Clinical Integration Analyst 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 The Senior Manager, Medicare Product Operations (NCOD) is responsible for providing leadership, operational oversight, and people management for the Non-Clinical Organization Determination (NCOD) team. This leader is accountable for ensuring accurate, timely, compliant, and member-centered coverage determinations while maintaining adherence to CMS regulations, and internal policies. The role oversees a team of managers and analysts responsible for evaluating member requests, issuing organization determinations, maintaining documentation, and supporting appeals- and grievance-related activities. This position serves as a key operational leader, driving quality, compliance, performance, process optimization, workforce development, and cross-functional collaboration. The Senior Manager partners with Compliance, Product, Appeals, Grievances, Eligibility, Technology, and vendor partners to ensure operational excellence and a best-in-class member experience. Responsibilities Include: Strategic Leadership Provides oversight for the NCOD operation, ensuring alignment with organizational goals, regulatory requirements, and member experience objectives. Establishes operational strategies, and performance standards that support long-term scalability and sustainability. Leads implementation of new NCOD workflo

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. Location Bureau County or surrounding area. Program Overview Help us elevate our patient 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 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 dually eligible members to change lives in new markets across the country. Position Summary/Mission Our Care Managers are frontline advocates for members who cannot advocate for themselves. They are responsible for 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. Fundamental Components & Physical Requirements Develops a proactive plan of care to address identified issues to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness. Uses clinical to

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. Company: Oak Street Health Title: Medical Scribe (Clinical Informatics Specialist) Location: 1113 Carlisle Rd, York, PA 17404 Role Description: At Oak Street Health, Clinical Informatics Specialists (CIS), or Medical Scribes, serve as vital clinical documentation assistants, supporting our primary care providers. Each Scribe is paired with a single provider, joining them in the exam room, during team huddles, and conducting post-visit summaries to ensure accurate, specific, and timely documentation. Our Scribes receive extensive training to become experts in our value-based care model, ICD-10 and CPT coding, electronic medical records, and population health. Their contributions allow our interdisciplinary team to proactively identify and help close care gaps, provide preventative measures for chronic conditions, and provide great patient experiences. This role is designed for individuals seeking significant clinical exposure, particularly those on a pre-med or healthcare administration track. Because providers and patients rely heavily on this partnership, successful candidates should expect a 1 - 2 year commitment. This opportunity offers an immersive, paid position to gain clinical experience, chronic disease management, and a deep understanding of patient care workflows before advancing to MD, PA, Nursing, or other professional hea

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. This is for an every other weekend home clinic position at the Madison clinic location. A Brief Overview As the largest retail health care provider in the nation and a Fortune Top 10 industry leader, MinuteClinic offers a unique opportunity to deliver affordable, accessible, and comprehensive high‑quality care to patients, families, and communities. Our providers are empowered to practice holistically with strong clinical support, collaborative resources, and a unified “one store, one team” approach. This is a clinic-based role focused on delivering the highest-level quality in-person patient care. Virtual care visits may be conducted from the clinic during periods of lower onsite patient volume and when doing so does not delay or interfere with in‑person care. MinuteClinic is proud to hold the American Nurses Credentialing Center (ANCC) Pathway to Excellence® designation, recognizing our commitment to a healthy work environment through Transformational Leadership, Quality, Safety, Shared Governance, Well-being, and Professional Development. What Our Providers Enjoy Autonomy to manage your practice with dedicated collaborative and organizational support Flexible scheduling and strong work–life balance Exceptional tools, training, and clinical resources Evidence‑based guidelines and access to leading assessment and treatme

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. This is a Casual Part Time role, delivering quality healthcare at our greater Phoenix area HealthHubs. A Brief Overview As the largest retail health care provider in the nation and a Fortune Top 10 industry leader, MinuteClinic offers a unique opportunity to deliver affordable, accessible, and comprehensive high‑quality care to patients, families, and communities. Our providers are empowered to practice holistically with strong clinical support, collaborative resources, and a unified “one store, one team” approach. This is a clinic-based role focused on delivering the highest-level quality in-person patient care. Virtual care visits may be conducted from the clinic during periods of lower onsite patient volume and when doing so does not delay or interfere with in‑person care. MinuteClinic is proud to hold the American Nurses Credentialing Center (ANCC) Pathway to Excellence® designation, recognizing our commitment to a healthy work environment through Transformational Leadership, Quality, Safety, Shared Governance, Well-being, and Professional Development. What Our Providers Enjoy Autonomy to manage your practice with dedicated collaborative and organizational support Flexible scheduling and strong work–life balance Exceptional tools, training, and clinical resources Evidence‑based guidelines and access to le

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 the largest retail health care provider in the nation and a Fortune Top 10 industry leader, MinuteClinic offers a unique opportunity to deliver affordable, accessible, and comprehensive high‑quality care to patients, families, and communities. Our providers are empowered to practice holistically with strong clinical support, collaborative resources, and a unified “one store, one team” approach. This is a clinic-based role focused on delivering the highest-level quality in-person patient care. Virtual care visits may be conducted from the clinic during periods of lower onsite patient volume and when doing so does not delay or interfere with in‑person care. MinuteClinic is proud to hold the American Nurses Credentialing Center (ANCC) Pathway to Excellence® designation, recognizing our commitment to a healthy work environment through Transformational Leadership, Quality, Safety, Shared Governance, Well-being, and Professional Development. What Our Providers Enjoy Autonomy to manage your practice with dedicated collaborative and organizational support Flexible scheduling and strong work–life balance Exceptional tools, training, and clinical resources Evidence‑based guidelines and access to leading assessment and treatment planning tools Opportunity to deliver both in‑person and virtual care, driven by in‑clini

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. Title: Registered Nurse Company: Oak Street Health Role Description: The purpose of a Registered Nurse at Oak Street Health is to build strong relationships with Oak Street Health patients by coordinating their care and providing a seamless experience to patients and their support team. At Oak Street Health you will use an integrated approach toward achieving desired patient outcomes by utilizing standards, guidelines and pathways for care delivery. Through clinical assessment, intervention and education you will ensure our patients are provided competent nursing care in a timely manner. Our Registered Nurses drive quality care, it is of vital importance that our nurses incorporate data and information to improve care and enhance our patient outcomes. You will work to create an engaging and welcoming environment through team communication and delegation to empower other members of the care team to deliver the best care to our patients. Our Registered Nurses report to the Practice Manager or Nurse Supervisor (where applicable). Core Responsibilities: Provide competent nursing care by displaying proficiency in this role and executing job responsibilities in a safe and consistent manner Respond to incoming telephonic requests in a dependable manner, ensuring we are responsive to their needs and excee

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. Company: Oak Street Health Title: Medical Scribe (Clinical Informatics Specialist) Location: 1007 Summit Ave, Greensboro, NC 27405 Role Description: At Oak Street Health, Clinical Informatics Specialists (CIS), or Medical Scribes, serve as vital clinical documentation assistants, supporting our primary care providers. Each Scribe is paired with a single provider, joining them in the exam room, during team huddles, and conducting post-visit summaries to ensure accurate, specific, and timely documentation. Our Scribes receive extensive training to become experts in our value-based care model, ICD-10 and CPT coding, electronic medical records, and population health. Their contributions allow our interdisciplinary team to proactively identify and help close care gaps, provide preventative measures for chronic conditions, and provide great patient experiences. This role is designed for individuals seeking significant clinical exposure, particularly those on a pre-med or healthcare administration track. Because providers and patients rely heavily on this partnership, successful candidates should expect a 1 -

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. Company: Oak Street Health Title: Medical Scribe $1000 SIGN ON BONUS Role Description The purpose of a Medical Scribe at Oak Street Health is to support our primary care providers with clinical documentation so that they can focus on providing exceptional care to our patients. Scribes assist providers throughout the patient care journey - huddling each morning to plan for the day's visits, joining them in the exam room to observe and document, and touching base after the visit to assist with next steps. Beyond the typical Scribe role, these important care team members serve as clinical documentation assistants to their paired provider. Internally, we call them CISs (Clinic Informatics Specialists) in recognition of their important role in supporting accurate, specific, and timely clinical documentation. In addition to observing and documenting all patient encounters in real time, our Scribes become experts in our value-based care model and the documentation and care of chronic conditions, including ICD-10 and CPT coding. Scribes use this expertise to help providers identify and help close care gaps. Scribes receive extensive on-the-job training in clinical workflows, value-based medicine, preventative care for chronic conditions, 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. Title: Registered Nurse Company: Oak Street Health Location: 89-14 Parsons Blvd, Jamaica, NY 11432 Role Description: The Center Nurse is a clinical care team member operating within a Value-Based Care model, which prioritizes patient health outcomes and long-term wellness. In this model, the Center Nurse supports the health of patients by utilizing standards, guidelines and pathways for care delivery to prevent complications before they occur. Our Center Nurses drive quality care through clinical assessments, chronic condition management, and collaborating with the care team to reduce avoidable hospitalizations. You will foster an engaging and welcoming environment through effective team communication and delegation, empowering everyone on the team to deliver the best care to our patients. Our Center Nurses report to the Practice Manager. Core Responsibilities: Support patient assessment and prioritization for both walk-in and telephonic triage to ensure patients receive the right level of care and avoid unnecessary hospital visits. Execute protocol-driven chronic condition management. Perform skilled nursing procedures including wound care and medication administration (including vaccines). Provide comprehensive patient and caregiver education regarding chronic conditions and

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. *** Frederick, MD - Liberty Road Clinic (Full-time 30-35 hours) *** A Brief Overview As the largest retail health care provider in the nation and a Fortune Top 10 industry leader, MinuteClinic offers a unique opportunity to deliver affordable, accessible, and comprehensive high‑quality care to patients, families, and communities. Our providers are empowered to practice holistically with strong clinical support, collaborative resources, and a unified “one store, one team” approach. This is a clinic-based role focused on delivering the highest-level quality in-person patient care. Virtual care visits may be conducted from the clinic during periods of lower onsite patient volume and when doing so does not delay or interfere with in‑person care. MinuteClinic is proud to hold the American Nurses Credentialing Center (ANCC) Pathway to Excellence® designation, recognizing our commitment to a healthy work environment through Transformational Leadership, Quality, Safety, Shared Governance, Well-being, and Professional Development. What Our Providers Enjoy Autonomy to manage your practice with dedicated collaborative and organizational support Flexible scheduling and strong work–life balance Exceptional tools, training, and clinical resources Evidence‑based guidelines and access to leading assessment and treatment planning t

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. *** Rockville, MD Clinic (Full-time 30-35 hours) *** A Brief Overview As the largest retail health care provider in the nation and a Fortune Top 10 industry leader, MinuteClinic offers a unique opportunity to deliver affordable, accessible, and comprehensive high‑quality care to patients, families, and communities. Our providers are empowered to practice holistically with strong clinical support, collaborative resources, and a unified “one store, one team” approach. This is a clinic-based role focused on delivering the highest-level quality in-person patient care. Virtual care visits may be conducted from the clinic during periods of lower onsite patient volume and when doing so does not delay or interfere with in‑person care. MinuteClinic is proud to hold the American Nurses Credentialing Center (ANCC) Pathway to Excellence® designation, recognizing our commitment to a healthy work environment through Transformational Leadership, Quality, Safety, Shared Governance, Well-being, and Professional Development. What Our Providers Enjoy Autonomy to manage your practice with dedicated collaborative and organizational support Flexible scheduling and strong work–life balance Exceptional tools, training, and clinical resources Evidence‑based guidelines and access to leading assessment and treatment planning tools Op

Become a part of our caring community Humana’s Quality and Cost Strategy Analytics Team is seeking a Research Scientist 2 (Remote). Healthcare is rapidly changing, and our members are living longer, often with more chronic conditions. The Quality and Cost Strategy Analytics team identifies opportunities and build solutions to improve clinical outcomes and lower costs for millions of Medicare Advantage beneficiaries leveraging data science & analytics, clinical expertise, strategic mindset, and rigorous study designs. In this multi-disciplinary team, you will have the opportunity to work closely with strategy partners and clinicians to shape Humana’s future enterprise clinical strategies and initiatives. The Research Scientist 2 will lead research, evaluation and development of opportunities that optimize healthcare delivery, lower medical cost while improve member health outcomes, through applying mathematical, statistical, epidemiologic and data science methods. The Research Scientist 2 will also partner with stakeholders across the enterprise to identify, prioritize and measure the impact of core and novel solutions to significant problems in healthcare and improve the health of especially underserved population, using high volumes of structured and unstructured data. Responsibilities As a Research Scientist 2, you will: Research, prototype and scale new ideas to improve population health and healthcare delivery Collaborate with analytic and business teams to set objectives, approaches, and work plans Collaborate with strategy to evaluate existing programs and identify and measure new solutions to impact healthcare Leverage a wide range of analytics methods ranging from descriptive to prescriptive to transform high volumes of complex data into analytics solut

Become a part of our caring community The Financial Analytics Professional 2 manages data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues. The Financial Analytics Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Financial Analytics Professional 2 collates, models, interprets and analyzes data in order to identify, explain, influence variances and trends. Explains variances and trends in clinical and financial data and enhances modeling techniques to improve forecast accuracy. May possess financial or actuarial background. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Use your skills to make an impact Required Qualifications Bachelor's Degree 1&#43; years SQL and Python experience Microsoft Office (Excel, Power BI, etc.) Experience in compiling, modeling, interpreting and analyzing data in order to identify, explain, influence variances and trends Explain variances and trends and enhance modeling techniques Experience in managing data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Business Intelligence, Financial, or Actuarial background Azure Databricks experience</

Become a part of our caring community The Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Pre-Authorization Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Pre-Authorization Nurse completes medical necessity and level of care reviews for requested services using clinical judgment, and refers to team members for review depending on case findings. Educate providers on utilization and medical management processes. Enter and maintain relevant clinical information in various medical management systems. Understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Use your skills to make an impact Required Qualifications 2&#43; years of RN experience Active RN license in the state of Indiana Ability to be licensed in multiple states without restrictions Previous experience in utilization management, case management, discharge planning and/or home health or rehab Proficient with MS Office products including Word, Excel and Outlook Ability to work independently under general instructions and with a team Preferred Qualifications Bachelor's degree MCO experience Health Plan experience working with large carriers Previous Medicare/Medicaid experience Outpatient or home health experience in Utilization Manageme