Care Management Specialist in United States

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 Aetna Better Health is Aetna’s Medicaid managed care plan. Backed by over 30 years of experience managing the care of those with a broad array of health care needs, our Medicaid plans have demonstrated that getting the right help when you need it is essential to better health. That’s why Aetna® Medicaid plans include the guidance and support needed to connect our members with the right coverage, resources, and care. We are focused on enhancing quality and population health outcomes while integrating CVS assets to bring accessible healthcare to our members. Aetna Better Health of Maryland is seeking an experience leader with vast operational knowledge of Medicaid for its state-wide managed Medicaid business in the role of Chief Operations Officer (COO). The COO role will be strategic and committed to developing colleagues as well as relentlessly pursuing change that is best for the organization and its customers. The COO role will collaborate with the CEO to develop the strategic vision of the Health Plan, policies & procedures, and operational objectives including leading RFP readiness efforts. The COO will oversee high level strategic and operational activities of various plan functional areas which include traditional service operations (Claims, Provider Services, Information Technology, Grievance & Appeals and Member Services) as well as Medical Management (Quality, Netw

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 The Executive Director - Business Information Security Officer (BISO) will serve as a senior leader and trusted security advisor supporting all CVS Health lines of business, with accountability for leading the BISO team and driving mission, vision, and governance model. This individual will provide senior‑level leadership, strategic and tactical guidance for a world‑class enterprise cybersecurity program. As a business enabler, the BISO is an effective communicator with the technical aptitude to embed security strategy and risk‑based decision‑making into all aspects of the business. The BISO understands security risks, threats, vulnerabilities, control frameworks, and security technologies and translates their impact in business terms. The BISO must be capable of working closely with senior IT business leaders, executive leadership, and business subject matter experts (SMEs). This role requires demonstrated leadership, exceptional organizational skills, strong business and financial acumen, and the ability to influence and drive change at scale across the organization. <

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 Director, Corporate Communications will support the business objectives of the Chief Pharmacy Officer and Head of Specialty Operations by helping to develop and lead the execution of a communications strategy that advances key business and enterprise priorities. This role will drive communications in support of CVS Specialty’s business objectives while also leading executive communications, thought leadership opportunities, and content development that strengthen the voice and visibility of the Chief Pharmacy Officer across internal and external channels. The Lead Director will help shape communications that advocate for the evolving role of the pharmacist and advance the practice of pharmacy in alignment with the education and training of these professionals. In addition, this role will support communications strategy and execution for CVS Specialty, helping translate business priorities into clear, compelling messaging that underscores key differentiators of the business, including its focus on simplifying the patient experience, optimizing clinical outcomes through expert care and personalized support, and improving experiences through market-leading innovation and technology. This role requires a highly skilled communications leader who can counsel senior executives, translate complex healthcare and business issues into clear and compelling messaging, and o

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 Manager of Medicaid Compliance, you are responsible for the management, execution, and oversight of the compliance program activities and deliverables of a Medicaid managed care organization operating in a moderately complex regulatory environment. This role will allow you to serve as the designated Compliance Officer for Aetna’s Michigan (MI) Medicaid health plan. You will oversee the activities of other compliance team members assigned to the MI market. You will be responsible for developing and maintaining systems and processes that demonstrate the principles of an effective Compliance program and promote compliant and ethical behavior in the assigned Medicaid health plan. Responsibilities include, but are not limited to: Acts as the primary liaison to the state Medicaid agency, facilitating compliance and contract-related communications and activities Maintain the systems and tools to track, monitor, review, and submit required regulatory and compliance related deliverables and responses to state Medicaid agencies on or before required due dates; independently prepares and oversees the submission of complex regulatory reports and deliverables as needed on behalf of the Medicaid compliance team Facilitates the preparation for and management of external audits conducted by state Medicaid and related agencies or partners in conjunction wit

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. A Brief Overview Carries out and facilitates Scrum events, removes impediments, promotes collaboration, supports Product Owners, and drives continuous improvement across Agile teams. Ensures the effective implementation of the Scrum framework by creating an environment that enables team success, fosters continuous learning, and delivers business value. Coaches and mentors Scrum Masters and Agile teams while championing Agile principles, servant leadership, and organizational agility. What You Will Do Agile Leadership & Team Coaching Coaches Scrum Masters, Product Owners, and Agile teams on Agile principles, Scrum values, and best practices for project and product delivery. Guides teams in self-organization, cross-functionality, accountability, and continuous improvement. Promotes a growth mindset and fosters a culture of adaptability, transparency, collaboration, and experimentation. Helps establish and implement a common language and framework for Agile team collaboration. Scrum Facilitation & Delivery Excellence Facilitates and oversees Scrum ceremonies, including daily stand-ups, sprint planning, sprint reviews, retrospectives, and backlog refinement sessions. Removes impediments and proactively addresses risks and obstacles that impact team productiv

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. A Brief Overview As a Senior IT Project Manager, you will manage the resources, schedule and budget across teams, ensuring effective delivery. Your role focuses on creating an environment that enables team success, fostering collaboration, and driving continuous improvement. While this is a senior-level position, it is an Individual Contributor (IC) role, meaning you will influence and guide teams without direct people management responsibilities. What You Will Do Manage resources, schedule and budget. Design and develop tools and processes for effective team delivery. Analyze team productivity and quality data to generate actionable insights for improvement. Develop and execute stakeholder communication strategies to gather feedback and incorporate it into process enhancements. Implement knowledge-sharing systems (e.g., wikis, documentation platforms) to promote transparency and collaboration. Act as a liaison between teams and stakeholders, removing obstacles and ensuring smooth delivery. Minimum Requirements 7–10&#43; years of relevant experience in agile project management delivery or Scrum Master roles. Strong problem-solving and decision-making skills. Proven ability to collaborate effectively across teams and stakeholders.<

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 Risk Management is charged with protecting company assets. This group is responsible for minimizing risk – in legal, financial and operational areas – and its affects on the organization, as well as for enforcing security and safety measures. Coordinate effective resolution of member and/or provider/practitioner appeals, complaints and grievances. Responsible for the day-to-day management of staff to ensure effective resolution of member or provider/practitioner appeals, complaints and grievances for all products, which may contain multiple issues and, may require coordination of responses from multiple business units. Ensure timely, customer focused response to appeals, complaints and grievance. Responsible for day-to-day implementation of Aetna's appeals, complaints and grievances policies and procedures. Identifies trends and issues; reports on and recommends solutions. Accountable for meeting the financial, operational, and quality objectives of the unit. -Manages team's productivity and resources, communicates productivity expectations and balances workload to achieve customer satisfaction through prompt/accurate handling of customer concerns. -Serves as a content model expert and mentor to team regarding Aetna's policies and procedures, regulatory and accreditation req

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 Manager - Process Engineering leads high-impact process improvement and Business Process Management (BPM) initiatives across Information Security and Technology Solutions (ISTS). This role is accountable for enabling operational excellence by designing, standardizing, improving, and governing ISTS processes using agentic workflows, Lean Six Sigma, and Business Process Management disciplines. The Manager- Process Engineering serves as both a delivery leader and capability builder, ensuring that ISTS has well-documented, measurable, and continuously improving processes with clear ownership, performance indicators, and controls. This role partners closely with technology tower leaders, Experience Owners, Process Owners, and risk, security, and compliance stakeholders to reduce operational friction, increase capacity, mitigate risk, and strengthen enterprise controls. Key Responsibilities: Apply DMAIC and Lean Six Sigma methodologies to solve complex, cross‑funct

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 Manager, Corporate Development — M&A Integration plays a critical role in advancing the organization’s mergers, acquisitions, divestitures, and strategic growth initiatives. This individual will support multiple transactions simultaneously and partner closely with business leaders and cross-functional teams to plan and execute due diligence, integrations, and separations. As a key member of the M&A Integration team, the Senior Manager will develop and manage value chain analyses, entanglement assessments, stranded-cost analyses, one-time cost evaluations, service grids, and transition services agreements for acquisitions and divestitures. The ideal candidate brings strong M&A execution experience, strategic thinking, financial acumen, stakeholder-management expertise, and the ability to deliver results in a complex, matrixed environment. Key Responsibilities Transaction Execution and Integration Support multiple acquisitions, divestitures, and strategic transactions concurrently. Partner with Corporate Development leadership to evaluate, plan, and execute complex transactions. Lead critical integration and separation planning activities to support smooth transitions and achieve transaction objectives. Develop and maintain transaction workplans, timelines, milestones, risk logs,

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 122,000 colleagues serve people in more than 160 countries. JOB DESCRIPTION: Job Title Senior Medical Writer / Senior Project Manager, Clinical Evaluation Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and your family, be your true self, and live a full life. You’ll also have access to: Career development with an international company where you can grow the career you dream of. Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year. An excellent retirement savings plan with a high employer contribution. Tuition reimbursement, the Freedom 2 Save student debt program, and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree. A company recognized as a great place to work in dozens of countries worldwide and named one of the most admired companies in the world by Fortune. A company that is recognized as one of the best big companies to work for as well as the best place to work for diversity, working mothers, female executives, and scientists. The Oppor

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 122,000 colleagues serve people in more than 160 countries. JOB DESCRIPTION: Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and your family, be your true self, and live a full life. You’ll also have access to: Career development with an international company where you can grow the career you dream of. Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year. An excellent retirement savings plan with a high employer contribution Tuition reimbursement, the Freedom 2 Save student debt program, and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree. A company recognized as a great place to work in dozens of countries worldwide and named one of the most admired companies in the world by Fortune. A company that is recognized as one of the best big companies to work for as well as the best place to work for diversity, working mothers, female executives, and scientists. The Opportunity This position works out of our Altavista, VA

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 122,000 colleagues serve people in more than 160 countries. JOB DESCRIPTION: Engineering Standards Manager Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and your family, be your true self, and live a full life. You’ll also have access to: Career development with an international company where you can grow the career you dream of. Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year. An excellent retirement savings plan with a high employer contribution Tuition reimbursement, the Freedom 2 Save student debt program, and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree. A company recognized as a great place to work in dozens of countries worldwide and named one of the most admired companies in the world by Fortune. A company that is recognized as one of the best big companies to work for as well as the best place to work for diversity, working mothers, female executives, and scientists. The Opportunity

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 122,000 colleagues serve people in more than 160 countries. JOB DESCRIPTION: WORKING AT ABBOTT: At Abbott, you can do work that matters, grow, and learn, care for yourself and family, be your true self and live a full life. You’ll also have access to: Career development with an international company where you can grow the career you dream of. Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year. An excellent retirement savings plan with high employer contribution Tuition reimbursement, the Freedom 2 Save student debt program and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree A company recognized as a great place to work in dozens of countries around the world and named one of the most admired companies in the world by Fortune. A company that is recognized as one of the best big companies to work for as well as a best place to work for diversity, working mothers, female executives, and scientists. THE OPPORTUNITY: The Global Head of Market Access is the senior enterprise leader responsible for creating and leading a world-class Market Access Center of Excellence that serves as a growth engi

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 115,000 colleagues serve people in more than 160 countries. JOB DESCRIPTION: Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and family, be your true self and live a full life. You’ll also have access to: Career development with an international company where you can grow the career you dream of . Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year. An excellent retirement savings plan with high employer contribution Tuition reimbursement, the Freedom 2 Save student debt program and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree. A company recognized as a great place to work in dozens of countries around the world and named one of the most admired companies in the world by Fortune. A company that is recognized as one of the best big companies to work for as well as a best place to work for diversity, working mothers, female executives, and scientists. The Opportunity The Senior Product Manager position works out of our Austin, TX or Sylmar, CA location in the Cardiac Rhythm Management Division.<