Jobs in Il Work From Home

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 an individual contributor role. The Senior Manager negotiates, executes, conducts high level review and analysis, dispute resolution and/or settlement negotiations of contracts. Works with larger and more complex, market/regional/national based groups/systems in accordance with company standards to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals and cost initiatives. The Senior Manager will be responsible for contracting and implementing fee for service and value-based agreements with key physician groups, facilities, and ancillary providers to support commercial and individual exchange networks. This person will also work collaboratively with Aetna and CVS departments to identify initiatives to improve physician performance and quality of care provided to our members. Recruits providers as needed to ensure attainment of network expansion and adequacy targets. Accountable for cost arrangements within defined groups. Collaborates cross-functionally to manage provider compensation and pricing development activities, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities. What You’ll Do Lead end-to-end contract negotiations, execution, and analysis with a focus on hospital, ph

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 CVS Health Digital is looking for hands-on, passionate people who want to join a high energy and growing team to make a difference in customers lives and who want to be on the forefront of digital innovation that aims to reinvent what a pharmacy and a health care company can be in the digital world. Currently, we are seeking a Staff Software Development Engineer, who will serve as a senior technical leader on a cross-functional product team responsible for designing, developing, and delivering scalable healthcare technology solutions. You will play a critical role in driving architecture decisions, mentoring engineers, and partnering with product, UX, and business stakeholders to build secure, cloud-native applications that enhance the digital healthcare experience. In this role, you will lead the development of distributed systems and microservices leveraging Java, Spring Boot, event-driven architectures, and modern cloud technologies. This Staff Engineer will also guide data migration and interoperability initiatives, supporting healthcare integrations that enable seamless and secure exchange of clinical data across platforms. The ideal candidate combines strong software engineering expertise with a passion for innovation, technical leadership, and delivering high-quality solutions in an Agile environment. Expectations for the Role Software

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. Utilization Management Nurse Consultant (RN) Make a meaningful impact on patient care from wherever you are. We are seeking an experienced Registered Nurse (RN) to join our Utilization Management team. In this role, you will use your clinical expertise to review healthcare services, support appropriate care decisions, collaborate with providers, and help members navigate their healthcare journey. What You'll Do Review clinical information and apply evidence-based criteria to make coverage recommendations. Collaborate with healthcare providers and internal teams to support quality patient outcomes. Identify opportunities for care coordination and member support programs. Promote effective healthcare utilization and contribute to high-quality service delivery. Manage multiple systems and priorities in a fast-paced, team-oriented environment. Required Qualifications Active, unrestricted RN license in your state of residence. Minimum 2 years of RN experience in an adult acute care or critical care setting . Associate's Degree in Nursing. Strong communication, computer, and multitasking skills. Ability to work schedules that may include evenings, weekends, and holidays as part of a 24/7 operation. Preferred Qualificatio

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 Oak Street Health takes a team-based approach to providing outstanding patient care. In partnership with various Service Operation leaders (Call Center, Third Party Services, Medical Records, Triage Nurse, Pharmacy Technicians, etc.) the Quality Supervisor helps us meet our goal of successfully managing the continuity of care for all of our patients. As a leader in Service Operations, this supervisor oversees a team of Quality and Issue resolution Specialists tasked with reviewing, analyzing, investigating and auditing service standards and processes. The Quality Supervisor will be an expert in Service Operation protocol, standards, and expectations, who is able to resolve escalated issues as well as perform daily supervisory functions such as team monitoring, motivating, recognizing, coaching, and training. In direct collaboration with the Service Operations Quality Manager, the Supervisor participates in staffing, managing, and engaging a team, in addition to supporting Service Operations in delivering timely, high quality care. Core Responsibilities: Directly supervises a team of Quality and Issue Resolution specialists, providing daily direction and communication to ensure quality audits and issues are completed in a timely, efficient, and accurate manner. Ensures all Specialists have the appropriate tra

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 Description Summary The Application Developer is responsible for designing, building, and maintaining automation solutions that support claims processing workflows within the Rocket Automation platform. This role partners closely with business, governance, and operations teams to translate defined requirements into scalable, reliable automation capabilities. The Developer serves as a technical expert, ensuring solutions are built to enterprise standards and operate efficiently in production, while supporting continuous improvement of automation performance and stability. Key Responsibilities Design, develop, and enhance automation solutions based on clearly defined business requirements and processing rules Translate functional requirements into technical logic, ensuring accuracy and scalability of automation workflows Perform unit testing, system testing, and validation of automation solutions prior to deployment Support production deployments, including release readiness, implementation, and post-production monitoring Troubleshoot and resolve defects, errors, and performance issues in production automation processes Maintain and enhance existing automation solutions to improve efficiency, accuracy, and throughput Monitor automation performance and system health, identifying opportunities for optimization and i