In Home Health 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 Senior Actuary - Network position within the network analytics team provides the financial tools and analytics to support network strategy in alignment with market/business growth priorities. The market-specific responsibilities will provide individuals with the opportunity to develop in-depth knowledge of market dynamics and to establish strong cross-functional relationships with key business partners, including network, MEU, and commercial actuarial teams. Additional core areas of focus include network discounts, emerging trend analytics, and pricing and contracting support. Key responsibilities will include: Discounts – Develop a quarterly, market-level discount review process to inform Regional Leads and Chief Network Officers of changes in benchmarking based on the latest view, identifying gaps and pressured areas to consider for future negotiations. Provide meaningful information to the field on the impact and expected timing of new negotiations beyond current consultant benchmarking. Emerging Trend Analytics – Engage cross-functionally with Network, MEU, and other teams to drive enhanced contract negotiation strategies using data-driven recommendations for MedRx and Behavioral Health. Pricing – provide support for Aetna Whole Health / APCN Plus (Performance Networks), joint ventures, and narrow network pricing across all

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 Senior Product Manager, you will lead product strategy and roadmap development for the organization's Epic electronic health record (EHR) platform and integrated clinical informatics tools. You will own the product strategy and requirements for our Revenue Cycle Management (RCM) domain, which is focused on CDI, coding, billing, collections, integrity and analytics. These are critical for ensuring the end to end workflow from accurate clinical documentation to appropriate coding and A/R completeness. You’ll apply deep Epic platform expertise, user-centric design, and agile methodologies to drive adoption, quality, and safety across enterprise informatics initiatives to improve healthcare delivery for our patients. What You'll Do Responsible for defining the product vision and strategic direction for your Epic Domain, ensuring continuous alignment with senior business and engineering leaders. You'll translate high-level business goals into a clear, actionable product strategy that are tied to OKRs. Partner with business stakeholders to define the product roadmap, overseeing day-to-day backlog management and prioritization to ensure alignment with your strategic vision. You will assess value and develop business cases to inform the nature and scope of new initiatives. This includes evaluating buy vs. build opportunities and identifying

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 Performs complex medical economic projects (e.g. contract rate modeling) Accountabilities include identification and completion of key deliverables to ensure all business objectives are met. Responsible for the development and implementation of key medical economics business efforts e.g.medical cost initiatives, policies/programs, budget and analytical models. Partners and consults with Network Management to provide medical cost analysis to assess effectiveness of contracted rates, creating and implementing plans to effectively manage medical costs based on analysis or trends. Develops market specific provider reimbursement schedules Oversees the production of both standard and ad-hoc reports used for risk assessment analysis, budgeting, and hospital chargemaster analysis and forecasting. Coordinates rate approvals and develops pricing for most complex contractual arrangements. Develops and communicates tactical and strategic plans to satisfy information needs across products, segments and markets to a broad audience Required Qualifications 3+ years demonstrated leadership and/or project management experience 3+ years of healthcare and/or analysis experience. Preferred Qualifications • Knowledge of managed care and how provider reimbursement policies relate to the control of me

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 Ready to take your clinical skills to the next level? Check out this outstanding opportunity for a Medicaid Prior Authorization Pharmacist with Aetna! This is a Clinical Pharmacist position supporting Medicaid Prior Authorization. An active TX or AZ pharmacist license that is in good standing is required. New hire is required to obtain the secondary license (AZ or TX) within 90 days of hire . We are hiring for the 10:30 am - 7:00 pm CST shift (post training). The training schedule is: 10:00 am - 6:30 pm CST. You will be required to work one Saturday every 4-6 weeks and occasional holidays. This is a fully remote position open to qualified candidates within the United States who currently hold active, unrestricted TX or AZ pharmacist licensure. Required Qualifications - Active and unrestricted TX and/or AZ pharmacist license - New hire is required to obtain the secondary license (AZ or TX) within 90 days of hire . - Demonstrated experience with clinical decision-making while applying evidence-based clinical guidelines/criteria; utilizing formularies/preferred drug lists. - Experience working in a high production, remote team environment - 3+ years experience working as a pharmacist or completion of PGY1 managed care residency, includin

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. Role Summary Supports the development and execution of strategic advisory on Trade-related topics (pharmaceutical purchasing and contracting) for the PBM Client Underwriting organization. Contributes to strategies by analyzing market intelligence and data insights, partnering with cross-functional stakeholders, and delivering actionable recommendations. Develops appropriate responses and documentation to address Trade-related requests arising from state Market Conduct Examinations . Manages processes and ensures consistent delivery of insights to support business outcomes. What You Will Do Provide strategic advisory on Trade implications of PBM client pricing strategies and client requests, partnering with cross-functional stakeholders to address business needs Contribute formulary, rebate, and other Trade insights to inform Underwriting RFP strategy and enhance rebate value for prospects and renewing clients Ensure Trade-related contractual requirements are appropriately addressed within RFP responses Serve as Trade liaison to Compliance team and other pertinent stakeholders on growing work to support state Market Conduct Exam inquiries, leading Trade response efforts on requests and follow-ups Provide input on key Underwriting assumptions that may impact future rebate value Analyze and apply market intelligence

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 Underwriting role is for Meritain Health, an independent subsidiary of Aetna and CVS, and one of the nation's largest employee benefits administrators. We have the resources of a national carrier coupled with the unique flexibility and devoted service of a third-party administrator (TPA). The Meritain Health underwriting department supports the attainment of organizational goals through the issuance of prospective and existing business quotations and proposals. Including administrative fee pricing, stop loss, RFP questionnaire responses, and plan consultation. This fully-remote position will have the opportunity to work on a diversified book of business including Mid-Market and our Captive/Alternate channels. Responsibilities Include: Provide guidance and consultation to our Sales and Client Management teams on pricing and stop loss strategies Prepares and issues quotations and other financial deliverables for prospective and existing business while meeting established departmental TAT goals. Prepares financial projections on prospects utilizing financial models in Excel and Salesforce. Marketing and placement of stop loss policies, negotiating terms based upon claims data, strategy, relationships. and cost avoidance/reduction efforts. Works with leaders from key functional areas to understand p

This is where your work makes a difference. At Baxter, we believe every person—regardless of who they are or where they are from—deserves a chance to live a healthy life. It was our founding belief in 1931 and continues to be our guiding principle. We are redefining healthcare delivery to make a greater impact today, tomorrow, and beyond. Our Baxter colleagues are united by our Mission to Save and Sustain Lives. Together, our community is driven by a culture of courage, trust, and collaboration. Every individual is empowered to take ownership and make a meaningful impact. We strive for efficient and effective operations, and we hold each other accountable for delivering exceptional results. Here, you will find more than just a job—you will find purpose and pride. Baxter Healthcare Corporation values the growth and advancement of its employees. As a Maintenance Technician, you will work with advanced technology within a lively and encouraging environment. Our team commits to steady development, enabling you to sharpen your skills and aid in fulfilling our mission. Your expertise will play a vital role in maintaining flawless production equipment operation. This allows us to achieve demanding production schedules and maintain top-tier standards. This role presents an outstanding opportunity to cover the Weekend night shift, Friday through Sunday from 11:30pm to 11:30am. It supports a balanced work-life arrangement and the possibility to succeed in a fast-moving environment. Job Responsibilities Identify and resolve problems in both legacy and contemporary equipment featuring programmable logic controller (PLC) systems (Siemens, Allen Bradley, etc.), vision systems, electrical schematics, photo eyes/sensors, limit switches, proximity switches, temperature controllers, variable speed drives, motors, servos, pneuma

Become a part of our caring community The Provider Contracting Professional supports the West Region in the negotiation, analysis, and maintenance of physician and other provider agreements for an organization delivering healthcare to the senior population. You will assist with contract management activities, provides analytical support, and ensure accurate documentation within established processes and guidelines. You will report to a Director, Provider Contracting. Job Responsibilities: Support the contracting team in drafting, reviewing, and processing provider contracts and amendments Collaborate with market engagement, leadership, and legal teams to facilitate contract execution and resolve basic contract term revisions Assist in communicating contract terms, payment structures, and reimbursement rates to IPA and ACO provider groups under the guidance of senior staff Conduct initial financial analyses of contracts and terms; prepare summaries for senior review Maintain contract files and documentation within the organization's tracking system, ensuring accuracy and compliance Assist in identifying and reaching out to potential providers for network development based on current needs and network composition Prepare reports and updates for contracting initiatives as requested Manage assigned priorities and deadlines, escalating complex issues to senior team members Use your skills to make an impact Required Qualifications 2+ years' experience in provider contracting, network management, or a related healthcare field Knowledge of managed care or value-based contracting Understand contract terms and basic financial impact Preferred Qualifications Experience supporting ACO or IPA provider

We're transforming the grocery industry At Instacart, we invite the world to share love through food because we believe everyone should have access to the food they love and more time to enjoy it together. Where others see a simple need for grocery delivery, we see exciting complexity and endless opportunity to serve the varied needs of our community. We work to deliver an essential service that customers rely on to get their groceries and household goods, while also offering safe and flexible earnings opportunities to Instacart Personal Shoppers. Instacart has become a lifeline for millions of people, and we’re building the team to help push our shopping cart forward. If you’re ready to do the best work of your life, come join our table. Instacart is a Flex First team There’s no one-size fits all approach to how we do our best work. Our employees have the flexibility to choose where they do their best work—whether it’s from home, an office, or your favorite coffee shop—while staying connected and building community through regular in-person events. Learn more about our flexible approach to where we work. Why this role is on the menu Instacart Business (inclusive of Instacart Health) is scaling fast, and our commercial teams, leadership, and external partners need reliable, high-quality data to keep pace with it. We're hiring a Business Insights Lead to own this end to end — building the reporting infrastructure, analytical frameworks, and insights delivery that turn raw data into decisions. This role sits at the intersection of data, strategy, and commercial execution: you'll be the go-to analytical partner for internal leadership and the single point of accountability for external partner reporting. A year from now, GTM leaders will trust the numbers, partners will get consistent and timely reporting, and the business will have a repeatable system for surfacing growth opportunities before they're obvious. What you'll cook up in your first year A reporting system G

We're transforming the grocery industry At Instacart, we invite the world to share love through food because we believe everyone should have access to the food they love and more time to enjoy it together. Where others see a simple need for grocery delivery, we see exciting complexity and endless opportunity to serve the varied needs of our community. We work to deliver an essential service that customers rely on to get their groceries and household goods, while also offering safe and flexible earnings opportunities to Instacart Personal Shoppers. Instacart has become a lifeline for millions of people, and we’re building the team to help push our shopping cart forward. If you’re ready to do the best work of your life, come join our table. Instacart is a Flex First team There’s no one-size fits all approach to how we do our best work. Our employees have the flexibility to choose where they do their best work—whether it’s from home, an office, or your favorite coffee shop—while staying connected and building community through regular in-person events. Learn more about our flexible approach to where we work. Why this role is on the menu Instacart Business (inclusive of Instacart Health) is scaling fast, and our commercial teams, leadership, and external partners need reliable, high-quality data to keep pace with it. We're hiring a Business Insights Lead to own this end to end — building the reporting infrastructure, analytical frameworks, and insights delivery that turn raw data into decisions. This role sits at the intersection of data, strategy, and commercial execution: you'll be the go-to analytical partner for internal leadership and the single point of accountability for external partner reporting. A year from now, GTM leaders will trust the numbers, partners will get consistent and timely reporting, and the business will have a repeatable system for surfacing growth opportunities before they're obvious. What you'll cook up in your first year A reporting system G

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 is a remote work from home role anywhere in the US but must be able to work EST hours. Working hours will be Monday-Friday 8am-4:30pm EST. No weekends, holidays, or travel will be required. The Clinical Case manager is a licensed Clinical Social Worker position. This role partners with a registered nurse case manager to utilize a collaborative process of assessment, planning, and advocacy to meet a member’s benefit plan and/or health needs. Responsibilities include researching available options and resources for members with financial, transportation, safety and housing needs. Population spans the entire lifecycle. All member contact is done telephonically or via electronic exchange. This position works to empower members to make positive lifestyle and medical choices and works as a team with other clinical staff to assist members with community resources for medical, financial and behavioral health. Required Qualifications Must live in North Carolina Master's Degree in Social Work

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. ••work from Home- Candidate may reside in Texas or Arizona•• At CVS Health, we believe we can change the world by improving patient lives, one call at a time. Our Telephonic Registered Nurses (RN) have patient contact in the uniqueness of a telephonic practice setting, where they are impacting lives across the country. You will continue to experience the reasons you became a nurse without having to be in a bedside patient care environment. Working from home, you will be part of a specialized team on the cutting edge of patient care. Working collaboratively with health care professionals, you will provide a meaningful patient experience, while using your critical thinking skills to develop, implement, and evaluate comprehensive plans of care for multiple disease state patients. As a Telephonic Registered Nurse, you will a profound effect on the lives of the patients and caregivers via each outbound call, providing education and support for their new medication. Along with the Compliance and Persistency team, you are the continuity of care supporting defined patient populations through the use of our state-of-the-art telecommunications nursing outreach programs. To be successful in this Registered Nurse position, you must have excellent written and verbal customer service skills, as well as advanced computer skills in order to interact with patients. Our Registered Nurses redefine the way

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: Ready to take your Medical Director career to the next level with a Fortune 6 company? Join Aetna, a CVS Health company, and make a meaningful impact on the health and well-being of Medicaid members across the country. Aetna operates Medicaid managed care plans in Arizona, Florida, Illinois, Kentucky, Louisiana, Maryland, Michigan, New Jersey, New York, Ohio, Oklahoma, Pennsylvania, Texas, Virginia, and West Virginia. We are seeking a Medical Director to join our centralized Medical Management team. This work-from-home position will primarily support Aetna Better Health of Louisiana , while also providing support across the other health plans as needed. In this role, you will partner with Medical Management staff to ensure timely, consistent, and clinically sound decisions for members and providers. Key responsibilities include: Utilization Management and medical necessity reviews Prior authorization and precertification determinations Concurrent review for inpatient and outpatient services Acute and post-acute care reviews Peer-to-peer consultations with treating providers Pharmacy reviews and first-level appeal determinations Collaboration with multidisciplinary clinical and operational teams The Medical Director also participates in a rotating on-c

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 At Aetna®, part of CVS Health, we proudly serve more than 26 million medical members through our broad range of health plan offerings. We're committed to delivering a simpler, more meaningful, and personal health care experience to each of them. As a Medicaid Proposal Writer, you will play a critical role in the quality of our RFP responses and the efficiency of the whole team. As the Proposal Writer, you will continuously strive to increase your knowledge of Aetna Medicaid, products offered, and industry best practices to develop thoughtful, strategic, compliant responses to RFPs/RFIs. This role is a work from home opportunity, which can be based anywhere in the United States. Job Responsibilities: Work on writing assignments varying in length and detail supporting strategic, functional, and operational topics across the entire proposal Collaborate with Capture and Proposal Managers, Proposal Directors, and Subject Matter Experts to outline and prepare final proposal responses Analyze proposal sections and content development to identify connections, ensure alignment, and support a cohesive overall narrative Interviews with subject matter experts (SMEs) to identify and collect pertinent information for compliant and compelling responses, upd

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