Jobs at CVS Health

Provides strategic healthcare regulatory counsel for digital products and services throughout the product development lifecycle. Drafts and negotiates agreements, reviews communications, identifies legal and business risks, and advises internal teams on healthcare laws, privacy, data use, interoperability, and digital technology. Supports mobile apps and online platforms, collaborates across legal and business functions, and applies regulatory frameworks to achieve business objectives.

Transforms data into actionable insights for CVS Health’s Direct-to-Consumer channels. Develops reporting solutions, quality dashboards, and analytics on agent behavior, quality trends, and process opportunities. Partners with Quality Assurance, Compliance, Operations, and Vendor Management to ensure data integrity and improve performance. Supports vendor oversight, internal reporting, and quality-monitoring innovation using tools such as Excel, SQL, and NICE CXone, with a focus on Medicare sales processes.

Lead and manage multiple, cross-functional enterprise marketing programs. Develop integrated marketing plans, timelines, and capacity forecasts. Apply PMO governance, drive stakeholder alignment, surface risks and mitigation, provide portfolio visibility, and improve PMO processes using program and portfolio management tools.

Lead cloud and data platform engineering for analytics and AI: implement DevSecOps CI/CD pipelines, automate infrastructure with IaC, manage Snowflake data warehouse and ingestion, oversee cloud cost reporting and FinOps, and evaluate/operate emerging AI/LLM capabilities and governance. Act as senior individual contributor collaborating with security, finance, and engineering teams to optimize performance, security, and cost.

Lead technical strategy for a 50–150+ engineer organization, establish architecture and engineering standards, drive delivery, and partner with executives on technology investments. Embed production-grade generative AI, LLMs, agentic workflows, and ML automation into engineering. Own AI platforms, distributed systems, cloud-native backend architecture, modernization initiatives, microservices migrations, and engineering transformation while ensuring scalable, reliable outcomes.

Leads strategic and operational initiatives across Southeast Medicare markets, translating territory priorities into workplans, milestones, governance processes, and execution paths. Coordinates alignment among market leaders, shared services, and enterprise partners; tracks decisions, risks, dependencies, and action items; escalates issues; and supports process standardization, continuous improvement, and consistent application of Medicare Advantage best practices.

Leads Group Retiree Solutions open enrollment strategy, operational execution, planning, training, performance tracking, dashboards, budgets, and cross-functional initiatives. Partners with account management, marketing, service operations, and business stakeholders to improve workflows, mitigate risks, monitor results, and implement process enhancements. Presents performance insights, drives consensus, and supports member experience and business objectives.

The Senior Manager, Sales Operations & Analytics oversees sales processes, drives operational effectiveness, and provides performance insights to enhance sales productivity and decision-making.

Leads the strategic vision, roadmap, and execution of the Health100 platform engineering organization. Oversees complex integrations, platform modernization, cloud migrations, engineering governance, architecture, delivery, talent development, vendor strategy, and stakeholder alignment. Guides multi-team initiatives across distributed systems, cloud-native technologies, and AI-enabled solutions while ensuring quality, operational reliability, measurable outcomes, and high-performing engineering teams.

Lead accessibility strategy and execution across product, design, and engineering. Drive audits, remediation plans, metrics, SLAs, training, and executive reporting to embed inclusive practices and remove digital barriers.

The Strategic Account Manager leads digital media campaigns, manages client and supplier relationships, and drives strategic planning, execution, and performance analysis to enhance business growth and achieve advertising goals.

The role involves leading a high-skilled tech team in modernizing CVS Health's Claims Adjudication platform through strategic development, integration, and execution of technology solutions.

Reviews and reworks sensitive, complex medical and hospital claims for compliance, provider, network, and large-scale rework projects. Performs root cause analysis, researches claim issues, coordinates with appropriate teams, and resolves claims accurately by project deadlines while meeting quality and turnaround expectations.

Reviews and reworks sensitive, complex medical and hospital claims for compliance, provider/network, and large-scale rework projects. Performs root cause analysis, identifies discrepancies, resolves claims accurately, coordinates with relevant teams, and meets project deadlines while maintaining quality and productivity standards.

Configure, design, maintain, and support Epic Ambulatory environments and EHR solutions. Lead discovery calls, design sessions, requirements gathering, workflow analysis, gap assessments, technical documentation, testing, vendor upgrades, and system changes. Collaborate with providers, project managers, technical teams, business stakeholders, and vendors to translate clinical and business needs into technical specifications and deliver project documentation.

Manages Dental and Availity provider portal operations, including production inventory, access provisioning, payer space administration, portal monitoring, file transfers, data exchanges, incident resolution, compliance impact reviews, testing, and release management. Partners with business, technology, and vendors to resolve operational issues, maintain portal functionality, support data integrity, and ensure continuous service delivery.

Analyze and document claim and encounter data, write complex SQL queries and reports, perform root-cause analysis, support system enhancements, execute test scripts, and collaborate with stakeholders to deliver data-driven solutions for healthcare claims/encounters.

Leads software engineering strategy and modernization for Specialty Pharmacy, overseeing product design, development, testing, delivery, and operational efficiency. Manages distributed engineering and change management teams, including hiring, coaching, performance management, and career development. Partners with business, product, and technology leaders to execute roadmaps, drive innovation, improve quality and time to market, and develop scalable cloud-based solutions using microservices, containerization, and AI technologies.

Reviews and adjudicates healthcare claims using coverage, medical necessity, eligibility, coding, member identification, and cost-containment guidelines. Resolves discrepancies, processes rework claims, manages claim queues and correspondence, and ensures accurate, timely adjudication using multiple systems and post-containment tools.

Leads complex, high-visibility strategic projects within the Product Rules organization. Responsibilities include managing project teams and resources, coordinating cross-functional stakeholders, communicating roadmaps and progress to executives, analyzing metrics, driving process simplification, managing change, and delivering large-scale initiatives. The role requires strategic thinking, innovation, persuasive communication, and continuous improvement across a matrixed organization.