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.

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.

Performs pharmaceutical rebate reconciliation, payment tracking, dispute resolution, reserve analysis, variance investigation, and financial reporting. Reviews contract terms, analyzes manufacturer payment data, identifies late or disputed payments, communicates with pharmaceutical manufacturers and internal partners, maintains dispute records, and responds to balance inquiries. Requires strong analytical, organizational, communication, and problem-solving skills, plus experience with Excel and financial or analytical work.

Negotiate and manage provider contracts, single-case agreements, disputes, and settlements for Aetna. Analyze forecast and cost changes, develop impact assessments and process improvements, and support cost-saving initiatives. Maintain relationships with providers and internal teams, ensure contract performance meets compliance, quality, accessibility, and financial goals, and coach junior colleagues. The role requires expertise in provider contracting, claims operations, patient management, and Aetna systems.

Conducts complex investigations of dental providers and practices involving healthcare fraud, waste, and abuse. Prepares evidence and case referrals for clinical, legal, leadership, and law-enforcement review; documents case activity; supports corrective actions and fraud-prevention controls; presents findings; and provides testimony in civil and criminal proceedings. Requires healthcare fraud investigation experience, research and data-analysis skills, medical terminology knowledge, and business travel for legal proceedings.

Leads implementation of customer benefit plans for self-funded healthcare clients. Manages project planning, timelines, budgets, deliverables, risks, quality controls, change management, stakeholder communication, and post-project improvement initiatives. Coordinates cross-functional teams, resolves issues, prepares progress reports, manages multiple projects, and coaches junior colleagues. Requires significant healthcare client-facing and project management experience.

Lead the architecture, development, and operation of enterprise-grade full-stack software for clinician-facing and performance-management experiences. Design distributed systems, drive technical initiatives, improve scalability and maintainability, adopt modern technologies, deliver iterative releases, and collaborate across organizations. Mentor engineers and establish strong engineering practices. The role requires polyglot programming, cloud platforms, modern front-end development, SQL, distributed systems, and production operations experience.

Leads the Finance Technology AI Enablement engineering team, setting technical strategy and delivering AI, ML, and GenAI solutions. Responsibilities include managing and mentoring engineers, translating business needs into technical roadmaps, overseeing concurrent initiatives, establishing scalable architecture and DevOps practices, and ensuring governance, security, privacy, and compliance. The role also advises stakeholders on AI adoption, enables low-code and full-stack solutions, and reports program value and risks to senior leadership.

Designs, develops, deploys, and supports complex integrations between Workday and internal or external systems. Builds Workday Extend and Orchestrate applications, configures Studio integrations and connectors, manages APIs, data migration, release updates, documentation, production support, and incident resolution. Partners with technical and business stakeholders, coordinates vendors, contributes to Agile projects, and mentors team members while ensuring scalable, secure, and maintainable integration solutions.

Develops payer-specific negotiation playbooks, pre-negotiation frameworks, deal reviews, and market intelligence for CVS Pharmacy’s major payer relationships. Translates market insights and negotiation outcomes into repeatable tools, facilitates post-mortems, drives adoption of negotiation processes, and influences senior cross-functional stakeholders without direct authority. This individual contributor role supports payer relations and prepares for future commercial deal ownership.

Leads payer deal intelligence, financial modeling, market analysis, and negotiation decision support for pharmacy reimbursement agreements. Builds multi-year scenarios, sensitivity analyses, and pre-negotiation packages; recommends deal positions and walk-away points to senior leaders. Manages concurrent analytical deliverables, translates quantitative findings into executive recommendations, and supports cross-functional finance and payer strategy forums.

Reviews and adjudicates routine medical claims, verifies eligibility and benefit coverage, applies coding and medical necessity guidelines, identifies discrepancies, and ensures accurate processing within turnaround requirements. Communicates with providers and members, investigates claims requiring additional review, handles correspondence, routes complex claims, and analyzes claims data for trends and process improvements.