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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 The Waste & Error Certified Coding Manager is responsible for leading the Certified Coding Analyst and W&E Team Lead roles that conduct medical claim reviews and coding audits to identify billing errors, waste, abuse, fraud, and payment integrity opportunities. The Manager provides direct people leadership, establishes operational priorities, ensures consistent application of coding and billing requirements, and is accountable for team productivity, quality, service levels, compliance, and employee development. This role partners closely with the W&E team lead, who provides day-to-day technical guidance and subject matter support to the coding team. The Manager retains accountability for staffing, performance management, workload oversight, escalations, audit readiness, process improvement, and delivery of business outcomes. The position also represents the team in discussions with senior leadership, Medical Directors, Legal, Compliance, Analytics, Operations, and other Payment Integrity partners. Primary Responsibilities People Leadership & Team Development Lead, coach, and develop a team of Certified Coding Analysts and Senior Certified Coding Analysts. Establish clear role expectations, performance goals, productivity standards, quality requirements, and accountability measures. Conduct regular perfor

Excelauditing
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Humana
📍 United States• Remote
19 days ago

Become a part of our caring community With over 10 million sales interactions annually, Humana understands that while great products are important, it’s the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. The Manager, Sales Support plays a vital leadership role in enabling sales success and operational efficiency across the field sales organization. This role is responsible for managing a team of Sales Support Professionals, partnering with regional and channel leadership, and aligning cross-functional support across compliance, operations and other HQ partners. This individual supports effective execution of sales strategies and drives continuous process improvement to maximize field productivity and performance. Primary Duties and Responsibilities: Strategic Sales Support Serve as the lead point of contact for field execution of strategic initiatives. Support field execution of channel initiatives, product launches, and training deployments. Guide field teams through workflows and escalate issues when necessary. Support the deployment of career field channel initiatives to drive regional performance. Operational Execution & Performance Management Lead sales operations activities such as territory alignment, resource allocation, and performance reporting. Prepare reports and presentations for sales leadership, including performance dashboards and forecasts. Leverage in-market data to identify trends, opportunities, and risks, and translat

REMOTEsalesforceExcelPower BI
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19 days ago

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

recruitment
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Our Purpose Mastercard powers economies and empowers people in 200+ countries and territories worldwide. Together with our customers, we’re helping build a sustainable economy where everyone can prosper. We support a wide range of digital payments choices, making transactions secure, simple, smart and accessible. Our technology and innovation, partnerships and networks combine to deliver a unique set of products and services that help people, businesses and governments realize their greatest potential. Title and Summary Associate Product Specialist, Launch Program 2027 - United States Why join Mastercard’s Launch Program? Over the course of this 18-month program, you'll build specialized expertise through hands-on experience, structured learning, and mentorship from industry leaders. You'll work on real business challenges, applying your skills to projects that create meaningful impact. Along the way, you'll deepen your knowledge of Mastercard's business, collaborate with teams across the organization, and develop the technical, analytical, and professional capabilities needed to accelerate your career. By the end of the program, you’ll have a strong foundation in your chosen field and the confidence to continue to grow here at Mastercard. About the team In Product Management, you will have the chance to learn how to develop business cases for new product opportunities, develop scalable customer-centric products, and see those projects through go-to-market. When joining one of our highly collaborative product teams, you will have the opportunity to build and manage great products. We are looking for passionate and talented professionals who share our vision for developing scalable customer-centric products with agility and excellence. What you’ll do As an Associate Product Specialist, y

aiproject managementrecruitment
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C
20 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 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

REMOTEpythonjavasql
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Cvshealth
📍 United States• Remote
20 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 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

REMOTEExcelauditing
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C
20 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 The Lead, Senior Decision Scientist serves as a strategic analytics and ideation leader supporting Payment Integrity Affordability initiatives with a primary focus on Fraud, Waste & Error (FWE) and Special Investigations Unit (SIU) programs. This role provides leadership and guidance to a team of Decision Scientists while driving the development, evaluation, and implementation of innovative opportunities that improve affordability outcomes and strengthen Payment Integrity capabilities. The Lead Decision Scientist is responsible for establishing analytical frameworks, managing ideation pipelines, defining success metrics, and identifying cross-functional opportunities that create enterprise value across Payment Integrity programs. Required Qualifications 7+ years of experience in healthcare analytics, Payment Integrity, Fraud, Waste & Error (FWE), Special Investigations, or related healthcare operations. 5+ years of experience leading analytical projects or providing technical leadership within a healthcare environment. Demonstrated experience working with healthcare claims platforms including ACAS, QNXT, HRP, or comparable systems. Experience using SAS, SQL, Python, R, or other analytical and statistical programming languages. Experience performing advanced data analysis, opportunity identification, trend analy

pythonsqlai
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C
20 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. The Store Manager In Training (SMIT) job is a development focused role that is crafted to prepare you for a CVS Store Manager position. The SMIT program is designed to enhance your career as a future store leader. We support your development towards the store manager role by participating in a self-paced, collaborative training over the span of 16 weeks. We provide both virtual and hands on learning experiences to develop you as a leader. Our team of people, that support your growth toward your leadership career include: your District Leader, Human Resources Business Partner, Training Store Manager, and your Store Manager coach. Some of the skills needed for this role are: Communicate well verbally and in writing to support and lead your team. Perform customer care duties to provide high levels of service. Execute merchandising strategies to support store sales growth. Manage the store inventory and assets to maintain profitability. We are invested in your growth and anticipate that you will be as well. We expect our SMIT's to: Actively engage with your leader in Key Learning Experiences to support you on your path to promotion during the structured program. Support your store as management team member and lead in a manner that is consistent with CVS values and p

human resources
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C
20 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. The Store Manager In Training (SMIT) job is a development focused role that is crafted to prepare you for a CVS Store Manager position. The SMIT program is designed to enhance your career as a future store leader. We support your development towards the store manager role by participating in a self-paced, collaborative training over the span of 16 weeks. We provide both virtual and hands on learning experiences to develop you as a leader. Our team of people, that support your growth toward your leadership career include: your District Leader, Human Resources Business Partner, Training Store Manager, and your Store Manager coach. Some of the skills needed for this role are: Communicate well verbally and in writing to support and lead your team. Perform customer care duties to provide high levels of service. Execute merchandising strategies to support store sales growth. Manage the store inventory and assets to maintain profitability. We are invested in your growth and anticipate that you will be as well. We expect our SMIT's to: Actively engage with your leader in Key Learning Experiences to support you on your path to promotion during the structured program. Support your store as management team member and lead in a manner that is consistent with CVS values and p

human resources
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C
20 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 An Operations Supervisor is a key leader supporting the CVS Store Management team in planning and driving store execution and performance while building consumer loyalty to CVS/pharmacy through a focus on excellent customer service. When there is no manager onsite, the Operations Supervisor leads the store and supervisory staff, ensures that store operations run smoothly, and is responsible for ensuring the completion of all opening and closing procedures. Essential Functions: 1. Management Work effectively with store management and store crews Supervise the store’s crew through assigning, directing and following up of all activities Effectively communicate information both to and from store management and crews 2. Customer Service Assist customers with their questions, problems and complaints Promote CVS customer service culture. (Greet, offer help, and thank) Handle all customer relations issues in accordance with company policy and promote a positive shopping experience for all CVS customers Provide colleagues personalized customer service feedback and coaching (E.g., myImpact coaching; myCustomer feedback; personal observations) Maintain cu

customer service
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C
20 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. The Store Manager In Training (SMIT) job is a development focused role that is crafted to prepare you for a CVS Store Manager position. The SMIT program is designed to enhance your career as a future store leader. We support your development towards the store manager role by participating in a self-paced, collaborative training over the span of 16 weeks. We provide both virtual and hands on learning experiences to develop you as a leader. Our team of people, that support your growth toward your leadership career include: your District Leader, Human Resources Business Partner, Training Store Manager, and your Store Manager coach. Some of the skills needed for this role are: Communicate well verbally and in writing to support and lead your team. Perform customer care duties to provide high levels of service. Execute merchandising strategies to support store sales growth. Manage the store inventory and assets to maintain profitability. We are invested in your growth and anticipate that you will be as well. We expect our SMIT's to: Actively engage with your leader in Key Learning Experiences to support you on your path to promotion during the structured program. Support your store as management team member and lead in a manner that is consistent with CVS values and p

human resources
View job →
C
Cvshealth
📍 Indianapolis
20 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 A Shift Supervisor is a key leader supporting the CVS Store Management team in driving store execution and performance while building consumer loyalty to CVS/pharmacy through a focus on excellent customer service. When there is no manager or Operations Supervisor onsite, the Shift Supervisor leads the store staff, ensures that store operations run smoothly, and is responsible for ensuring the completion of all opening and closing procedures. Essential Functions: 1. Management Work effectively with store management and store crews Supervise the store’s crew through assigning, directing and following up of all activities Effectively communicate information both to and from store management and crews 2. Customer Service Assist customers with their questions, problems and complaints Promote CVS customer service culture. (Greet, offer help, and thank) Handle all customer relations issues in accordance with company policy and promote a positive shopping experience for all CVS customers Maintain customer/patient confidentiality 3. Merchandise/Presentation Price merchandise Stock shelves Execute the displays, sign and inventory of weekly, promotional, and seasonal merchandise</

customer service
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C
Cvshealth
📍 Indianapolis
20 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 A Shift Supervisor is a key leader supporting the CVS Store Management team in driving store execution and performance while building consumer loyalty to CVS/pharmacy through a focus on excellent customer service. When there is no manager or Operations Supervisor onsite, the Shift Supervisor leads the store staff, ensures that store operations run smoothly, and is responsible for ensuring the completion of all opening and closing procedures. Essential Functions: 1. Management Work effectively with store management and store crews Supervise the store’s crew through assigning, directing and following up of all activities Effectively communicate information both to and from store management and crews 2. Customer Service Assist customers with their questions, problems and complaints Promote CVS customer service culture. (Greet, offer help, and thank) Handle all customer relations issues in accordance with company policy and promote a positive shopping experience for all CVS customers Maintain customer/patient confidentiality 3. Merchandise/Presentation Price merchandise Stock shelves Execute the displays, sign and inventory of weekly, promotional, and seasonal merchandise</

customer service
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C
20 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 A Shift Supervisor is a key leader supporting the CVS Store Management team in driving store execution and performance while building consumer loyalty to CVS/pharmacy through a focus on excellent customer service. When there is no manager or Operations Supervisor onsite, the Shift Supervisor leads the store staff, ensures that store operations run smoothly, and is responsible for ensuring the completion of all opening and closing procedures. Essential Functions: 1. Management Work effectively with store management and store crews Supervise the store’s crew through assigning, directing and following up of all activities Effectively communicate information both to and from store management and crews 2. Customer Service Assist customers with their questions, problems and complaints Promote CVS customer service culture. (Greet, offer help, and thank) Handle all customer relations issues in accordance with company policy and promote a positive shopping experience for all CVS customers Maintain customer/patient confidentiality 3. Merchandise/Presentation Price merchandise Stock shelves Execute the displays, sign and inventory of weekly, promotional, and seasonal merchandise</

customer service
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C
20 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 A Shift Supervisor is a key leader supporting the CVS Store Management team in driving store execution and performance while building consumer loyalty to CVS/pharmacy through a focus on excellent customer service. When there is no manager or Operations Supervisor onsite, the Shift Supervisor leads the store staff, ensures that store operations run smoothly, and is responsible for ensuring the completion of all opening and closing procedures. Essential Functions: 1. Management Work effectively with store management and store crews Supervise the store’s crew through assigning, directing and following up of all activities Effectively communicate information both to and from store management and crews 2. Customer Service Assist customers with their questions, problems and complaints Promote CVS customer service culture. (Greet, offer help, and thank) Handle all customer relations issues in accordance with company policy and promote a positive shopping experience for all CVS customers Maintain customer/patient confidentiality 3. Merchandise/Presentation Price merchandise Stock shelves Execute the displays, sign and inventory of weekly, promotional, and seasonal merchandise</

customer service
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