CVS Health - Remote Work From Home Jobs & Careers | FlexJobs (2024)

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• AZ

Evaluate members' needs and eligibility, coordinate care plans, identify high-risk factors, and provide coaching and support to achieve optimal health outcomes. Must have 2 years of related experience and reside in Arizona. Bilingual preferred.

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• Cumberland, RI

Lead and mentor a team of Accounting professionals. Design, implement and maintain key controls over Rebate accounting. Evaluate key reserves and communicate to Senior Management. Identify areas for process improvement and drive automation.

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• Cumberland, RI

Lead, mentor, and develop a team of Accounting professionals. Design and implement key controls over Rebate accounting, receipts, and payments. Evaluate reserves and recommend adjustments. Streamline and automate processes.

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• IL

Responsible for numerous adherence outreach efforts to ensure our patients are staying on their medications and remaining adherent and compliant to their therapies.

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• Houston, TX

Outreach and engage with members to introduce and complete health risk assessments. Provide support and connect members with appropriate care team personnel. Document calls accurately and protect member confidentiality.

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• GA, AZ, OH, TX, FL, PA

Outreach DSNP members via phone, gather comprehensive information about their medical needs, develop their Individualized Care Plan, and connect them with appropriate care team personnel. Ensure highest level of compliance integrity.

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• TX, AZ, NV

Outreach members via phone to introduce services, complete health risk assessment, and create care plans. Use motivational interviewing and consultative techniques to gather comprehensive information about member's needs. Accurately document calls an..

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• Hartford, CT

Design, implement, and maintain automated workflows and processes for public cloud governance. Develop governance frameworks for managing cloud resources, access controls, and cost optimization. Collaborate with teams to integrate cloud automation so..

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• RI, TX, IL

Lead strategic account team to deliver solutions, client satisfaction, and service delivery. Influence client up-sell opportunities through consultative selling skills. Develop and deliver quarterly and annual reporting to clients on drug trend and f..

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• Hartford, CT

Design, develop, and maintain automated solutions for database deployment, configuration, backup and recovery, monitoring, and performance tuning. Collaborate with software development teams to integrate database automation process. Troubleshoot and ..

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• NY

Automate IT processes and develop solutions to enhance system monitoring, alerting, and reporting capabilities. Manage source code and version control using GitHub. Collaborate with cross-functional teams to streamline processes and troubleshoot issues.

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• Hartford, CT

Perform complex analytics and reporting on population health management, health and economic outcomes. Optimize risk scores, collaborate on risk adjustment programs, and provide process improvement recommendations.

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• Phoenix, AZ, or US National

Formulate pricing strategy and execute financial modeling. Collaborate with sales and account services to provide recommendations on pricing and negotiation strategy. Develop and maintain domain expertise in PBM and enterprise profitability.

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• KS

Negotiate, analyze, and manage contracts with providers across all lines of business. Recruit providers to expand the network. Collaborate cross-functionally on pricing and reimbursem*nt activities. Develop and refine network strategies.

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• Columbus, OH

Provide telephone-based consultation and counseling services to members, including crisis intervention, lifestyle management, and counseling sessions. Collaborate with a team of professionals and maintain compliance with policies and regulatory standards.

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• Hartford, CT

Lead cloud engineering and automation teams to deliver innovative cloud-based solutions aligned with business goals. Develop cloud strategy, oversee cloud engineering management and automation, and foster team leadership and development.

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• Harrisburg, PA

Lead Solution Architect responsible for developing business, application/integration, data, infrastructure, platform, and security architectures. Collaborate with various teams to create solution architectures for key strategic initiatives and delive..

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• RI

Manager specializing in strategic data analyses to support key business decisions for the PBM line of business. Use data-driven insights to develop winning business strategies and enhance existing solutions. Strong expertise in financial modeling, da..

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• Bloomington, MN, Downers Grove, IL

Lead discussions and negotiations for high-value rebate contracts with pharmaceutical manufacturers. Develop and foster strong relationships with direct manufacturers and industry partners. Coordinate with key leaders responsible for pharmacy benefit..

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• VA

A Clinical Transformation Specialist is responsible for developing and implementing physical and behavioral health integration programs, providing education and technical support, and interfacing with providers to develop and implement Value Based Co..

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• AZ

Develop architecture strategies, design execution, collaborate with stakeholders, lead teams, remove barriers, support diversity and inclusion, deliver executive presentations, and execute business plans.

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• Woonsocket, RI

Develop dashboards, tools, and processes to deliver actionable insights to leadership. Gather and analyze data to create executive reports. Communicate key findings to cross-functional teams and senior leadership.

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• MD

Coordinate medical services, perform non-medical research, maintain documentation, and promote communication with stakeholders. Sedentary work with visual acuity required. 2+ years clinical experience and high school diploma/GED required.

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• US National

Lead end-to-end proposal activities for large, complex Medicaid proposals. Ensure high engagement and collaboration across internal and external teams, adhere to established processes, and produce high-quality, compliant proposal responses.

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• NY

Account Managers are the main contact for customers, overseeing operations, ensuring timely delivery, building relationships, handling issue tracking, driving solutions, and supporting operations and sales teams.

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• PA, NY, VA, TX, IL, MA, FL, CT, RI

Lead a team of Database Administrators to design, implement, and maintain secure, stable, and performant databases. Provide 24/7 support, oversee compliance and security, and ensure high-quality database design. Required: SQL and Windows experience.

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• TX

Lead process optimization, analysis, and improvement initiatives, utilizing Six Sigma, Agile, and Lean methodologies. Collaborate with cross-functional teams to streamline workflows, implement digital tools, and ensure compliance with organizational ..

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• Buffalo Grove, IL

Lead the Business Continuity and Crisis Management programs, including managing teams, developing business continuity plans, measuring progress against industry standards, and ensuring compliance to maintenance requirements.

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• VA

Maintain high production and quality factors, participate in development of credentialing processes and workflows, provide telephonic education to providers/producers on credentialing policies and procedures, identify and communicate trends.

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• Cumberland, RI

Design, develop, and maintain automated solutions for Open Source and Oracle databases. Collaborate with software development teams to integrate database automation. Propose innovative solutions for process improvement and automation in the database ..

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• MI

Negotiate, execute, and analyze contracts with large hospital systems and physician groups. Manage contract performance and develop strategic relationships to expand provider networks. Identify cost-saving initiatives and ensure provider needs are met.

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• MI

Constructs negotiation, execution, review, and analysis of contracts. Delivers dispute resolution and settlement negotiations with providers. Ensures contract performance aligns with accessibility, compliance, quality, financial, and cost goals.

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• Fairfield, NJ

Ensure accuracy in pharmaceutical dispensing, provide customer service to patients and healthcare professionals, and provide leadership and guidance to supporting staff as a pharmacist in a specialty mail order pharmacy...

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• Nashville, TN

Applies medical necessity guidelines, determines coverage, completes eligibility verification, identifies discrepancies, and applies all cost containment measures to assist in the claim adjudication process.

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• Harrisburg, PA

Lead a team of database administrators to design, implement, and maintain secure, stable, and performant database servers and technologies. Provide 24/7 support for production issues and ensure compliance with security standards.

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• US National

Provide telephone-based assessment, counseling, and informational services in a call center. Conduct mental health and substance abuse assessments, develop action plans, and collaborate with professionals. Maintain accurate documentation and confiden..

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• MN

Provide personalized customer service via phone, chat, or email. Resolve inquiries and issues, educate members on benefits and services, and identify trends to improve customer satisfaction. High school diploma or equivalent required.

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• PA

Answer customer inquiries and resolve issues through phone calls. Build relationships with customers, anticipate needs, and provide education on benefit plans. Collaborate with colleagues and participate in special projects. High school diploma requi..

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• TX

Maintain high production and quality. Develop credentialing processes and workflows. Identify improvement opportunities and recommend solutions. Provide telephonic education on credentialing policies and procedures.

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• PA, AZ, OH, TX, FL

Document and support the Community Care Program, make outreach calls to members, and demonstrate excellent customer service skills. Preferred qualifications include strong organizational skills and familiarity with medical terminology.

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• Scottsdale, AZ, Irving, TX, Northbrook, IL

Develop and manage project plans, assess and mitigate risks, collaborate with stakeholders to deliver high-quality outcomes. Strong communication skills required. Some travel may be required. Project management and Microsoft Office experience preferr..

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• FL

Implement custom specialty networks, track and record network performance, respond to inquiries, assist with client network filing requests, generate reporting, analyze data, and perform other assigned tasks.

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• GA

Maintain and manage multi-vendor mainframe z/OS Disk & Tape environments. Leverage storage management products/utilities. Perform storage monitoring/tuning for performance and capacity. Develop and deploy best practice solutions in alignment with bus..

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• Phoenix, AZ

Provide user support for workflow applications, assist with project management and process mapping, create and maintain documentation, monitor and resolve help desk issues, collaborate with internal partners to assess processes and recommend improvements.

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• Providence, RI

Provide user support for workflow applications, assist with project management and process mapping, create and maintain documentation, and collaborate with internal partners to assess processes and recommend improvements.

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• Mount Prospect, IL, Buffalo Grove, IL, Wheeling, IL, Palatine, IL, Bartlett, IL, Elgin, IL, Rolling Meadows, IL, Des Plaines, IL, Schaumburg, IL

Facilitate appropriate healthcare outcomes for members by providing care coordination, support, and education. Evaluate members' needs and eligibility, coordinate care plan activities, and monitor care plan progress. Identify and escalate quality of ..

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• TX

Lead Director responsible for managing provider contracts, negotiating high-value contracts with complex providers, managing contract performance, identifying cost-saving initiatives, and collaborating cross-functionally to achieve network expansion ..

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• US National

Manage vendor relationships and coordinate tasks and projects to drive performance. Improve vendor processes and deliver on stakeholder and business performance. Communicate with internal and external teams to ensure operational excellence.

Featured

• CO

Lead Backend Node Developer responsible for providing technical leadership and guidance to the digital engineering team, researching and evaluating emerging technologies, designing and implementing complex features, and troubleshooting technical chal..

Featured

• MN

Lead a team to build internal tools for composing customer-facing pages across business units. Set OKRs, partner with leaders, hire high-performing engineers, and participate in design and architecture processes.

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