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Position Summary Sr. Manager, Medical Policy Quality Assurance (QA) & Rework Remediation is responsible for managing the day-to-day operations of the Medical Policy quality assurance and remediation program. This role oversees quality reviews, issue intake, defect investigation,…

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…

Position Summary As a Senior Content Designer, you like being at the intersection of content and design. You understand that content that's well designed is easy to follow and understandable. As a champion for our users, you organize and present content in a meaningful way. You…

Analyst, Plan Sponsor Services Technical at Cvshealth in Work From Home, United States. Remote.

Requisition Job Description A Brief Overview Coordinates and aligns activities across different operational teams to ensure smooth execution of daily operations. managing staffing levels, scheduling, and workload distribution to ensure adequate coverage and efficient resource…

A Brief Overview Coordinates and aligns activities across different operational teams to ensure smooth execution of daily operations. managing staffing levels, scheduling, and workload distribution to ensure adequate coverage and efficient resource utilization. Contributes to…

Position Summary Help us elevate our member care to a whole new level! 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 Fully Integrated Dual Eligible…

Position Summary Join us at the start of a new era in health care where technology is transforming how and where care is delivered, creating a more connected, effective care experience for all. Our mission at Signify Health is to build trusted relationships to make people…

Position Summary The Manager, Care Model is responsible for owning the day‑to‑day execution of a defined care model workstream, ensuring planned activities are delivered on time and with high quality. This role translates care model strategy and direction into detailed…

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…

Position Summary The Solution Architect, Epic STARS is responsible for the design, optimization, and strategic direction of Epic-based solutions supporting Medicare Star Ratings, HEDIS, and NCQA quality measure performance. This role bridges clinical quality strategy and…

Position Summary This is a remote work from home role anywhere in the US with virtual training. American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease…

Position Summary Coordinates Peer 2 Peer request for medical services in support quality effectiveness of the organization's health care services. Handles provider calls Peer 2 Peer requests, researches, and enters member information into systems. Required Qualifications 1-2…

Case Manager, Registered Nurse (Oncology experience required) at Cvshealth in Work From Home, United States. Remote.

Position Summary The Strategic Initiatives Lead advances the Medicare Technology strategy and operating model by working horizontally across technology teams, technology solutions, and coordinating with other Lines of Business within Aetna. As this technology team grows, the…