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

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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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• WA

Assist with establishing and implementing results-based programs and innovative initiatives for the network operations area, under general supervision. Collaborate internally and cross-functionally to support initial negotiations and re-negotiations...

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• TX

Accurately set up and review Medicare appeals cases, ensuring timely and correct decisions. Utilize work instructions for case processing, comply with CMS timelines and quality standards, and maintain knowledge of Medicare guidelines.

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• TX

Process Organization Determination and drug benefit exception requests in a call center environment. Conduct outreach to patients and providers, research and correct issues, and interpret general business correspondence. Ensure cases are properly closed.

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• Albany, NY

Maintain apps, troubleshoot, recreate issues, run SQL queries, and ensure proper computer operation. Prioritize and resolve end user requests, and backup service desk on phones. Must be willing to work weekends, after hours, or overtime if needed.

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• Raleigh, NC

Lead the growing Pharmacy Team for a healthcare organization, manage daily operations, establish goals and strategies, collaborate with internal and external partners, develop and deliver educational programs, and provide leadership and guidance to t..

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• US National

Ensure accurate setup and review of Medicare appeals cases. Thoroughly review requests for information, provide clear documentation, contact providers when necessary, and follow Medicare guidelines for case processing.

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• KY

Responsible for intake, investigation, and resolution of appeals, complaints, and grievances for all products. Coordinate responses from multiple business units, identify trends, and recommend solutions.

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• Hartford, CT

Design, develop, and implement ServiceNow ITOM solutions based on business requirements and industry best practices. Collaborate with stakeholders to gather requirements, define project scope, and establish project timelines. Configure and customize ..

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• Cumberland, RI, Pittsburgh, PA, Buffalo Grove, IL, Solon, OH, Scottsdale, AZ

Develop and review content for drug coverage programs across multiple business segments. Provide assistance and training to medical affairs and clinical development teams. Participate in cross-functional teams and mentor students and residents.

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• Cumberland, RI, Pittsburgh, PA, Buffalo Grove, IL, Solon, OH, Scottsdale, AZ

Support the development and management of Medicare formularies and utilization management programs. Create and maintain formularies, provide direction to internal partners, and interface with other teams and leadership to support product development ..

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• Cumberland, RI, Moon Township, PA, Scottsdale, AZ, Hartford, CT, Chicago, IL, Blue Bell, PA, Downers Grove, IL

Support leaders and employees with advice on company policies, manage workplace inquiries, provide coaching, corrective actions, and terminations. Collaborate with stakeholders to promote positive employee relations.

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• Providence, RI

Develop, implement, mature, and manage financial operations procedures. Ensure adherence to financial and accounting principles. Provide expertise in financial software and tools. Strong written and verbal communication skills required.

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• CA

Assist in resolving rejected clinical claims management. Make phone calls to insurance plans, work with local pharmacies to ensure timely dispensing of medications, and gather information for overrides/prior authorizations.

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• Chandler, AZ

Assess, plan, implement, and evaluate members' nutritional status. Develop and monitor nutrition plans, educate and support members to achieve optimal health. Utilize clinical guidelines/criteria and motivational interviewing skills to positively imp..

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• Buffalo Grove, IL, Hartford, CT, Woonsocket, RI, Chicago, IL, Dallas, TX, Irving, TX, Providence, RI, Worcester, MA, Pittsburgh, PA

Oversee development, maintenance, and execution of Traditional utilization management programs. Partner in a matrix relationship with colleagues at all levels and teams. Manage multiple complex, ongoing projects and meet timelines for critical delive..

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• TX

Assisting with the creation of month end close & Forecast/Budget review decks for Sr. Leadership. Uploading gross profit data into Hyperion and reconciling to supporting schedules.

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• US National

Lead team of Network Engineers managing, maintaining, and optimizing network infrastructure. Develop and deliver IT staff training on firewall management, security best practices, and emerging threats. Regularly review and audit firewall policies for..

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• OH, MS, TX, GA, NY, VA, IL, MA, NC, SC, CT, RI, TN, KY

Manage architectural design development and implementation of drawings for facilities, oversee project management of A&E firms and consultants, ensure conformance with standards and requirements, and manage multiple complex projects simultaneously.

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• IL

Work in multiple systems and portals, and handle inbound patient and internal colleague calls, as well as make outbound calls on a daily basis. Utilize your skills and healthcare industry expertise to efficiently solve insurance...

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• TX

Provide oversight for medical policy implementation, participate in program development and evaluation, and support medical management staff. Focus on utilization review/quality assurance and provide clinical expertise to support medical management p..

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• ND, SD, NE, KS, OK, TX, MN, IA, MO, AR, LA, WI, IL, KY, MS, AL, MI, IN, TN, GA, FL, OH, NC, SC, WV, VA, PA, DC, CT, NJ, NY, RI, NH, ME, MD, DE, VT, MA

Lead the development and deployment of Models of Care, provide clinical oversight to care management teams, collaborate with leadership and stakeholders, and ensure high-quality care is delivered to members. MD/DO with managed care and care managemen..

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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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• 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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• 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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• 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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• 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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• VA

Develop and implement account management strategies, maintain strong customer relationships, achieve revenue and earnings objectives, create demand and raise profile with customers, assess competitive environment, and develop sales strategies.

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• Springfield, IL

Rebate Forecast Contract Advisor interprets rebate contracts, maintains tools, collaborates with internal partners for market competitive rebate offers, and updates forecast model inputs. Financial analysis and advanced Excel skills preferred.

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• PA

Pharmacist responsible for providing exceptional customer service, accurate delivery of pharmaceutical care services, and leadership to supporting staff. Requires pharmacy experience and active licensure as a practicing pharmacist in Pennsylvania.

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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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• AZ, AK, FL, ID, IL, MA, NH, NC, RI, TN, TX, VT

Assist patients with their pharmacy needs, enroll patients in pharmacy services, and provide outstanding customer service. Interact with pharmacy staff and other care providers to streamline the prescription experience.

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• OK

Perform clinical research and maintain accurate documentation. Process requests in compliance with regulations. Communicate with case managers, pharmacies, and healthcare providers. Utilize pharmacy systems and protect member information.

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• Phoenix, AZ

Supports coordination of Medicaid/Medicare pharmacy services, processes authorization requests, evaluates/approves requests based on clinical guidelines, and promotes quality healthcare and pharmacy services.

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• Cumberland, RI

Handle customer inquiries by phone, fax, and email in a contact center environment. Process requests with accuracy and confidentiality while adhering to state and federal HIPAA/Privacy requirements. Work in a professional team environment.

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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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• Las Vegas, NV

Assist members with their pharmacy benefit plans by answering questions regarding prescription insurance, medication coverage, and mail order prescriptions. Provide heart-driven service and offer solutions to simplify their healthcare experience.

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• Chandler, AZ

Assist members with pharmacy benefit plans, answer questions about prescription insurance, medication coverage, and mail order prescriptions. Provide solutions to simplify healthcare experience and offer opportunities for growth within the company.

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• US National

Architect, design, and support complex voice and contact center solutions. Engineer fault-resilient multi-vendor solutions. Stay current with technology trends. Collaborate and drive effective partnerships across enterprise technology functions.

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• Corona, CA

Supervise store crew, communicate effectively with store management, and handle customer service issues. Must have deductive reasoning ability, analytical skills, and flexibility in schedule. Retail experience preferred.

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• Phoenix, AZ

Lead development across legacy underwriting modeling, data interpretation, and automated financial reporting. Manage multiple complex issues, work independently in a fast-paced environment, and prioritize effectively. Exceptional communication and pr..

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• PA

Lead and develop a comprehensive security strategy for secure development lifecycle. Mentor and lead a team of security engineers. Collaborate with product management and engineering teams to integrate security into all stages of development.

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• Woonsocket, RI

Support the execution of production events at corporate headquarters. Responsible for AV support in conference rooms, town halls, and leader events. Troubleshoot AV equipment and manage calls on WebEx and Microsoft Teams.

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• PA

Lead and execute enterprise-wide secure development program, align secure development goals with overall business objectives and technology strategies, and establish and enforce secure coding standards and best practices.

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• US National

Identify potential customers and decision makers in Life Science industry for RWE Recruitment sales into Phase III/IV clinical trial solutions. Build relationships, increase revenue, develop sales pipeline, collaborate with internal stakeholders.

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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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• Chandler, AZ

By assimilating health/nutritional assessment data analysis, establishes a plan of care based on members health status/risks, education, and support needs. Partners with members to identify opportunities for integration into available internal/external..

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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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