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. 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, accurate and specific documentation, population health data streams, and team based care. Because our patients and providers rely on our Scribes, the ideal candidate should commit at least 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. Position Summary Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours. Preference for those residing in mountain or pacific time zones. Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members. Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care Communicates with providers and other parties to facilitate care/treatment Identifies members for referral opportunities to integrate with other products, services and/or programs Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function. Typical office working environment with productivity and quality expectations. Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor. Sedentary work involving periods of sitting, talking, listening. Work requires sit

Become a part of our caring community Services represent one of the organization’s most consequential sources of capability, capacity, transformation and external spend. The Associate Vice President, Services Procurement will lead the enterprise strategy for contingent workforce, outsourcing and offshoring, consulting and clinical services, converting third-party services into measurable business outcomes, workforce agility, operating leverage and sustainable value. The AVP will serve as the senior Procurement partner to leaders across the Insurance segment and Corporate Services, helping shape operating-model, workforce and transformation decisions before sourcing begins or a supplier solution is selected. The leader will bring deep expertise in global business services, business process outsourcing, workforce solutions and complex professional services. The mandate is to strengthen business-case quality, establish clear make, buy, build, automate and partner choices, create fit-for-purpose commercial models, manage transitions and hold providers accountable for committed outcomes. Success will be measured by whether business leaders make better services and workforce decisions, transformations deliver their promised value, and suppliers improve performance and innovation. Key Responsibilities Serve as the Strategic Services Partner to Business Leaders Serve as the senior Procurement relationship leader and trusted commercial advisor to Insurance segment and Corporate Services leadership. Develop a deep understanding of business strategy, operating plans, transformation roadmaps, workforce needs and financial commitments, and translate them into integrated services, workforce and supplier strategies. Engage upstream of supplier selection to frame the problem, test demand and assess make, buy, build, automate, offshore, outsource

Become a part of our caring community The Market Finance Lead is a key member of the Gulf South Region’s finance team responsible for connecting market financial performance with operational effectiveness. This role will partner closely with Corporate Finance, Network Performance, Network Contracting, and regional Health Services teams. This individual will manage a team covering a diverse set of responsibilities around Medicare Advantage financial business operations with a heavy focus on value-based providers. This role reports to the Market Finance Director. This role analyzes financial results, claims experience, utilization trends, contract performance, membership, and provider performance data to identify opportunities, influence business decisions, and support market growth and operational improvement. The Market Finance Lead will partner closely with regional leadership, actuarial, corporate finance, clinical, risk adjustment, market operations, network performance, network contracting, sales/MarketPoint, and value-based care providers. This individual will translate complex financial and operational data into meaningful insights, recommendations, and action plans that improve performance across the market. As the Market Finance Lead, you will: Manage a team to review value-based providers’ financial performance, membership, cost and utilization trends, contractual results, and opportunities for improvement. Lead the financial portion of provider engagement prep sessions prior to joint operating committee meetings to advise the Network Performance team on contract performance and opportunities for improvement. Lead analysis and reporting related to value-based provider and contract performance, including financial results, utilization, claims experience, membership, and operational trends. Leverage data analytics, business ins

Become a part of our caring community Become a valued member of Humana's Internal Review Team as a Grievances & Appeals Representative 2, where you will play a critical role in addressing client concerns and denials. You will perform thorough reviews of clinical documentation to assess whether grievances, appeals, or additional requests are justified. Then, you will provide final determinations utilizing your expertise and collaboration with clinical and other Humana teams. Your contributions will directly support Humana's commitment to delivering high-quality service and making a positive difference in the lives of those we serve. Must be passionate about contributing to an organization focused on continuously improving consumer experiences. Key Responsibilities: Assign cases to team members for submission to an independent entity for 2nd level review. Monitor and record the number of cases assigned to the team, as well as the distribution of cases among individual associates. Operate within established guidelines to maintain work expectations and quality standards, while exercising discretion in prioritizing tasks and managing timelines with minimal supervision. Demonstrate flexibility and resilience in adapting to evolving processes and a fast-paced work environment. Use your skills to make an impact Required Qualifications Minimum of 1 year of customer service experience Minimum of 1 year of data entry experience Experience in a production-driven environment Must have strong experience using multiple Microsoft systems simultaneously (Teams, SharePoint, Excel, etc.) Ability to manage large volume on inventory daily Preferred Qualifications Previous inbound call center or related customer service experi

We anticipate the application window for this opening will close on - 7 Oct 2026 Careers that change lives start here. Medtronic is a global leader in healthcare technology with a Mission to alleviate pain, restore health, and extend life. Our 95,000 employees work across more than 150 countries to put patients first — developing innovative medical technologies that improve the lives of 72+ million patients each year. Your unique talents will help shape the future of healthcare while building a career grounded in purpose, growth, and impact. A Day in the Life We are seeking a committed professional to join our team. While this is a remote position not located at a physical Medtronic site, the candidate hired will be required to reside within the territory and drive to multiple accounts throughout the region. A valid driver's license is essential for this role. Medtronic's Acute Care & Monitoring (ACM) business works together with the global healthcare community to solve clinically meaningful problems, with technologies and solutions for blood oxygen management, respiratory compromise, and perioperative complications. We have an exciting opportunity for a Senior Monitoring Sales Representative to join our ACM sales team. In this role, you will be driving sales growth and market share by promoting our Respiratory & Monitoring Solutions portfolio to key clinical leaders in the ICU, General Care Floors, and Procedural Sedation departments. This is an excellent opportunity for a skilled sales professional. Are you ready to take the next step in your career and write a chapter in our story of innovation? Location: Houston, TX A Day in The Life The successful candidate will promote the ACM portfolio to specialists a

Work Flexibility: Field-based Field Service Technician – Power Tools As a Field Service Technician supporting Power Tools, you will serve as a key technical resource for healthcare customers across your assigned territory. This field-based role focuses on equipment service, troubleshooting, maintenance, and documentation, with most of your time spent traveling in a company-provided vehicle between customer sites, resolving technical issues, and ensuring equipment performs as intended. Success in this role depends on delivering a positive customer experience through effective service support, clear communication, accurate documentation, and strong collaboration with healthcare customers, clinical staff, sales partners, and internal stakeholders. This role requires the ability to manage multiple service priorities, work independently in customer environments that can be fast-paced or stressful, and collaborate with internal partners when additional support or coordination is needed. What You Will Do Develop and maintain strong relationships with customers and internal partners, including sales and commercial teams, to deliver exceptional customer experiences, ensure optimal equipment performance, and support business goals within the assigned territory. Travel to hospitals and healthcare facilities to complete assigned service requests, installations, and preventive maintenance activities. Troubleshoot, diagnose, and repair equipment issues to restore functionality and minimize downtime. Install, maintain, and inspect medical equipment in accordance with service guidelines and quality standards. Support software, connectivity, and system configuration activities as required to maintain equipment performance. Coordinate service schedules, prioritize customer requests, communicate service findings and recom

Work Flexibility: Field-based What You’ll Do As an Orthopaedic Instruments Sales Representative, you will drive business growth by selling medical devices and surgical products within your assigned territory. You will leverage your strong communication, negotiation, and presentation skills to influence a wide range of stakeholders, while effectively managing complex sales cycles involving multiple decision-makers. Thriving in a fast-paced, high-performance environment, you take full ownership of your business—demonstrating strong organization, accountability, and time management as you work to consistently meet and exceed your sales goals. Develop and execute territory sales plans to achieve and exceed quota Build and maintain relationships with surgeons, operating room staff, SPD, supply chain, and hospital administrators Conduct product demonstrations, evaluations, and trials in clinical and operating room environments Support and lead product launches, conversions, and implementations Deliver in-services and training to clinical staff on proper product use Identify and advance new business opportunities and pipeline growth Analyze territory performance, track sales metrics, and communicate results to leadership Provide real-time problem solving in fast-paced surgical environments What you need Required: Bachelor’s degree OR 5+ years of outside sales, B2B sales, or territory management experience Preferred: 2+ years of experience in medical device sales, or healthcare sales, or B2B outside sales with quota responsibility, strongly preferred Proven track record of quota attainment, revenue growth, or territory expansion Experience selling into hospitals, physicians, healthcare systems, payroll, or B2B

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Utilization Management Nurse Consultant Clinical Precertification RN (Medicare) Remote | Full-Time | Weekday Schedule Are you a Registered Nurse ready to make an impact beyond the bedside? Join our team and use your clinical expertise to ensure members receive the right care at the right time. What You’ll Do Review clinical cases and make coverage determinations using evidence-based guidelines Collaborate with providers and care teams to coordinate appropriate treatment Apply clinical judgment to support utilization and benefit management decisions Identify opportunities to improve care quality and member outcomes Serve as a clinical resource across internal and external stakeholders What You Bring - REQUIRED Active, unrestricted RN license in the state of residence. 3&#43; years of RN experience, including 1&#43; year in Med/Surg Strong clinical assessment and decision-making skills Experience with Microsoft Office (Outlook, Teams, Excel) Ability to work Monday–Friday, 9:00 AM–6:00 PM in your time zone. Utilization Management is a 24/7 operation and work schedules will include holidays and evening hours Associate Degree in Nursing Nice to Have Utilization Management or Prior Authorization experience Managed care background</l

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 - Processes prior authorization requests received by phone, fax, or electronically and utilizes various computer resources, existing criteria, and medication guidelines to perform clinical research to support prior authorization reviews. - Proactively completes prior authorization approvals and denials that are due to expire and maintains complete, timely, and accurate documentation. - Reviews potential prior authorization denial language to ensure NCQA requirements are met. - Follows prior authorization workflow, policies, and procedures during the course of the workday. - Answers a potentially high volume of prior authorization inquiry calls from provider's offices, pharmacies, and internal partners and uses various computer resources to communicate prior authorization status or decisions. - Maintains a balance of productivity, quality and timeliness of work. - Participates in training and continuing education as required. - Participates in team/departmental meetings as required. - Excellent attendance is a must. - Successful pharmacy technicians will be proficient in drug name and diagnosis pronunciation, recognizing medical terminology, and navigating multiple computer resources to document conversations and prior authorization decisions. - Successful pharmacy technicians will possess good written and verbal communication

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 - Supports comprehensive coordination of Medicaid and/or Medicare pharmacy services including intake and processing of pharmacy authorization requests. - Promotes and supports quality effectiveness of healthcare and Pharmacy Services. - Evaluates, authorizes approval, and communicates decisions for pharmacy requests according to clinical guidelines. - Evaluates and authorizes approval of pharmacy requests received by telephone, facsimile, and/or other means using client clinical criteria. - Determines appropriateness for medications. Communicates decision to physicians, physician’s office staff, medical management staff, members, and/or pharmacists. - Will perform clinical research to support request. - Performs non-medical research including eligibility verification, COB, and benefits verification. - Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements. - Process requests in compliance with various laws and CMS regulations and company policies and procedures. - May communicate with Aetna Case Managers, Health Plan Staff, External Pharmacies and Health Care Providers. - Promotes communication, both internally and externally, to enhance effectiveness of medication therapy management services. - Sedentary work involving significant periods of sitting, tal

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 remote work from home role anywhere in the US but must be able to work EST hours. Working hours will be Monday-Friday 8am-4:30pm EST. No weekends, holidays, or travel will be required. The Clinical Case manager is a licensed Clinical Social Worker position. This role partners with a registered nurse case manager to utilize a collaborative process of assessment, planning, and advocacy to meet a member’s benefit plan and/or health needs. Responsibilities include researching available options and resources for members with financial, transportation, safety and housing needs. Population spans the entire lifecycle. All member contact is done telephonically or via electronic exchange. This position works to empower members to make positive lifestyle and medical choices and works as a team with other clinical staff to assist members with community resources for medical, financial and behavioral health. Required Qualifications Must live in North Carolina Master's Degree in Social Work

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: Associate Practice Manager Company: Oak Street Health Role Description: The purpose of an Associate Practice Manager at Oak Street Health is to lead and manage operations at a single primary care clinic location in accordance with company values and standards. Associate Practice Managers supervise clinical and non-clinical team members, support operational initiatives, drive their team towards achieving patient satisfaction and clinical outcomes measured via a variety of metrics, and generally ensure the clinic is running smoothly and in a timely manner on a daily basis. Core Responsibilities: Staff Management and Development Hire, train, supervise, coach, mentor and manage a multi-disciplinary team of 15&#43; Ensure the center is a Great Place to Work and our teams are engaged and thriving; build a culture of engagement and demonstrate the Values and Service Behaviors at all times Clinic Operations Ensure clinic operations are running smoothly and safely on a daily basis, including ensuring there is adequate staffing each day, arranging coverage for any call-offs or scheduled PTO and ensuring that all Standard Operating Procedures are followed Ensure that we are providing an Unmatched Patient Experience and provide service recovery as needed Drive result

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 Full Time Float position in the Chattanooga market. 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</l

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 We are seeking a skilled and analytical Senior Product Analytics Associate to lead the development and execution of a data-driven product roadmap. The ideal candidate will have a deep understanding of product analytics, strong problem-solving skills, and experience working with cross-functional teams to support strategic initiatives. As a Senior Product Analytics Associate, you will work closely with cross-functional teams including engineering, product, and clinical operations. Roles and Responsibilities: Define, track, and report on product metrics including performance and profitability Build and maintain robust data transformation models using dbt (or similar frameworks like Dataform or SQL-based ETL tools) to ensure analytics-ready datasets Design and interpret A/B tests; when A/B testing is not feasible, apply causal inference methods (e.g., Diff-in-Diff, Propensity Score Matching) to determine product efficacy. Develop ROI projections for analytics projects to prioritize deliverables by business impact Tell compelling stories through data, articulating technical information to a non-technical audience Build and maintain Power BI dashboards to