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 Fraud, Waste, and Abuse (FWA) Analyst II identifies and develops potential healthcare fraud leads through data mining, claims analysis, and investigative research. As a key contributor to the SIU lead development process, this role evaluates provider, member, pharmacy, and ancillary healthcare billing patterns for signs of fraud, waste, abuse, and other anomalies. The Analyst II uses internal claims data, analytical tools, business rule results, and industry intelligence to assess potential FWA concerns and determine whether they warrant formal investigation. This role requires strong analytical skills, healthcare claims expertise, and the ability to translate complex data into actionable investigative leads and recommendations. Essential Responsibilities Lead Development & Fraud Detection Develop proactive and reactive leads to identify potential fraud, waste, and abuse. Generate FWA leads by mining claims databases, reporting tools, and investigative systems. Validate and refine leads generated by business rules to assess their credibility and investigative value. Examine spike analyses, utilization trends, payment anomalies, and outlier reports for unusual billing patterns. Evaluate provider, member, pharmacy, DME, transportation, and facility billing for indicators of fraud or abuse. Moni
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Data Collector And Annotator in United States
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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 Fraud, Waste, and Abuse (FWA) Analyst II identifies and develops potential healthcare fraud leads through data mining, claims analysis, and investigative research. As a key contributor to the SIU lead development process, this role evaluates provider, member, pharmacy, and ancillary healthcare billing patterns for signs of fraud, waste, abuse, and other anomalies. The Analyst II uses internal claims data, analytical tools, business rule results, and industry intelligence to assess potential FWA concerns and determine whether they warrant formal investigation. This role requires strong analytical skills, healthcare claims expertise, and the ability to translate complex data into actionable investigative leads and recommendations. Essential Responsibilities Lead Development & Fraud Detection Develop proactive and reactive leads to identify potential fraud, waste, and abuse. Generate FWA leads by mining claims databases, reporting tools, and investigative systems. Validate and refine leads generated by business rules to assess their credibility and investigative value. Examine spike analyses, utilization trends, payment anomalies, and outlier reports for unusual billing patterns. Evaluate provider, member, pharmacy, DME, transportation, and facility billing for indicators of fraud or abuse. Moni
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 is seeking a highly skilled and visionary Sr. Manager to lead and manage our enterprise Cisco Application Centric Infrastructure (ACI) environment and the transition to Cisco Nexus Dashboard Fabric Controller (NDFC). This role sits within the Network Engineering team and is pivotal to driving the modernization and scalability of our next-generation data center fabric. This role will help set and drive the network technology strategy for ISTS, ensuring that ISTS delivers on our mission to transform technology and provide an agile, cost optimized and resilient set of network infrastructure services to meet the evolving needs of all the CVS Health lines of business. The ideal candidate will have experience supporting complex enterprise network environments and demonstrate deep expertise in Cisco ACI and NDFC technologies. As a strategic leader, you will be responsible for setting the direction, leading a team of engineers, and ensuring the operational integrity, performance, and evolution of our fabric-based data center architecture. This position will also mentor staff members in an effort to develop excellent enterprise networking skills. Key Responsibilities Lead the deployment, administration, and lifecycle management of the Cisco ACI environment Oversee the strategic transition to and ongoing management of the Cisco
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 Seeking a Senior Analyst to join the Group Medicare Advantage Actuarial team to assist with Part C analysis & pricing. More specifically, this role will be responsible for the following: Updating assumptions used in pricing Part C Maintaining existing portfolio view reporting Supporting plan sponsor experience refund reconciliations and UW data/reporting needs Collaborating with Underwriting on plan sponsor pricing opportunities for both new business and renewal business Required Qualifications Bachelor’s degree along with 3+ years related experience Prior healthcare experience Experience working with large and detailed data sets Preferred Qualifications Strong communication and collaboration skills Solid technical, analytical, and creative problem-solving skills Be organized, data driven, statistically minded and demonstrate an attention to detail Be self-motivated, intellectually curious with a desire to continuously improve processes Be adaptable as business needs and priorities evolve Familiarity with Medicare Part C and/or Group pricing Education Bachelor’s degree or higher in act
Our vision is to transform how the world uses information to enrich life for all . Micron Technology is a world leader in innovating memory and storage solutions that accelerate the transformation of information into intelligence, inspiring the world to learn, communicate and advance faster than ever. Micron is expanding its semiconductor manufacturing operations in Boise through a historic $15 billion investment that will support next-generation DRAM production and advanced manufacturing capabilities. This growth creates exciting opportunities for students to contribute to the future of semiconductor technology while working in a highly collaborative, data-driven manufacturing environment. The High Volume Manufacturing Process Engineer Intern supports process optimization, yield improvement, throughput enhancement, cost reduction, and issue resolution within a manufacturing area. This role partners closely with equipment engineering, operations teams, process owners, and cross-functional stakeholders to improve process performance and achieve key manufacturing objectives. Responsibilities Drive process optimization and manufacturing efficiency initiatives by monitoring process performance, analyzing data, and supporting area throughput and wafer output goals. Identify, troubleshoot, and resolve process issues that could result in yield loss, defects, equipment restrictions, excursions, or production impacts, escalating concerns when necessary. Apply SPC, FDC, Design of Experiments (DOE), and structured problem-solving methodologies, including 8D, to improve process capability and equipment performance. Partner with process owners, operations teams, and engineering stakeholders to address chronic process issues and support continuous improvement initiatives. Leverage Artificial Intelligence and data a
Our vision is to transform how the world uses information to enrich life for all . Micron Technology is a world leader in innovating memory and storage solutions that accelerate the transformation of information into intelligence, inspiring the world to learn, communicate and advance faster than ever. The Global Procurement team drives Micron's growth through strategic sourcing, cost optimization, supplier partnerships, and supply chain resiliency initiatives. Leveraging data-driven insights, market intelligence, and innovative technologies, the team delivers value across Micron's global operations while fostering a collaborative culture focused on continuous improvement and professional development. As a Category Supplier Management Intern, you will support category management and strategic sourcing initiatives that drive business value across Micron's global procurement organization. You will gain hands-on experience in cost analysis, supplier management, category strategy development, sourcing activities, and AI-enabled process improvements while partnering with procurement professionals and business partners worldwide. Responsibilities Support category management and strategic sourcing activities through market research, supplier analysis, benchmarking, and category strategy development. Assist with cost analysis, should-cost modeling, and market intelligence activities to identify savings opportunities and support business decisions. Collaborate with Category Managers, suppliers, and internal partners to support procurement objectives and supplier relationship management efforts. Analyze sourcing trends, supplier performance, and procurement metrics to develop recommendations and drive continuous improvement initiatives. Support AI adoption initiatives by identifying u
Our vision is to transform how the world uses information to enrich life for all . Micron Technology is a world leader in innovating memory and storage solutions that accelerate the transformation of information into intelligence, inspiring the world to learn, communicate and advance faster than ever. At Micron, we are transforming how the world uses information to enrich life. The High Bandwidth Memory (HBM) Design team develops industry-leading memory solutions that enable advances in Artificial Intelligence, high-performance computing, graphics, and data-center applications. Our engineers collaborate across global teams to deliver innovative memory architectures and semiconductor technologies that power next-generation computing systems. As an HBM Design Engineer Intern, you will work alongside experienced memory engineers and gain hands-on experience in semiconductor design, simulation, verification, and analysis. This internship provides exposure to industry-standard design methodologies, EDA tools, and cross-functional collaboration throughout the product development lifecycle. You will also have opportunities to apply AI-Assisted and AI-Enabled workflows to improve engineering productivity, debug efficiency, and design quality. Responsibilities Assist with the design, simulation, analysis, and verification of HBM memory and logic circuits using industry-standard semiconductor design tools. Support RTL development, circuit implementation, timing analysis, power analysis, and functional validation activities. Develop scripts, automation solutions, and AI-Assisted workflows to improve design productivity, debug efficiency, and design-flow quality. Collaborate with Design, Verification, Physical Design, CAD, and Product Engineering teams on technical reviews, debug activities, and project deliv
Systems Software Engineer, Missile Defense National Team (Associate, Experienced, Senior) Company: The Boeing Company The Boeing Company is looking for a Systems Software Engineer, Missile Defense National Team (Associate, Experienced or Senior level) to join our Missile Defense National Team in Colorado Springs, CO or Huntsville, AL. This position requires an active U.S. Secret Security Clearance for which the U.S. Government requires U.S. Citizenship. The Missile Defense National Team (MDNT) was established in 2004 to develop and deploy the Missile Defense Agency’s (MDA) Command, Control, Battle Management, and Communications (C2BMC) system. This system ingests data from sensors around the globe to create a single source of information for the warfighter to enable engagements. The C2BMC Program is a full lifecycle defense contract providing solutions across the engineering capability to include system architecture, development, deployment, operations and maintenance, and sustainment of the Missile Defense System (MDS). This work integrates efforts from multiple companies (teammates) with systems engineering experience in model-based systems engineering (MBSE), requirements development, modeling and simulation (M&S), network design, integration and test, and analysis. This position will focus on supporting the Ballistic Missile Defense System (BMDS). The Boeing Missile Defense Programs support the Missile Defense Agency's (MDA) mission to develop and deploy a layered Missile Defense System to defend the United States, its deployed forces, allies, and friends from missile attacks in all phases of flight. Be a part of our passionate and highly motivated team who are excited to be on the forefront of defense of
Satellite Systems Engineer (Associate) Company: The Boeing Company Boeing Defense, Space, and Security (BDS) seeks a seeks a Satellite Systems Engineer to serve as Global Positioning System (GPS) Satellite Bus Systems Engineer to serve on the Global Positioning System (GPS) IIF program, within our Space, Intelligence & Weapon Systems (SI&WS) division located at El Segundo, CA. GPS is a satellite-based radio-navigation system owned by the United States government and operated by the United States Space Force and is the world's first global utility. GPS provides position, navigation, and timing (PNT) data to military and civilian users globally with countless applications and an unlimited number of users. Boeing has over 45 years of history in GPS, including achieving full system capability in 1995. The current Boeing team supports the US Space Force by sustaining and monitoring the health and capabilities of the 12 GPS Block IIF satellites in the GPS constellation, launched from 2010 to 2016. The Boeing GPS sustainment team also provides support to our U.S. Space Force customer with reports and expertise on all aspects of the GPS system. Sustainment efforts will continue through the life of the Block IIF satellites, with a design life expectancy to 2031 and beyond. The program currently operates under a 10-year sustainment contract, from 2022 to 2031. As GPS Satellite Bus Systems Engineer , you will be a key member of a high-performing team engaged in critical projects related to the GPS IIF satellite constellation. You will train to become a subject matter expert for satellite Bus subsystems on the GPS Block IIF satellites and for GPS performance trending and analysis. You will also work closely with the spacecraft payl
F-18 Landing Gear Technical Support Specialist Company: Boeing Aerospace Operations Boeing Global Services (BGS) is seeking an F/A-18 Landing Gear Technical Support Specialist in Fort Walton Beach, FL. This individual will compile, analyze and format data to produce engineering lifecycle products, services and processes. The specialist will verify regulatory conformance and contractual compliance, enforce configuration control, and maintain design and maintenance documentation to company, contractual and Navy standards. Position Responsibilities: Compile, analyze and format technical and maintenance data to produce and maintain engineering lifecycle products, spreadsheets, web pages (e.g., SENTINAL), and other documentation Verify regulatory conformance and contractual compliance of products using standard guidelines; identify and document nonconformances and follow through to resolution Maintain configuration control and design documentation per company, contractual and Navy standards (CNAFINST 4790.2 Series / NAMP) Read, interpret and apply Navy Technical Directives (TD), Supplemental Technical Certificates (STC), Airworthiness Directives (AD), and engineering guidance to ensure compliant repairs and configuration actions Create, update and maintain Assembly Service Records (ASR), Equipment History Records (EHR), and Scheduled Component Repair (SRC) cards IAW CNAFINST 4790.2 Series Administer and update the OOMA NALCOMIS Configuration Management Database to manage logsets, track life limits and record component histories Use and maintain Navy databases (e.g., NATEC, Deckplate) to support configuration and maintenance actions Process and track aircraft components for overhaul per OEM instructions
Become a part of our caring community The Senior Process Improvement Professional analyzes and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Senior Process Improvement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Process Improvement Professional researches best business practices within and outside the organization to establish benchmark data. Collects and analyzes process data to initiate, develop and recommend business practices and procedures that focus on enhanced safety, increased productivity and reduced cost. Determines how new information technologies can support re-engineering business May specialize in one or more of the following areas: benchmarking, business process analysis and re-engineering, change management and measurement, and/or process-driven systems requirements. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. Use your skills to make an impact Required Qualifications The Sr. Process Improvement Professional must meet one, (1) of the following requirements: Licensed Professional (LSW) in the state of Kentucky OR ability to obtain, Master’s degree from an accredited university or college in social work, psychology or related health and human services area with a minimum of one, (1) year professional experience in case management.
Become a part of our caring community The Grievances and Appeals Representative 4 role in the Internal Review Team is responsible for managing appeal denials, by reviewing clinical documentation, determining whether further action is needed, and validating final determinations in coordination with clinical and internal Humana partners. Key Responsibilities: Manage Level 1 appeal cases , ensuring accuracy, completeness, and compliance with CMS requirements Review clinical documentation to support appeal determinations and escalation decisions Coordinate with clinical teams and internal partners to finalize appeal outcomes Investigate and resolve member and provider issues with a focus on timely resolution Maintain high productivity and quality standards in a production-driven environment Ensure strict adherence to confidentiality and compliance regulations Independently prioritize and manage multiple high-volume case assignments Proactively embraces change and supports smooth transitions in a dynamic work environment Use your skills to make an impact Required Qualifications: 1+ year of grievance & appeals and/or customer service experience Strong data entry skills Proficiency in Microsoft Office Applications Experience in a production-driven environment Experience prioritizing and delivering multiple assignments Strong commitment to confidentiality and high-quality results Preferred Qualifications: Associate's or Bachelor's degree 2–4 years of grievance and appeals experience Medical claims processing experience Previous inbound call center experience Experience wi
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 The Care Management Support Assistant contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Management Support Assistant performs basic administrative/clerical/operational/customer support/computational tasks. Typically works on routine and patterned assignments. The Care Management Support Assistant will review inbound referrals and correspondence for processing, fulfilment or resolution utilizing all appropriate software systems and resources. Screen physician’s orders and documentation to identify that all qualifying medical documentation and required information is included. When necessary, request additional applicable information from referring entity. Perform verification of benefits coverage and eligibility for services per Health Plan contract. Review referral data matching it against specified medical terms and diagnoses or procedure codes and follow established procedures for approving request or referring request for further review. Provide referral management education to members and providers regarding medical benefits, referral status and prior authorizations. Communicate with patient to confirm demographics and explain the details of the services/care requested. Coordinate the timely delivery of care and services with providers. Also communicate with referring entities, providers, and members regarding final referral determination while maintaining detailed documentation to record patient, physician, referral source and provider interactions and communications. Work with Pre-Authorization, Utilization Management, Billing, Pharmacy, and Home Care r
Become a part of our caring community The Senior Portfolio Enablement Lead is a strategic portfolio transformation role responsible for shaping and enabling Humana's portfolio operations, Agile Release Train (ART) design, and Ways of Working across the portfolio. Acting as a trusted advisor to senior executives (SVPs, VPs, and portfolio leaders), the role translates transformation strategy into scalable execution by diagnosing portfolio delivery challenges, guiding organizational design, and improving alignment, flow, and value delivery. As a Senior Portfolio Enablement Lead, you will: Partner with portfolio and organization leadership to develop and enable portfolio, aligned to enterprise portfolio operations to achieve portfolio initiatives their outcomes. Perform quantitative and qualitative assessments, including stakeholder analysis and change impact assessments, to develop data-driven change strategies for key stakeholder groups. Build and manage portfolio transformation roadmaps to drive executive buy-in and sponsor engagement across technology and business/product leadership and leadership to drive understanding and adoption of key changes Develop Release Train Engineers to our Humana Ways of Working and enterprise tooling subject matter experts for Agile Release Trains and Scrum Teams Measure effectiveness of change interventions through defined metrics and continuously evolve plans to optimize adoption outcomes Regularly report activity status to organizational, portfolio and transformation leadership; proactively escalate and help resolve risks and issues Partners with leaders to align all continuous improvement goals and objectives Partner with Release Train Engineers in the portfolio to monitor activity level of continuous improvement, adoption of Humana Ways of Working, risks patterns
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