Jobs at CVS Health

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.

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 strategy and execution for Growth Analytics by building executive scorecards, financial and workforce planning, and organizational programs. Own vision, roadmap, delivery, adoption, and impact measurement for AI- and analytics-driven data products while partnering with data teams and stakeholders to drive data-driven decisions and measurable business outcomes.

Leads Health100’s B2B partner marketing strategy across healthcare audiences, including demand generation, pipeline growth, sales enablement, partner messaging, launches, and commercial readiness. Develops audience-specific value propositions and marketing materials, collaborates with Sales and Product teams, gathers commercial insights, and establishes KPIs to measure partner engagement and marketing impact. The role may be hybrid in Massachusetts, Rhode Island, or New York, with full-time remote consideration.

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

Leads Health100’s consumer growth engine, owning strategy and execution across awareness, acquisition, onboarding, engagement, and retention. Builds the consumer marketing team, operating model, and scalable growth capabilities; translates product features into compelling value propositions; drives data-informed experimentation; and manages agency and enterprise marketing partnerships. The role also defines success metrics, integrates with Product, Digital, Analytics, and Experience teams, and communicates strategy and performance to executives in a fast-moving, startup-like environment.

Leads Health100’s B2B partner growth and marketing engine, including positioning, demand generation, pipeline development, sales enablement, go-to-market planning, and partner adoption. Builds the partner marketing team, operating model, systems, and performance metrics while partnering closely with Sales, Product, Marketing, and Commercial teams. Creates executive-ready narratives and sales materials, manages agency relationships, and drives measurable commercial outcomes in a fast-moving, regulated healthcare technology environment.

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.

Lead strategy, development, and execution of CMX events to drive brand and commercial impact. Own annual events calendar, vendor relationships, budget and logistics, presenter coordination, sales enablement, post-event analysis, and cross-functional partnership to position CMX as a retail media thought leader.

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.

This role involves leading strategic planning, product innovation, and cross-functional collaboration to enhance pharmacy analytics and drive growth initiatives for CVS Health.

Owns the lifecycle of AI-powered analytics products supporting clinicians, from requirements and discovery through production and maintenance. Partners with data scientists, engineers, clinicians, and executives to define roadmaps, prioritize trade-offs, establish data contracts and SLAs, validate model results, track performance, and demonstrate ROI. Leads Agile scrum teams and drives cross-functional delivery in complex healthcare environments.

Supports stop loss claims filing for self-funded employer groups by preparing and submitting filing packages, tracking reimbursements, reconciling discrepancies, reviewing documentation, and coordinating with carriers, clients, underwriting, finance, eligibility, and client support teams. The role monitors claims trends, resolves issues, maintains accurate records, escalates delays, and helps improve processes while ensuring timely and accurate reimbursements.

Performs utilization management for healthcare members by reviewing clinical information, applying coverage criteria and guidelines, making coverage determinations or recommendations, coordinating with providers, identifying referral opportunities, and promoting quality and effective benefit utilization. The role is fully remote but requires working designated hours, including possible weekends and holidays, while maintaining secure HIPAA-compliant home-office and technology requirements.

Performs utilization management for healthcare members by reviewing clinical information, applying coverage criteria and guidelines, making coverage determinations, coordinating with providers, identifying referral opportunities, and supporting quality and benefit utilization. The role is fully remote, requires active RN licensure, and involves secure system navigation, Microsoft Office use, and collaboration across healthcare teams.

Assesses clinical information and applies healthcare criteria, policies, and judgment to make utilization and coverage determinations. Coordinates care with providers, identifies referral opportunities, promotes quality and effective benefit use, and supports utilization management operations. The role requires an active RN license, clinical experience, healthcare systems navigation, and strong communication skills in a remote work environment.

Assesses clinical information and applies healthcare criteria, policies, and clinical judgment to make coverage determinations and recommendations. Coordinates with providers and internal teams, identifies referral opportunities, supports benefit and utilization management, and promotes quality and effective healthcare services. The role requires an active RN license, clinical experience, comfort with multiple technology platforms, and strong communication skills in a work-from-home environment.