a role that positively impacts the lives and health of others. You will work in an environment where the highest professional and ethical standards are maintained as well as full compliance with all Federal, State and Local laws and regulations. Pharmac

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 Health is everything. At CVS Health, we are committed to increasing patient access to care, lowering costs and improving the quality of care. Millions of times a day, we’re helping people on their path to better health— from advising patients on their prescriptions to helping them manage their chronic and specialty conditions. Because we’re present in so many moments, big and small, we have an active, supportive role in shaping the future of health care. Pharmacy Technicians are at the forefront of our purpose as they deliver compassionate care to our millions of patients every day. Come join our team of dedicated and caring Pharmacy Technicians who demonstrate our core values of Accountability, Caring, Collaboration,Innovation and Integrity in everything they do in our pharmacies every day. Whether you are new to working in pharmacies or are an experienced Pharmacy Technician, we have a place for you on our team to use your skills and talents to serve and care for our patients and customers. The Pharmacy Technician position provides individuals with an opportunity to work in a leading retail pharmacy company and in a role that positively impacts the lives and health of others. You will work in an environment where the highest professional and ethical standards are maintained as well as full compliance with all Federal, State and Local laws and regulations. Pharmac

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 Health is everything. At CVS Health, we are committed to increasing patient access to care, lowering costs and improving the quality of care. Millions of times a day, we’re helping people on their path to better health— from advising patients on their prescriptions to helping them manage their chronic and specialty conditions. Because we’re present in so many moments, big and small, we have an active, supportive role in shaping the future of health care. Pharmacy Technicians are at the forefront of our purpose as they deliver compassionate care to our millions of patients every day. Come join our team of dedicated and caring Pharmacy Technicians who demonstrate our core values of Accountability, Caring, Collaboration,Innovation and Integrity in everything they do in our pharmacies every day. Whether you are new to working in pharmacies or are an experienced Pharmacy Technician, we have a place for you on our team to use your skills and talents to serve and care for our patients and customers. The Pharmacy Technician position provides individuals with an opportunity to work in a leading retail pharmacy company and in a role that positively impacts the lives and health of others. You will work in an environment where the highest professional and ethical standards are maintained as well as full compliance with all Federal, State and Local laws and regulations. Pharmac

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 Health is everything. At CVS Health, we are committed to increasing patient access to care, lowering costs and improving the quality of care. Millions of times a day, we’re helping people on their path to better health— from advising patients on their prescriptions to helping them manage their chronic and specialty conditions. Because we’re present in so many moments, big and small, we have an active, supportive role in shaping the future of health care. Pharmacy Technicians are at the forefront of our purpose as they deliver compassionate care to our millions of patients every day. Come join our team of dedicated and caring Pharmacy Technicians who demonstrate our core values of Accountability, Caring, Collaboration,Innovation and Integrity in everything they do in our pharmacies every day. Whether you are new to working in pharmacies or are an experienced Pharmacy Technician, we have a place for you on our team to use your skills and talents to serve and care for our patients and customers. The Pharmacy Technician position provides individuals with an opportunity to work in a leading retail pharmacy company and in a role that positively impacts the lives and health of others. You will work in an environment where the highest professional and ethical standards are maintained as well as full compliance with all Federal, State and Local laws and regulations. Pharmacy Technicia

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 Health is everything. At CVS Health, we are committed to increasing patient access to care, lowering costs and improving the quality of care. Millions of times a day, we’re helping people on their path to better health— from advising patients on their prescriptions to helping them manage their chronic and specialty conditions. Because we’re present in so many moments, big and small, we have an active, supportive role in shaping the future of health care. Pharmacy Technicians are at the forefront of our purpose as they deliver compassionate care to our millions of patients every day. Come join our team of dedicated and caring Pharmacy Technicians who demonstrate our core values of Accountability, Caring, Collaboration,Innovation and Integrity in everything they do in our pharmacies every day. Whether you are new to working in pharmacies or are an experienced Pharmacy Technician, we have a place for you on our team to use your skills and talents to serve and care for our patients and customers. The Pharmacy Technician position provides individuals with an opportunity to work in a leading retail pharmacy company and in a role that positively impacts the lives and health of others. You will work in an environment where the highest professional and ethical standards are maintained as well as full compliance with all Federal, State and Local laws and regulations. Pharmac

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 Health is everything. At CVS Health, we are committed to increasing patient access to care, lowering costs and improving the quality of care. Millions of times a day, we’re helping people on their path to better health— from advising patients on their prescriptions to helping them manage their chronic and specialty conditions. Because we’re present in so many moments, big and small, we have an active, supportive role in shaping the future of health care. Pharmacy Technicians are at the forefront of our purpose as they deliver compassionate care to our millions of patients every day. Come join our team of dedicated and caring Pharmacy Technicians who demonstrate our core values of Accountability, Caring, Collaboration,Innovation and Integrity in everything they do in our pharmacies every day. Whether you are new to working in pharmacies or are an experienced Pharmacy Technician, we have a place for you on our team to use your skills and talents to serve and care for our patients and customers. The Pharmacy Technician position provides individuals with an opportunity to work in a leading retail pharmacy company and in a role that positively impacts the lives and health of others. You will work in an environment where the highest professional and ethical standards are maintained as well as full compliance with all Federal, State and Local laws and regulations. Pharmacy Technicia

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 Health is everything. At CVS Health, we are committed to increasing patient access to care, lowering costs and improving the quality of care. Millions of times a day, we’re helping people on their path to better health— from advising patients on their prescriptions to helping them manage their chronic and specialty conditions. Because we’re present in so many moments, big and small, we have an active, supportive role in shaping the future of health care. Pharmacy Technicians are at the forefront of our purpose as they deliver compassionate care to our millions of patients every day. Come join our team of dedicated and caring Pharmacy Technicians who demonstrate our core values of Accountability, Caring, Collaboration,Innovation and Integrity in everything they do in our pharmacies every day. Whether you are new to working in pharmacies or are an experienced Pharmacy Technician, we have a place for you on our team to use your skills and talents to serve and care for our patients and customers. The Pharmacy Technician position provides individuals with an opportunity to work in a leading retail pharmacy company and in a role that positively impacts the lives and health of others. You will work in an environment where the highest professional and ethical standards are maintained as well as full compliance with all Federal, State and Local laws and regulations. Pharmacy Technicia

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 Health is everything. At CVS Health, we are committed to increasing patient access to care, lowering costs and improving the quality of care. Millions of times a day, we’re helping people on their path to better health— from advising patients on their prescriptions to helping them manage their chronic and specialty conditions. Because we’re present in so many moments, big and small, we have an active, supportive role in shaping the future of health care. Pharmacy Technicians are at the forefront of our purpose as they deliver compassionate care to our millions of patients every day. Come join our team of dedicated and caring Pharmacy Technicians who demonstrate our core values of Accountability, Caring, Collaboration,Innovation and Integrity in everything they do in our pharmacies every day. Whether you are new to working in pharmacies or are an experienced Pharmacy Technician, we have a place for you on our team to use your skills and talents to serve and care for our patients and customers. The Pharmacy Technician position provides individuals with an opportunity to work in a leading retail pharmacy company and in a role that positively impacts the lives and health of others. You will work in an environment where the highest professional and ethical standards are maintained as well as full compliance with all Federal, State and Local laws and regulations. Pharmac