- CVS Health (Jefferson City, MO)
- …**The Epic Implementation Project Manager assists the Lead Director with informatics initiatives with a focus on strategic execution, stakeholder alignment, and ... delivery excellence. This role is responsible for translating organizational goals into actionable project plans, managing cross-functional teams, and ensuring the successful implementation of Epic. The ideal candidate brings deep expertise in IT project… more
- CVS Health (Jefferson City, MO)
- …The Cost Management team resides within the Network and Pharmacy Solutions organization at Meritain Health and oversees payment integrity products and strategy, with ... a number of internal and external stakeholders that rely on the team's analyses and business expertise. The Sr. Analyst Business Consultant will use data and analytical skills to support financial and operational performance analysis, strategic initiatives,… more
- CVS Health (Jefferson City, MO)
- …Responsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD codes that are submitted to the Centers for ... Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal policies and procedures. + Proven ability to… more
- CVS Health (Jefferson City, MO)
- …Transformative role for accounting professionals looking for growth and progression opportunities in a large public Company. This role provides exposure to a vast ... At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans… more
- CVS Health (Jefferson City, MO)
- …The Pharmacy Program Manager is an individual contributor (non-people manager) role. This is a remote role requiring a HIPAA-compliant workspace and is open to ... qualified candidates within the United States. Usual working hours are 8:00am-5:00 pm or 9:00am-6:00 pm in the time zone of residence, per business needs. There are no weekends or corporate holidays expected with this role. Minimal travel (less than 10%) is… more
- CVS Health (Jefferson City, MO)
- …Include: + Defining specifications and documentation for rating methodology changes + Testing and sign-off for ERNIE system enhancements + Creating exhibits to ... demonstrate rating method results for regulatory/underwriting inquiries + Investigating historical pricing practices across national commercial large group business + Assessing claim impact of benefit relativity changes Technical Responsibilities Include: +… more
- CVS Health (Jefferson City, MO)
- …Defines operational activities and executes on strategic direction related to Cyber Resiliency for CVS Health's Digital, Data, Analytics & Technology (DDAT) ... Cybersecurity GRC team, guiding colleagues in facilitating cyber resiliency activities across the enterprise. Manages, develops and implements procedures, controls, and reporting to ensure compliance with NIST Cyber resiliency frameworks. Consults on efforts… more
- CVS Health (Jefferson City, MO)
- …We're seeking a Data Engineer to design and implement data pipelines that power analytical capabilities. This hands-on role requires an understanding of data ... At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans… more
- CVS Health (Jefferson City, MO)
- …+ 7+ Years of Asset Management Experience - Subject Matter Expert of Hardware Asset Management Practices. + 5+ years of experience working with internal and/or ... At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans… more
- CVS Health (Jefferson City, MO)
- …**This is a remote work from home role anywhere in the US with virtual training.** American Health Holding, Inc (AHH) is a medical management company that is a ... At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans… more
- CVS Health (Jefferson City, MO)
- …**This is a remote position, the working schedule is** **9:30am-6pm CST/ EST. Please note no schedule or break changes will be allowed.** The Health Survey Specialist ... plays a critical role within the DSNP team. The Health Survey Specialist outreaches DSNP members via phone to introduce the DSNP services and complete the Health Risk Assessment (HRA). The HRA is the first step in creating the member's Individualized Care Plan… more
- CVS Health (Jefferson City, MO)
- …Our preference for qualified candidates is in either Missouri, Illinois, Indiana, Ohio or Kansas for this remote/hybrid opportunity . Develops and implements account ... At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans… more
- CVS Health (Jefferson City, MO)
- …Must live/work in PST The Care Management Associate (CMA) supports comprehensive coordination of medical services that include intake and outgoing calls for medical ... services. We work closely with both case management team and utilization management team. * The Care Management Associate will review eligibility and benefits and open pre-certification cases and either approve or send to nursing staff for review. * The Care… more
- CVS Health (Jefferson City, MO)
- …This role is responsible for onboarding the complex/variable pharmacy needs of our diverse client base. You will be responsible for consulting the client on what ... products, solutions and strategy are most appropriate and viable for the plan design. This individual will be responsible for producing a world-class experience that helps retain and grow the MPS block of business. Strong communication and coordination with… more
- CVS Health (Jefferson City, MO)
- …Aetna, a CVS Health company, is the nation's premier health innovation company helping people on their path to better health. We are building a new health care model ... that is easier to use, less expensive, and puts the consumer at the center of their care. Aetna's Medicare Stars Team is growing and expanding! This is exciting opportunity to join a high performing, collaborative team as a Data Scientist. This individual will… more
- CVS Health (Jefferson City, MO)
- …The Senior Analyst, Account Management will serve as a fully dedicated advocate to senior employees and their families employed by a leading financial services ... company. **Key Responsibilities** + Serve as the main point of contact for senior leaders working closely with the Benefits team to ensure a seamless and high-quality Aetna experience. + Serve as a primary point of contact for member service inquiries. +… more
- CVS Health (Jefferson City, MO)
- …Summary** + Support the development and implementing of Medicare Part D strategy through the execution of operational, functional, and business targets within the ... Medicare Part D clinical Operations and Formulary Development team, ensuring measurable impact. + Contribute with the execution of strategic initiatives aligned with the organization's goals, utilizing project management tools, data analysis, and stakeholder… more
- CVS Health (Jefferson City, MO)
- …**The Senior Manager, Pharma Services Growth is a critical member of the Trade Strategy team, which is tasked with leveraging CVS Health's size and scale to create ... differentiated, one-of-a-kind solutions for pharmaceutical manufacturers that reduce the costs of goods and make pharmaceuticals more accessible for CVS customers, clients, members, and patients across the CVS Health enterprise. This high visibility position… more
- CVS Health (Jefferson City, MO)
- …The Corporate Functions & Pharmacy Consumer Wellness (PCW) IT Compliance Team is looking for a resource to become our Identity and Access Management (IAM) Domain SME. ... This person will help our team develop, maintain, and continuously improve upon the Compliance support and governance framework for the IAM domain. He or she will serve as a key player in our day-to-day operations, navigate the Compliance workload and emerging… more
- CVS Health (Jefferson City, MO)
- …This Case Manager RN position is a fully remote position. Candidates from any state are welcome to apply, however, preference is for candidates in compact RN states. ... Normal Working Hours: Monday-Friday 9:00am - 5:30pm (9:00am being the earliest start time) in the time zone of residence. Team is open to varying hours until 8:00pm EST. There is a late shift rotation until 8:00pm EST and holiday on-call as needed. There is no… more
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