Jobs at CVS Health

Leads technology, data, privacy, and third-party risk legal services. Oversees privacy incident investigations and response, HIPAA risk assessments, breach analysis, remediation, policy development, and compliance with healthcare and state privacy regulations. Partners with cross-functional stakeholders to implement privacy and data governance programs, communicate complex requirements, and protect sensitive organizational data. May manage and mentor team members while handling high-impact privacy initiatives.

Designs, configures, governs, and optimizes Workday security across HCM, Compensation, Payroll, Talent, Recruiting, Reporting, and integrations. Responsibilities include managing security groups and policies, resolving access issues, administering requests through ServiceNow, conducting access reviews and audit activities, analyzing report security, supporting releases and deployments, maintaining documentation, tracking operational metrics, and contributing to security modernization and role redesign.

Leads end-to-end delivery of healthcare technology, automation, AI, and decision-management solutions for Utilization Management. Translates business needs into technical requirements, user stories, roadmaps, and delivery plans; manages product backlogs and Agile ceremonies; coordinates business, clinical, architecture, engineering, and vendor teams; oversees risks, dependencies, governance, and executive reporting; and evaluates integrations, APIs, enterprise architecture, healthcare interoperability, EDI, and rules-engine implementations.

Supports creation and maintenance of Small Group product conversion prototype controls for Traditional and HNO products. Sets up plans in CCI and PMA to support automated case installation, interprets product and plan data, handles compliance and legislative requests, researches issues, and coordinates with enterprise departments. Requires insurance product knowledge, data analysis, database experience, strong problem-solving, communication, and deadline-management skills.

Supports the sales proposal process by developing customer-focused proposals, gathering source-system information, calculating fees, organizing questionnaire responses, reviewing plan designs, preparing deviation documents, and compiling ancillary coverage proposals. Conducts business impact assessments, contributes to sales presentations and marketing surveys, and supports proposal initiatives under supervision. Requires EAP industry experience, professional writing, presentation skills, and cross-functional collaboration.

Supports CVS Health’s Enterprise Risk Management program through quantitative risk analysis, model maintenance and enhancement, regulatory deliverables, stress-scenario analysis, data quality controls, documentation, and governance activities. The role uses SQL, Excel, VBA, R, or Python to prepare datasets, perform statistical analysis, automate processes, reconcile results, and produce reporting. It also partners with stakeholders to interpret business data, validate assumptions, communicate findings, and improve risk-management processes.

Develop and deploy data science solutions for pharmacy benefits and member experience, including predictive models, generative AI pipelines, and rules-based logic. Extract and analyze large-scale data with Python and SQL, manage model lifecycles, monitor production performance, and communicate insights to clinical and business leaders. Collaborate with data scientists, engineers, and operational stakeholders to solve complex healthcare and PBM problems.

Coordinates provider education programs, including scheduling, meetings, training logistics, speaker outreach, communications, educational materials, documentation, and stakeholder follow-up. Maintains program trackers, attendance and evaluation data, dashboards, standard operating procedures, and status updates. Supports provider onboarding, coaching, clinical excellence sessions, CME administration, program reporting, and ad hoc education initiatives while collaborating with clinical and operational leaders.

Leads enterprise workforce performance and incentive strategy for Aetna’s frontline Service Operations workforce. Owns program strategy, governance, measurement frameworks, analytics, financial stewardship, technology enablement, change adoption, and continuous improvement. Advises executives, partners across Operations, Finance, HR, Payroll, and Technology, and manages a team responsible for program operations, reporting, governance, and stakeholder support.

Provides litigation support for CVS Health’s Healthcare Business, including matter intake, subpoena and records request management, legal holds, discovery coordination, deadline tracking, case reporting, attorney support, expense processing, and settlement-related check requests. The role handles confidential information, coordinates with internal stakeholders and external counsel, and contributes to special legal projects.

Performs pharmaceutical rebate reconciliation, payment tracking, dispute resolution, reserve analysis, variance research, and financial data analysis. Reviews contract terms, identifies late payments and disputed balances, communicates with pharmaceutical manufacturers, maintains dispute tracking records, and responds to open-balance inquiries. Collaborates with Trade Relations, Legal, and Accounting teams to help reduce clients’ drug spend.

Leads enterprise software architecture for a clinical insights platform across GCP and Azure. Defines scalable architectures for clinical AI/ML, LLM inference, data pipelines, real-time services, MLOps, and healthcare analytics. Establishes engineering standards, reference architectures, governance, and multi-year roadmaps while aligning engineering, product, clinical, and business stakeholders. Mentors senior technical staff and ensures systems meet HIPAA, security, privacy, and clinical data governance requirements.

Partners with business and technical teams to identify process improvement and automation opportunities. Implements approved tools, integrations, APIs, ETL processes, dashboards, and reporting solutions. Extracts and analyzes data from diverse sources, translates findings into actionable insights, documents requirements and solution designs, and presents results to stakeholders. The role supports scalable operational improvements across Corporate Affairs while maintaining clear communication and effective collaboration.

Leads digital product strategy and execution for patient acquisition, engagement, membership growth, and retention across healthcare delivery businesses. Oversees multidisciplinary product, engineering, data, Salesforce, and design teams; partners with marketing, sales, outreach, membership, retention, and clinical leaders. Drives scalable patient-facing platforms and integrations across Salesforce, Epic, CXone, Five9, marketing platforms, and partner systems while optimizing conversion, scheduling, service recovery, and lifetime membership value.

Design, deliver, and operate business-critical distributed systems at scale. The role requires full-stack software development, strong programming and SQL skills, cloud expertise, and experience with system architecture, concurrency, and large-scale operations. Preferred experience includes event-driven architectures, Kafka, REST, gRPC, Docker, Kubernetes, Terraform, monitoring platforms, CI/CD pipelines, and React or Angular frontend development.

Leads the digital product strategy, architecture, and software delivery for CVS Health’s Membership, Engagement, and Retention domain. Oversees engineering, data, Salesforce, Epic, and analytics teams; manages roadmaps, agile delivery, integrations, system reliability, and operational automation. Partners with healthcare and executive stakeholders to improve patient retention, membership attribution, service recovery, and value-based care outcomes while developing cross-functional product and engineering talent.

Design, deliver, and operate business-critical distributed systems for Signify Health’s value-based care technology platform. The role requires full-stack development, polyglot programming, scalable distributed-systems expertise, cloud engineering, SQL and relational database knowledge, and strong communication. Preferred experience includes event-driven architectures, AI-assisted development tools, Kafka, APIs, containers, Kubernetes, infrastructure as code, monitoring, CI/CD, and agile methods. Quarterly or as-needed travel is required.

Coordinate cross-functional implementation and operational integration of Claims Assist Manager capabilities across Commercial, Medicare, and Medicaid claims operations. Responsibilities include aligning stakeholders, managing dependencies and workstreams, coordinating SMEs and UAT, tracking defects and risks, supporting technology releases, facilitating governance, and ensuring business validation, training, adoption, compliance, and sustained operational value realization.

Leads complex technical implementations on the QNXT platform, primarily supporting Payment Integrity products. Oversees project planning, budgets, resources, risks, governance, deliverables, and timelines. Advises stakeholders, adapts project methodologies, benchmarks performance, ensures successful delivery, and mentors project managers and teams within a matrixed organization.

Leads Medicaid proposal governance and strategic planning across annual and multi-year cycles. Establishes governance forums, decision rights, operating rhythms, and accountability frameworks. Translates strategy into roadmaps, milestones, KPIs, and execution plans while incorporating financial, regulatory, and operational considerations. Partners with senior executives and cross-functional teams on business reviews, competitive positioning, and growth opportunities. Develops executive presentations and dashboards, standardizes processes, and mentors junior colleagues.