Jobs at CVS Health

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.

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.

Processes and adjudicates healthcare benefit claims by verifying eligibility, coverage, coding, medical necessity, documentation, and regulatory compliance. Reviews complex and rework claims, investigates discrepancies, manages claim queues, communicates with providers and members, and records accurate claim data. Analyzes claims trends and generates reports to support process improvements. The role includes 12–20 weeks of virtual training and a flexible schedule after ramp-up.

Leads a large, multidisciplinary engineering organization responsible for enterprise analytics platforms supporting healthcare applications, AI products, search, translation, and text summarization. Owns engineering strategy, architecture, code quality, platform modernization, reliability, scalability, observability, and cost efficiency. Partners with Data Science, Product, Analytics, and Architecture teams while mentoring leaders and communicating technical strategy to stakeholders.

Leads strategic sales enablement initiatives for Commercial and Specialty Markets, including value proposition development, sales pitches, field communications, client-facing content, and cross-functional execution. Oversees strategic sales experience activities and manages a team of business consultants, project managers, and communications professionals. Partners with senior leaders across Sales, Marketing, Product, Communications, and Strategy to improve sales effectiveness, retention, client engagement, and organizational transformation.

Leads healthcare quality data management, regulatory reporting, statistical analysis, dashboards, and intervention effectiveness evaluations. Develops data models and reporting frameworks using Tableau, Power BI, SQL, and Excel. Supports HEDIS, NCQA, Medicare Stars, Medicaid, and other quality initiatives by identifying performance gaps, informing interventions, and translating analytics into actionable insights for clinical, operational, and quality leaders.

Conduct complex healthcare fraud and abuse investigations involving Medicaid claims, including research, data mining, claims analysis, case preparation, regulatory compliance, and recovery efforts. Collaborate with medical, legal, and law enforcement stakeholders; communicate findings; provide testimony; document cases; mentor junior investigators; and support fraud, waste, and abuse controls.