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 Reviews and adjudicates complex, sensitive, and specialized medical claims in accordance with established plan processing guidelines. Functions as a subject matter expert by providing coaching, and offering guidance on escalated or technically challenging issues. Supports customer service operations by addressing inquiries and resolving issues to ensure a positive member experience. Additional Responsibilities - Reviews pre‑specified claims and those that exceed specialist adjudication authority or processing expertise. - Applies medical necessity guidelines, determines coverage, verifies eligibility, identifies discrepancies, and implements cost‑containment measures to support accurate claim adjudication. - Ensures compliance with all regulatory requirements and confirms that payments align with company policies and procedures. - Identifies and reports potential overpayments, underpayments, and other claim irregularities. - Performs claim rework calculations as needed. - Trains and mentors as needed to enhance team performance and technical proficiency. - Conducts outbound calls to obtain required information for claims or reconsideration requests. Required Qualifications - Minimum of 18 months of medical claim processing experience with a health insurance payor or third‑party administrator. - Proven
Jobs in United States
Senior Operations Director in United States
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Explore current senior operations director jobs across United States. Filter by work mode, employment type, experience, department, date posted and distance.
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 Senior Varicent Integration & Platform Engineer with expertise in technical architecture and integration to join the Human Resources Technology team. This experienced and motivated professional will support Compensation business operations by delivering optimal, scalable technology solutions. As an integral member of the team responsible for the Varicent Sales Performance Management (SPM) platform, its integrations, and its technical architecture, this role will address the needs of Total Rewards and Human Resources business partners and stakeholders. The ideal candidate will combine deep technical and platform expertise with a demonstrated ability to collaborate with technical and non-technical partners. The role will provide essential support to the Compensation organization for sales incentive technology needs and will collaborate with HR Technology, Centers of Excellence (COEs), and HR Shared Services across all business segments. This individual will establish cross-functional relationships throughout HR Technology and Human Resources to ensure that solutions and initiatives are effectively designed and implemented, with colleague satisfaction as a key goal. Primary Responsibilities: Collaborate with business and technical partners to support the Varicent technical architecture and integration roadmap, including the e
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 Software Engineer / Technical Lead (AI & Automation) will provide technical leadership for the design, development, modernization, and support of critical applications supporting Prior Authorization Operations (PAOps) under PBM line of business. This role will be responsible for building and maintaining scalable, cloud-native solutions that enable intelligent workflow automation, AI-driven decisioning, document processing, and business process optimization. The ideal candidate is a hands-on technical leader with strong software engineering and cloud architecture expertise, coupled with practical experience implementing Generative AI, Agentic AI, and Large Language Model (LLM) solutions in production environments. This individual will collaborate closely with Data Engineering, Data Science, Product, and Business teams to deliver highly available, secure, and scalable applications while driving innovation through AI-powered solutions. Key areas of focus include: Application architecture, development, and production support Cloud-native engineering and platform modernization Microservices and distributed systems AI/GenAI, Agentic AI, and LLM-based solutions Event-driven and streaming architectures Engineering best practices, mentoring, and technical leadership R
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 looking for a Functional & Technical Expert for the Varicent Sales Performance Management (SPM) platform to join our Human Resources Technology team. We’re seeking an experienced and motivated individual who is ready to take on the challenge of supporting Compensation business operations by providing optimal and scalable technology solutions. This person will be an integral part of a team responsible for Compensation solutions meeting the needs of CVS Health’s Total Rewards, and Human Resources business partners and stakeholders. The ideal candidate will possess a combination of functional and technical expertise, as well as a demonstrated ability to work collaboratively with both technical and non-technical partners. You will provide integral support to the Compensation Team for their sales incentive technology needs collaborating with HR Shared Services across all business segments. You will establish cross-functional relationships throughout HR Technology and Human Resources to ensure solutions and initiatives are effectively designed and implemented. Primary Responsibilities : Collaborate with business and technical partners to support the Compensation functional area for Sales Incentives, including the established list of global priorities and roadmaps. Work closely with business leaders and stakeholders to develop v
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 Designs enterprise-wide and/or cross-functional solutions to address business problems. This work results in initiatives that significantly impact organizational strategy, enabling the organization to be competitive in the marketplace and effectively serve its customers. Partners with business owners to optimize the achievement of strategic business objectives, to include profitable growth and improved organizational effectiveness. What you will do Directs the day-to-day complex business consulting operations to support the organization's goals and objectives. Administers processes and assignments for research, collecting, analyzing, and compiling data and information for the business consulting department reports. Handles files, reports, and financial records, and manages department record retention. Leads individuals to develop a high degree of customer service by fielding internal and external inquiries, finding resolutions, or redirecting as appropriate. Collaborates internally and externally with clients and senior management regarding the organization's goals and objectives. Advises the internal and external department point of contact ensuring concise communication with employees, stakeholders, and members of the senior management. Develops reports for the org
Senior DevSecOps Software Engineer Company: The Boeing Company The Boeing Company has an exciting opportunity for a Senior DevSecOps Software Engineer to support the Protected Tactical Enterprise Service (PTES) team in Colorado Springs, CO. As a DevSecOps Engineer on the Protected Tactical Enterprise Service (PTES) team, you will be responsible for integrating security practices within the development and operations lifecycle of tactical enterprise systems. You will collaborate closely with software developers, security teams, and infrastructure engineers to design, implement, and maintain secure, automated CI/CD pipelines, ensuring the delivery of resilient and compliant services in protected operational environments. Position Responsibilities: Leads the design, development, analyses, and maintenance of software systems that meet industry, customer and internal quality, safety, security and certification standards Partners with appropriate stakeholders to inform system definition and reviews translation of system-level requirements into software requirements and models that meet customer, operational and performance requirements and have clear traceability to design, code and test artifacts Reviews completion of software system-level analyses to identify risk, issues and opportunities; leads integration and deployment of mitigation actions throughout the software lifecycle. Leads code reviews to ensure alignment to requirements and standard Leads monitoring and reviewing test completion, verification processes and issue resolution for software systems Leads development of user documentation and training to educate end users about usage of software products Leads review of pr
$88.5K – $147.5K/yr
ROLE SUMMARY The Asset Lifecycle Management (ALM) Lead is responsible for the systematic tracking, installation, and removal of laboratory equipment throughout the entire lifecycle, from acquisition through deployment, maintenance, and final disposal. Operating within an R&D environment, this role facilitates asset preplanning, site assessments, and ensures all asset-related activities are documented, tracked, and compliant with regulatory standards. By optimizing equipment usage, managing inventory, coordinating maintenance, and driving process improvements, the ALM supports efficient and safe laboratory operations while controlling costs and enabling the lab for evolving technological requirements. This is to include but not be limited to supporting the regular updates and reconciliation of the Fixed Asset Registry (FAR) and physical inventory field activities. With input from both the customer equipment owner and the original equipment manufacturer (OEM), this role will develop the correct service program for assets within EAMS (Enterprise Asset Management System) or Pfizer’s Computerized Maintenance Management System (CMMS). Additionally, this position will be responsible for the documentation of asset maintenance activities within EAMS and support site EAMS administration requiring the review of training requirements and On the Job Training (OJT) for new resources requiring system access. The Asset Lifecycle Manager will also represent the site on various Global Workplace Experience (GWE) Communities of Practice or multi-site or global teams ensuring best practices and standards are being leveraged across the broader R&D portfolio. This position will foster and maintain working relationships with GWE, Preclinical & Translational Sciences (P&TS) Research and business operations team colleague and contractors to analyze needs, provide recommendations, and execute plans and options that ali
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 looking for a ServiceNow HRSD, Employee Center Pro and Knowledge expert to join our HR Colleague Experience Team. We’re seeking an experienced and motivated individual who is ready to take on the challenge of supporting HR business operations by providing optimal and scalable technology solutions. This person will be responsible for ServiceNow HR Services meeting the needs of Colleagues, HR Agents, and HR Business stakeholders. The ideal candidate will possess a combination of functional and technical expertise, as well as a demonstrated ability to work collaboratively with both technical and non-technical partners. This role is responsible for driving product roadmap and prioritization of HR shared services, content and intranet experiences. Responsibilities: Collaborate with business and technical partners to support the HRSD functional areas and roadmap, including colleague portal and HR Knowledge Management. Work closely with business leaders and stakeholders to develop vision, goals and roadmap for the Product. Maintain clear and up to date list of key deliverables and timelines, develop plans to achieve those targets and proactively communicate progress to a variety of stakeholders. Ensure that the delivered product meets or exceeds the business' needs and business objectives. Responsible for tim
Senior DevSecOps Software Engineer Company: The Boeing Company The Boeing Company has an exciting opportunity for a Senior DevSecOps Software Engineer to support the ADaPS organization in Huntsville, AL. ADaPS (an organization of over 100 software engineers) supports programs across the entire portfolio of Boeing products including Space Launch Systems (SLS) Upper Stage, Satellite Efforts, and Advanced Missile Defense efforts including Patriot Advanced Capability (PAC3). ADaPS specializes in implementing rapid prototyping and development programs using small, adaptable agile teams. Position Responsibilities: Oversees establishment and maintenance of modern software development environments, with formalized processes for development, implementation, integration, testing, documenting, and deploying software changes Works collaboratively with software engineering teams to deploy and operate systems Oversees development and maintenance of continuous integration / continuous delivery (CI/CD) pipelines Oversees automation and streamlining of operations and processes that support software testing, including script development as needed Builds and maintains tools for deployment, monitoring, and operations Communicates technical content to stakeholders Analyzes, plans, and executes mitigation strategies to prevent potential security risks, threats, and vulnerabilities Troubleshoots and resolves issues in development, testing, and production environments Supports software development and testing operations. Performs software research and trade studies Security Clearance: This position requires the ability to obtain a U.S. Se
As one of the technology industry's most desirable employers, NVIDIA has been redefining accelerated computing, computer graphics and leading the Artificial Intelligence revolution. NVIDIA's innovation is fueled by its great technology—and amazing people. We are seeking a Senior Silicon and System Product Lead to influence, innovate and take our next generation products to the market. As part of the Silicon Solutions Team, we architect and deliver groundbreaking system solutions that integrate all aspects of the system from silicon design, software design to operations and final deployment in multiple market segments that NVIDIA serves. This position offers an unique opportunity to collaborate with multiple organizations in the company and grow your career in a high impact role. We need a passionate, hard-working and creative individual to lead the products all the way from market analysis to delivering the features on the final product. What you'll be doing: Drive product performance and power targets, trade-off features/configurations and provide innovative solutions to complex silicon and system level problems. Evaluate new market segments and use cases; translate market requirements to engineering problem statements and metrics. Innovate Performance, power, yield and quality optimizations and features for the world’s fastest power-shipping products in the GPU and SoC market segments spanning gaming, automotive, datacenter and DL/AI. Develop methodologies and requirements for multi-functional teams to drive silicon and system product features to production. Incorporate productization feedback to improve the next generation. Lead the team for feature requirements and schedule from architecture to silicon phase of projects. Work alongside system architects, designers, marketing teams, chip and board designers, software/firmware engineers, HW/S
Our Purpose Mastercard powers economies and empowers people in 200+ countries and territories worldwide. Together with our customers, we’re helping build a sustainable economy where everyone can prosper. We support a wide range of digital payments choices, making transactions secure, simple, smart and accessible. Our technology and innovation, partnerships and networks combine to deliver a unique set of products and services that help people, businesses and governments realize their greatest potential. Title and Summary Senior Physical Security Analyst Overview • Physical security and compliance security officer, maintains and monitors physical security policies, standards, and best practices • Abides by Security guidelines relative to security standards to provide safety and security of staff and assets • Manages Security Control Center Coordinators and security operations. • Manages and administers physical security functions for company facilities to ensure the safety; security and protection of MasterCard employees and asset • Recognizes potential and realized security threats and takes reasonable action to mitigate risk or injuries to personnel and or property • Provides MasterCard Corporate Security Standard Operating Guidelines security supervisors and follows-up to ensure adherence • Manages Security officers by delegating department projects, tasks and assignments • Manages Security staff schedules to ensure proper coverage at all times Role • Interaction with employees and guests, provide direction on security policy and visitor directions as needed • Operational use of security systems • Trains and supervises Security officers with respect to the execution of established physical security policies, programs and procedures • Recommends the development and implementation of physical securi
$270K – $335K/yr
Why join us Brex is the intelligent finance platform that enables companies to spend smarter and move faster in more than 200 markets. By combining global corporate cards and banking with intuitive spend management, bill pay, and travel software, Brex enables founders and finance teams to accelerate operations, gain real-time visibility, and control spend effortlessly. Brex’s AI-native automation and world-class service eliminate manual expense and accounting tasks for customers so they can focus on what matters most. Tens of thousands of the world's best companies run on Brex, including DoorDash, Coinbase, Robinhood, Zoom, Plaid, Reddit, and SeatGeek. Working at Brex allows you to push your limits, challenge the status quo, and collaborate with some of the brightest minds in the industry. We’re committed to building a diverse team and inclusive culture and believe your potential should only be limited by how big you can dream. We make this a reality by empowering you with the tools, resources, and support you need to grow your career. Legal at Brex The Legal team helps the company grow responsibly, advocating for Brex and for the thousands of growing businesses we serve. We provide strategic advice and guidance to all Brex teams, protect Brex, advise on risk, and represent the company externally, negotiating with partners and interacting with regulators. Reimagining the financial system in a highly regulated environment requires creativity and resourcefulness, and we welcome the challenge. Where you’ll work This role will be based in our San Francisco office. We are a hybrid environment that combines the energy and connections of being in the office with the benefits and flexibility of working from home. We currently require a minimum of three coordinated days in the office per week, Monday, Wednesday and Thursday. As a perk, we also have up to four weeks per year of fully remote work! What you'll do As Risk Counsel, you will own the legal response to the moments t
$270K – $335K/yr
Why join us Brex is the intelligent finance platform that enables companies to spend smarter and move faster in more than 200 markets. By combining global corporate cards and banking with intuitive spend management, bill pay, and travel software, Brex enables founders and finance teams to accelerate operations, gain real-time visibility, and control spend effortlessly. Brex’s AI-native automation and world-class service eliminate manual expense and accounting tasks for customers so they can focus on what matters most. Tens of thousands of the world's best companies run on Brex, including DoorDash, Coinbase, Robinhood, Zoom, Plaid, Reddit, and SeatGeek. Working at Brex allows you to push your limits, challenge the status quo, and collaborate with some of the brightest minds in the industry. We’re committed to building a diverse team and inclusive culture and believe your potential should only be limited by how big you can dream. We make this a reality by empowering you with the tools, resources, and support you need to grow your career. Legal at Brex The Legal team helps the company grow responsibly, advocating for Brex and for the thousands of growing businesses we serve. We provide strategic advice and guidance to all Brex teams, protect Brex, advise on risk, and represent the company externally, negotiating with partners and interacting with regulators. Reimagining the financial system in a highly regulated environment requires creativity and resourcefulness, and we welcome the challenge. Where you’ll work This role will be based in our New York City office. We are a hybrid environment that combines the energy and connections of being in the office with the benefits and flexibility of working from home. We currently require a minimum of three coordinated days in the office per week, Monday, Wednesday and Thursday. As a perk, we also have up to four weeks per year of fully remote work! What you'll do As Risk Counsel, you will own the legal response to the moments 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. 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
We anticipate the application window for this opening will close on - 25 Sep 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 Job Specific Summary In this role, you will manage the design, planning, construction, and ongoing maintenance of equipment, machinery, buildings, and other facilities. You will oversee facility operations to ensure safe, efficient, and cost effective environments, while leading teams, managing resources, and supporting business needs through strategic facility planning and execution. This role is onsite supporting our Plymouth Facilities Manages the design, planning, construction, and maintenance of equipment, machinery, buildings, and other facilities Plans, budgets, and schedules facility modifications, including estimates for equipment, labor, materials, and related costs Designs and develops organizational policies relevant to the facilities department Oversees coordination of building space allocation and layout, communication services, and facilities expansion Establishes and oversees health and safety standards, as applicable Selects, develops, and evaluates personnel to ensure efficient and effective operation of the function Ensures corrective and preventative maintenance occur in a timely fashion and that work orders are recorded in CMMS Coordinates contrac
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