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Risk Specialist Jobs

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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 Case Management Coordinator is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness. - Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies. - Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. - Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. - Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. - Reviews prior claims to address potential impact on current case management and eligibility. - Assessments include the member’s level of work capacity and related restrictions/limitations. <

C
6 days ago

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 full-time field teleworker position that requires West Virginia residency. Travel is required 50% of the time or more, in the central region of WV. Field based travel locations may include member homes, residential treatment facilities, group homes, shelters, and detention facilities. Qualified candidates must reside in the region, in one of the following counties: Braxton, Calhoun, Clay, Fayette, Gilmer, Kanawha, Nicholas, Roane, Webster-Regional . Utilizes critical thinking and judgment to collaborate and inform the case management process, to facilitate appropriate healthcare outcomes for members by providing care coordination, support, and education for members through the use of care management tools and resources. Schedule is Monday-Friday standard business hours. No nights, no weekends, and no holidays. Evaluation of Members: -Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member’s needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services. - Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate. - Co

C
Cvshealth
📍 United States• Remote
6 days ago

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. Remote RN Case Manager 100% Remote | Nationwide Opportunity | Monday–Friday Schedule Are you a Registered Nurse passionate about helping members navigate complex healthcare needs? Join our Case Management team and make a meaningful impact by guiding members toward better health outcomes through personalized care planning, advocacy, and coordination. What You'll Do Conduct telephonic assessments to evaluate members' medical, behavioral, and social needs Develop individualized care plans that support improved health outcomes and overall wellness Identify barriers to care and implement strategies to reduce risk and improve member engagement Coordinate care across providers, programs, and community resources Review clinical information, claims history, and benefit eligibility to support appropriate interventions Utilize motivational interviewing and clinical judgment to engage members and support goal achievement Collaborate with multidisciplinary teams to address complex cases and facilitate optimal outcomes Ensure compliance with regulatory requirements and company case management standards WHAT YOU BRING - REQUIRED Active, unrestricted RN licens

REMOTEExcel
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The Teller is an entry-level position responsible for assisting with the execution of branch activities, including day-to-day delivery of client-facing services and processing transactions, in coordination with the Customer Service function. The overall objective is to provide high quality customer service and to help the branch generate revenue by delivering optimal solutions. Responsibilities: Serve as the first point of contact for Citi clients and provide a positive first impression through friendly and efficient customer service Perform efficient and accurate banking transactions including, managing cash supply for the branch, incoming/outgoing cash deposits, and maintaining branch vault cash Identify referral opportunities for new products and services based on client’s financial goals Educate clients on digital and self-service opportunities offered by Citi Adhere to bank policies, operational controls, and regulatory procedures to ensure the safety and security of client and bank assets Ensure all client needs are met and effectively manage client issues/concerns, escalating as needed Maintain working knowledge of client accounts as well as new and existing products and services offered. Fulfilling the clients’ necessities while providing an exceptional client experience is the expected behavior from all our employees and it will be measured by specific metrics. Appropriately assess risk when business decisions are made, demonstrating particular consideration for the firm's reputation and safeguarding Citigroup, its clients and assets, by driving compliance with applicable laws, rules and regulations, adhering to Policy, applying sound ethical judgment regarding personal behavior, conduct and business practices, and escalating, managing and reporting control issues with transparency. Qualifications: Previous re

customer service
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C
6 days ago

The Business Associate is a senior level position responsible for the overall administrative activities of a business. These tasks may include managing external audits, business continuity activities or addressing regulatory issues. The Business Associate may coordinate and manage activities such as the tracking of business financials, employee headcount and other administrative needs as necessary. May manage ad hoc projects as requested. Responsibilities: Serve as communications lead on strategy development and execution for internal business messaging Advance organization/people strategy goals including communications strategy, talent strategy, and employee engagement initiatives Assist leadership/Chief of Staff in promoting and executing communications program Drive productivity/ cost savings initiatives in partnership with the senior management team Participate in People Engagement Working Group and promote Voice of the Employee (VOE) communications Identify and develop business content for deployment, to enhance brand awareness with stakeholders and clients Advise, write and edit on company-wide communications Develop and maintain communication standards and procedures; serve as subject matter expert on communication tools and applications Develop monthly communications metrics to monitor and measure impact of the communication plan Participate in leadership meetings to assess scope of communications needs, educate leadership on strategy, and make recommendations for achieving desired impact Complete financial deliverables including monthly forecasts, the annual investment process, client reporting and ad hoc requests Leverage technology and tools to enable communications and generate excitement and interest in risk communications Appropriately assess risk when business decisions are made, demonstrating particular consideration

The Teller is an entry-level position responsible for assisting with the execution of branch activities, including day-to-day delivery of client-facing services and processing transactions, in coordination with the Customer Service function. The overall objective is to provide high quality customer service and to help the branch generate revenue by delivering optimal solutions. Responsibilities: Serve as the first point of contact for Citi clients and provide a positive first impression through friendly and efficient customer service Perform efficient and accurate banking transactions including, managing cash supply for the branch, incoming/outgoing cash deposits, and maintaining branch vault cash Identify referral opportunities for new products and services based on client’s financial goals Educate clients on digital and self-service opportunities offered by Citi Adhere to bank policies, operational controls, and regulatory procedures to ensure the safety and security of client and bank assets Ensure all client needs are met and effectively manage client issues/concerns, escalating as needed Maintain working knowledge of client accounts as well as new and existing products and services offered. Fulfilling the clients’ necessities while providing an exceptional client experience is the expected behavior from all our employees and it will be measured by specific metrics. Appropriately assess risk when business decisions are made, demonstrating particular consideration for the firm's reputation and safeguarding Citigroup, its clients and assets, by driving compliance with applicable laws, rules and regulations, adhering to Policy, applying sound ethical judgment regarding personal behavior, conduct and business practices, and escalating, managing and reporting control issues with transparency. Qualifications: Previous re

customer service
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N
6 days ago

NVIDIA is transforming accelerated computing, and our Data Center CPU Product Management team is developing the silicon and platforms that power the next generation of AI and data center infrastructure. We are seeking a Technical Program Manager, CPU Hardware Programs to lead progress across complex CPU silicon and platform projects. Working closely with the CPU Hardware Lead, this role links technical priorities and trade-offs to actionable plans involving architecture, silicon, platform, firmware, validation, performance, operations, and product teams. You will clarify complex dependencies, ensure critical decisions and commitments result in action, and build program mechanisms that keep teams coordinated from development through customer readiness. This is a highly visible technical program leadership position for someone who can work deeply within complex hardware programs while influencing engineering, product, operations, and customer-facing teams. What you'll be doing: Drive coordinated progress across CPU silicon and platform programs, maintaining a clear view of achievements, dependencies, risks, decisions, owners, and readiness criteria. Collaborate with architecture, silicon, platform, firmware, validation, performance, operations, and product teams to recognize cross-functional dependencies and advance essential steps to completion. Identify schedule, scope, quality, and readiness risks early, outlining technical trade-offs and bringing the right collaborators together to make timely decisions. Translate complex engineering inputs into concise, technically accurate program plans, requirements, decision records, risk assessments, and executive updates. Coordinate responses to hardware and platform questions from customers, partners, sales, and executives while ensuring commitments align with product requirements, technical evidence, and program capacity. Establish traceability ac

C
6 days ago

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 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 Plan (FIDE) 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 social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country. The Transition of Care CM plays a critical role in ensuring that our high-risk, medically complex, and vulnerable members—those enrolled in HIDE/FIDE SNP and other Medicaid waiver programs—experience safe, effective, and seamless transitions across care settings. The TOC CM ensures the member experiences a seamless transition to their next care setting. This includes members undergoing significant changes in health status that result in emergency department visits, inpatient admissions, or stays in skilled nursing or rehabilitative facilities. This position provides comprehensive care coordination, assists with the development and implementation of care plans, facili

M
6 days ago

Our vision is to transform how the world uses information to enrich life for all. Join an inclusive team passionate about one thing: using their expertise in the relentless pursuit of innovation for customers and partners. The solutions we build help make everything from virtual reality experiences to breakthroughs in neural networks possible. We do it all while committing to integrity, sustainability, and giving back to our communities. Because doing so can fuel the very innovation we are pursuing. Job Summary: As a NAND Reliability Product Engineer , you will be responsible for defining, assessing, and safeguarding the intrinsic and extrinsic reliability of Micron's NAND Flash products through advanced analytics, large-scale data infrastructure, AI, and engineering innovation. Your responsibilities will include developing scalable data and AI solutions that enable faster engineering decisions, improving product quality, and strengthening reliability risk assessment. Working at the intersection of semiconductor technology, reliability engineering, cloud computing, and AI/ML, you will collaborate closely with other teams like AI, IT, and Quality teams to drive data-driven reliability strategies and prevent customer escapes. This role offers deep technical ownership at the intersection of reliability methodologies, analytics platforms, and AI-enabled engineering workflows, with strong visibility across development and manufacturing organizations. Main Responsibilities: Drive development and enhancement of cloud-based data platforms that support reliability monitoring, engineering analysis, and product disposition workflows. Design, develop, and maintain scalable ETL pipelines for ingesting, validating, tran

pythonsqlaws
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Our vision is to transform how the world uses information to enrich life for all . Micron Technology is a world leader in innovating memory and storage solutions that accelerate the transformation of information into intelligence, inspiring the world to learn, communicate and advance faster than ever. The Opportunity We are seeking an experienced logistics leader to advance end-to-end logistics, customs compliance, warehouse governance, transportation performance, and third-party logistics partnerships within a complex global manufacturing environment. The role combines strategic leadership with hands-on execution and is suited to a professional with deep Malaysia logistics and regulatory expertise. Key Responsibilities · Lead inbound, outbound, cross-border, warehouse, repair, return, and service logistics operations. · Drive inventory accuracy, material traceability, warehouse controls, and scalable standard operating procedures. · Provide subject-matter expertise in Malaysia Customs requirements, including LMW, FIZ, bonded warehousing, duty exemptions, and import/export declarations. · Govern freight forwarders, customs brokers, carriers, and 3PL providers through clear SLAs, KPIs, and performance reviews. · Strengthen audit readiness, documentation controls, regulatory compliance, and logistics risk management. · Improve cost, cycle time, service, space utilization, and operational resilience through analytics, digitization, and continuous improvement. · Leverage artificial intelligence and advanced analytics to define and improve processes, automate workflows, strengthen decision-making, explore emerging capabilities, and build practical AI proficiency across logistics and warehouse operations. · Partner across supply chain, trade

artificial intelligenceaiSAP
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H
Humana
📍 United States• Remote• $73.4K – $100.1K/yr
6 days ago

Become a part of our caring community The Senior Data & Reporting Professional supports the Michigan Integrated Long-Term Services and Supports (MI LTSS) program through advanced analytics, operational reporting, performance monitoring, regulatory compliance reporting, and strategic data management. You will transform complex clinical, operational, quality, and financial data into actionable insights that support program oversight, state contract compliance, quality improvement initiatives, and executive decision-making. Your work assignments involve moderately complex to complex issues where analysis of situations or data requires an in-depth evaluation of variable factors. You will work independently, exercises considerable latitude in determining objectives and approaches to assignments, and begin to influence departmental strategy. The Senior Data & Reporting Professional partners closely with LTSS Care Management, Utilization Management, Quality, Finance, Compliance, Provider Operations, and Market Leadership to monitor program performance, identify operational opportunities, and support achievement of LTSS program requirements. Develop and maintain operational, clinical, quality, compliance, and executive dashboards supporting the MI LTSS program. Integrate and validate data from multiple systems, including care management platforms, quality monitoring tools, provider networks, claims data, assessment systems, and regulatory reporting sources. Create recurring and ad hoc reports supporting operational performance, regulatory compliance, quality improvement initiatives, and strategic program planning. Monitor LTSS performance indicators including Health Risk Assessments, InterRAI assessments, Nursing Facility Level of Care Determination (NFLOCD) completion, Person-Centered Service Plans, Integrated Care Team (ICT) participation,

REMOTEsqlExcelPower BI
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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. *New Hire Bonus - $3,000 Available!* Location: This is a full-time telework position requiring 50-75% travel in and around Metro east/Southern Illinois Schedule: Standard business hours Monday-Friday 8:00am-5:00pm CST. Position Summary The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process. The Case Management Coordinator facilitates appropriate healthcare outcomes for members by providing assistance with appointment scheduling, identifying and assisting with accessing benefits and education for members through the use of care management tools and resources. Key Responsibilities Evaluation of Members: Through the use of care management tools and information/data review, conducts comprehensive evaluation of member’s needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services. Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate. Coordinates and implements assigned care plan activities and monitors care plan progress. Enhancement of Medical Appropriateness and Quality of Care: Using holistic a

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. *$3,000 New Hire Bonus Available!* Location: This is a full-time telework position requiring 50-75% travel in and around Northwest Il including Winnebago, Boone, Stephenson, Ogle, Jo Daviess. Schedule: Standard business hours Monday-Friday 8:00am-5:00pm CST. Position Summary The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process. The Case Management Coordinator facilitates appropriate healthcare outcomes for members by providing assistance with appointment scheduling, identifying and assisting with accessing benefits and education for members through the use of care management tools and resources. Key Responsibilities Evaluation of Members: Through the use of care management tools and information/data review, conducts comprehensive evaluation of member’s needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services. Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate. Coordinates and implements assigned care plan activities and monitors care plan progress. Enhancement of Medical Appropriatenes

Our vision is to transform how the world uses information to enrich life for all . Micron Technology is a world leader in innovating memory and storage solutions that accelerate the transformation of information into intelligence, inspiring the world to learn, communicate and advance faster than ever. Job Summary – Technical Program Manager, Smart Manufacturing AI Pathfinding & Innovation (AIPI) We are seeking a highly strategic and technically fluent Technical Program Manager (TPM) to join our Smart Manufacturing AI Pathfinding & Innovation (AIPI) team. In this role, you will sit at the absolute forefront of technological discovery, guiding initiatives from speculative research concepts into functional proofs-of-concept (PoCs). This team focuses explicitly on exploring unproven AI architectures, next-generation large language models (LLMs), speculative multimodal systems, and emerging agentic frameworks. As an AIPI TPM, you will thrive in deep ambiguity. You aren't just tracking timelines; you are structuring the discovery process itself. You will bridge the gap between research, machine learning engineers, infrastructure teams, and executive leaders to systematically de-risk and validate the future of our AI technical roadmap. This role requires a strong technical foundation and hands-on experience in managing complex AI/ML and data-driven projects. You will collaborate with cross-functional teams including data scientists, engineers, SMEs, and senior leadership to define functional objectives, translate them into actionable plans, and ensure seamless execution. <span style="co

machine learningaiproject management
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Our vision is to transform how the world uses information to enrich life for all. Join an inclusive team passionate about one thing: using their expertise in the relentless pursuit of innovation for customers and partners. The solutions we build help make everything from virtual reality experiences to breakthroughs in neural networks possible. We do it all while committing to integrity, sustainability, and giving back to our communities. Because doing so can fuel the very innovation we are pursuing. Job Summary We are seeking a Facilities Engineer to lead engineering, maintenance, and continuous improvement initiatives across critical facility systems that support advanced semiconductor manufacturing. This role is responsible for ensuring the safety, reliability, efficiency, and sustainability of facility infrastructure while supporting site growth and operational excellence. The successful candidate will work closely with cross-functional teams to optimize system performance, support infrastructure expansion projects, drive digitalization initiatives, and achieve site, departmental, and corporate objectives. Key Responsibilities Safety, Compliance & Reliability Champion environmental, health, and safety (EHS) compliance across all facility operations. Conduct risk assessments and promote a culture of safety and operational discipline. Perform Failure Mode and Effects Analysis (FMEA) to eliminate single points of failure and improve system resilience. Lead post-incident reviews and implement corrective and preventive actions for system abnormalities. Engineering & Maintenance Lead the commissioning, operation, maintenance, troubleshooting, and optimization

artificial intelligenceairecruitment
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