care manager (rn)

nurse

care manager rn

Molina Healthcare

JOB DESCRIPTION
 
Job Summary
 
Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.
 
Essential Job Duties
 
<ul>
<li>Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments.</li>
<li>Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.</li>
<li>Conducts telephonic, face-to-face or home visits as required.</li>
<li>Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.</li>
<li>Maintains ongoing member caseload for regular outreach and management.</li>
<li>Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care.</li>
<li>Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration.</li>
<li>Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.</li>
<li>Assesses for barriers to care, provides care coordination and assistance to member to address concerns.</li>
<li>May provide consultation, resources and recommendations to peers as needed.</li>
<li>Care manager RNs may be assigned complex member cases and medication regimens.</li>
<li>Care manager RNs may conduct medication reconciliation as needed.</li>
<li>25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications</li>
<li>At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.</li>
<li>Registered Nurse (RN). License must be active and unrestricted in state of practice.</li>
<li>Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.</li>
<li>Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA).</li>
<li>Demonstrated knowledge of community resources.</li>
<li>Ability to operate proactively and demonstrate detail-oriented work.</li>
<li>Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.</li>
<li>Ability to work independently, with minimal supervision and self-motivation.</li>
<li>Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations.</li>
<li>Ability to develop and maintain professional relationships.</li>
<li>Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.</li>
<li>Excellent problem-solving, and critical-thinking skills.</li>
<li>Strong verbal and written communication skills.</li>
<li>Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.</li>
</ul>
Preferred Qualifications
 
<ul>
<li>Certified Case Manager (CCM).</li>
</ul>
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
 
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
 Pay Range: $26.41 - $51.49 / HOURLY
 <ul>
<li>Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.</li>
</ul>

Care Manager (RN)

Humana

<div>
 
 Become a part of our caring community and help us put health first
 
 
 
 Are you a transitioning military service member or a military spouse looking for an internship that supports the goal to put health first?
 
 
 The DOW SkillBridge Internship and Military Spouse Fellowship Programs will provide you with key training to perform your internship. You will partner with your team to support members, projects, and to meet goals impacting business outcomes. The professionals you work with at Humana will depend on the type of internship you select. They may include healthcare professionals, HR, and IT, to name a few. The objective is to support and facilitate care for members.
 
 
 To be eligible for this internship, you must either be a transitioning military service member or a military spouse, and you must obtain eligibility to participate in these DOW sponsored programs.
 
 
 The Prior Authorization, Registered Nurse, RN, Intern will report to a manager of the National Medicaid team. You will utilize training and engage formerly acquired skillsets to complete medical necessity reviews for requested services using clinical judgment and provides referrals to internal stakeholders for further review depending on case findings.
 
 
 
 You will participate in the following assignments in this role:
 
 
 
 
 Clinical Review
 
 
 
 <ul>
 <li>
 Conduct comprehensive clinical reviews of prior authorization requests to determine medical necessity and benefit eligibility.
 </li>
 <li>
 Apply advanced evidence-based clinical guidelines in review decisions.
 </li>
 <li>
 Ensure compliance with accreditation, state, and federal regulations.
 
 
 </li>
 </ul>
 
 Communication And Coordination
 
 
 
 <ul>
 <li>
 Communicate with healthcare providers to obtain necessary clinical information and clarify requests.
 </li>
 <li>
 Coordinate with medical directors and interdisciplinary teams to support decision-making.
 </li>
 <li>
 Serve as a liaison between clinicians, internal departments, and members.
 
 
 </li>
 </ul>
 
 Documentation And Reporting
 
 
 
 <ul>
 <li>
 Document all review findings and decisions in clinical documentation systems.
 </li>
 <li>
 Ensure timely and accurate documentation of prior authorization determinations.
 </li>
 <li>
 Support reporting initiatives and provide data for performance improvement projects.
 
 
 </li>
 </ul>
 
 Quality Assurance
 
 
 
 <ul>
 <li>
 Implement quality assurance measures to ensure accuracy and consistency in prior authorization decisions.
 </li>
 <li>
 Conduct regular audits and reviews to maintain high standards of service.
 </li>
 <li>
 Identify process improvement opportunities and contribute to performance improvement projects.
 
 
 </li>
 </ul>
 
 Education And Training
 
 
 
 <ul>
 <li>
 Educate providers and staff on prior authorization policies, criteria, and review processes.
 </li>
 <li>
 Provide mentorship and feedback to nonclinical staff and peers to enhance workflow efficiency.
 </li>
 <li>
 Stay current with clinical best practices and regulatory changes.
 
 
 </li>
 </ul>
 
 Required Qualifications
 
 
 
 
 Use your skills to make an impact
 
 
 
 <ul>
 <li>
 You must be a transitioning service member eligible to participate in the DOW SkillBridge or a military spouse eligible to participate in the military spouse fellowship&middot;
 </li>
 <li>
 Active Registered Nurse, RN, enhanced Compact, (eNLC) license without restrictions or disciplinary action.
 </li>
 <li>
 Minimum two (2) years clinical nursing experience such as acute care, emergency room, ICU, skilled or rehabilitation setting.
 </li>
 <li>
 Working knowledge of MS Office including Word, Excel, PowerPoint, and Teams in a Windows based environment and an ability to quickly learn new systems and ability to troubleshoot and resolve basic technical difficulties in a remote environment.
 </li>
 <li>
 Possess an interest in working in the managed care industry
 
 
 </li>
 </ul>
 
 Preferred Qualifications
 
 
 
 <ul>
 <li>
 Bachelor's degree
 </li>
 <li>
 Previous Medicare/Medicaid experience.
 </li>
 <li>
 Previous experience in prior authorization, utilization management.
 </li>
 <li>
 Experience working with MCG or Interqual guidelines.
 </li>
 <li>
 Certification in Case Management, (CCM) or Utilization Review, (UR).
 </li>
 <li>
 Knowledge of payer policies, insurance companies and government health programs.
 
 
 </li>
 </ul>
 
 Workstyle:
 
 Remote Work at Home
 
 
 
 Location:
 
 Must reside in a state that participates in the enhanced compact license, (eNLC)
 
 
 
 Work Schedule:
 
 Weekdays 8:00 AM to 4:30 PM Central Time
 
 
 
 Travel:
 
 None
 
 
 
 Additional Information
 
 
 
 
 Work At Home Requirements
 
 
 
 <ul>
 <li>
 WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
 </li>
 <li>
 A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
 </li>
 <li>
 Satellite and Wireless Internet service is NOT allowed for this role.
 </li>
 <li>
 A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
 
 
 </li>
 </ul>
 
 The DOW SkillBridge Internship Program
 
 provides transitioning military service members time to gain civilian work experience while still on active duty with an employer for a period approved by their command and the DOW, with an average timeline of 90 days.
 
 
 
 The Military Spouse Fellowship Program
 
 connects military spouses with employers offering a variety of professional onsite, field, or remote based opportunities for a period up to 12 weeks.
 
 
 <ul>
 <li>
 Networking opportunities will be provided while participating in the Internship or Fellowship.
 </li>
 <li>
 Due to factors such as location, and/or requirements that cannot be modified, full-time employment is not guaranteed upon completion of the Internship or Fellowship.
 
 
 </li>
 </ul>
 
 Interview Format
 
 As part of our hiring process, we will be using a screening and interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring leaders with an enhanced method for decision-making. If you are selected to move forward from your application prescreen, you will receive an email correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview.
 
 (please be sure to check your spam or junk folders often to ensure communication isn't missed)
 
 If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
 
 
 Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
 
 
 
 
 
 Scheduled Weekly Hours
 
 
 
 
 
 1
 
 
 
 About Us
 
 
 
 Humana Inc. (NYSE: HUM) is committed to putting health first &ndash; for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health &ndash; delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
 
 
 
 Equal Opportunity Employer
 
 
 
 It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
</div>

Preauthorization Registered Nurse

CVS Health

<div>We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger &ndash; helping to simplify health care one person, one family and one community at a time.
Position Summary
At Aetna, our health benefits business, we are committed to helping our members achieve their best health in an affordable, convenient, and comprehensive manner. Combining the assets of our health insurance products and services with CVS Health&rsquo;s unrivaled presence in local communities and their pharmacy benefits management capabilities, we&rsquo;re joining members on their path to better health and transforming the health care landscape in new and exciting ways every day.
Aetna is seeking an Executive Director, Clinical Health Services for Aetna Clinical Solutions. This critical leader will oversee enterprise clinical strategy and operations that drive high‑quality care management, exceptional member experiences, and strong clinical outcomes. The Executive Director provides strategic direction, operational leadership, and day‑to‑day oversight of multidisciplinary teams of clinicians and support staff.
This role partners closely across the enterprise&mdash;clinical teams, quality, operations, program design, finance, and external healthcare partners&mdash;to deliver coordinated care, ensure regulatory compliance, optimize utilization, and advance organizational goals.
Key Responsibilities
Strategic &amp; Operational Leadership<ul><li>
Lead the development and execution of clinical strategy supporting Commercial Care and Specialty Operations.</li><li>
Oversee daily operations for multidisciplinary care teams, ensuring consistent, high‑quality clinical practices and service delivery.</li><li>
Develop and implement staffing models that are cost‑effective, compliant, and aligned with membership and business needs.</li><li>
Manage budget, staffing, and operational performance across lines of business.</li></ul>
Clinical Excellence &amp; Care Coordination<ul><li>
Collaborate across departments to support comprehensive member care, including assessments, care planning, coordination with providers, and continuous monitoring to improve outcomes.</li><li>
Guide teams to advocate for members, ensuring effective communication, resource utilization, and overall well‑being.</li><li>
Direct implementation of care models, workflows, and procedures that ensure high‑quality, evidence‑based care.</li><li>
Conduct and oversee clinical record reviews to ensure documentation quality and timeliness.</li></ul>
Performance, Utilization, and Quality<ul><li>
Monitor and analyze performance of utilization management and care management programs; implement strategies to improve outcomes and experience.</li><li>
Identify operational gaps and lead initiatives to enhance efficiency, clinical quality, and member and provider satisfaction.</li><li>
Ensure compliance with all applicable federal and state regulations.</li></ul>
Cross‑Functional Partnership &amp; Stakeholder Engagement<ul><li>
Partner with executive leaders, internal teams, regulators, consultants, and external stakeholders to advance clinical and operational objectives.</li><li>
Maintain relationships with community health providers, ambulatory partners, and population health organizations to support coordinated care across the continuum.</li><li>
Represent the organization in key meetings and with external agencies, including governmental and payer entities.</li></ul>
People Leadership &amp; Culture<ul><li>
Lead, develop, mentor, and inspire high‑performing teams through coaching, recognition, and effective change leadership.</li><li>
Build an environment that supports professional development, mobility, and operational excellence.</li><li>
Foster a culture grounded in CVS Health&rsquo;s Heart‑At‑Work Behaviors with a strong focus on members and colleagues.</li><li>
Support recruitment, retention, and engagement of a diverse, inclusive workforce reflective of the communities we serve.</li></ul>
Program Strategy &amp; Standardization<ul><li>
Partner with Clinical Health Services leadership to advance standardized practices for care transition management and enterprise clinical operations.</li><li>
Define training strategies for clinical and program staff to support consistent, high‑quality practices.</li><li>
Lead annual goal‑setting and operational planning aligned with Clinical Health Services and organizational priorities.</li></ul>
Required Qualifications
The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment. This position offers broad exposure to all aspects of the company&rsquo;s business, as well as significant interaction with all the business leaders. The candidate will be expected to have the following key attributes:<ul><li>
10+ years progressive experience in clinical care management, population health, or utilization management.</li><li>
Unrestricted RN license in good standing.</li><li>
5+ years of senior leadership overseeing multi‑disciplinary clinical teams.</li><li>
Demonstrated success leading large‑scale care management programs (case, disease, and complex care management).</li><li>
Experience with commercial populations (employer‑sponsored insurance) strongly preferred.</li><li>
Proven accountability for clinical outcomes, utilization management, and financial performance.</li><li>
Strong relationship‑building experience with external clients, including plan sponsors and consulting firms.</li><li>
Expertise in program strategy, including planning, executing, and optimizing strategic initiatives.</li><li>
Deep knowledge of improving quality of care and reducing costs across operations, network management, provider relations, and care/medical management.</li><li>
Strong analytical and data capabilities, including modeling, synthesizing information, and deriving actionable insights.</li><li>
Expertise in clinical and health plan operations, including Policy Management, Care Management, Quality, Compliance, and Regulatory Management.</li><li>
Proven ability to drive new strategies and lead initiatives in cross‑functional, matrixed environments.</li><li>
Skilled in leading, influencing, and motivating teams to achieve high performance and outcomes.</li><li>
Adept at simplifying and communicating complex information to diverse audiences.</li><li>
Strong critical thinking, disciplined decision‑making, and focus on timely execution.</li><li>
Demonstrated experience transitioning from traditional approaches to innovative strategies and championing change.</li><li>
Effective problem‑solving abilities and strong organizational, multi‑tasking, and adaptability skills.</li><li>
Skilled in tactful communication with customers, community stakeholders, and clinical staff.</li><li>
Ability to evaluate cost‑benefit impacts to inform sound decisions.</li><li>
Experience working within clinical settings and across diverse cultural dynamics of staff and patients.</li><li>
Knowledge of care transitions and available patient resources.</li><li>
Digital literacy with the ability to manage sensitive information ethically and responsibly.</li><li>
Open to remote work arrangements across the U.S.</li></ul>
Preferred Qualifications<ul><li>
Certification in Case Management (CCM, ACM) or related population health credentials.</li><li>
Experience integrating or overseeing digital health or vendor‑based care solutions.</li><li>
Background in enterprise clinical transformation or population health strategy.</li></ul>
Education 
Master&rsquo;s Degree preferred. Active RN license required.
Travel
25%
Pay Range
The typical pay range for this role is:
$184,112.00 - $396,550.00 
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company&rsquo;s equity award program. 
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits &ndash; investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul><li>
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li><li>
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li><li>
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li></ul>
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 04/18/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</div>

Executive Director, Clinical Health Services - Aetna Clinical Solutions

<div>We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger &ndash; helping to simplify health care one person, one family and one community at a time.
Position Summary 
The External Affairs Administrator will inform and execute the OhioRISE Plan&rsquo;s outreach and engagement activities in priority communities and with priority stakeholders.<div>
Responsibilities include:</div><div> 
a. Serve as the primary OhioRISE Plan contact for all county and child-serving agencies, promoting alignment between community needs and the OhioRISE Plan and encouraging collaboration amongst local leaders, organizations, stakeholders, CMEs, and the OhioRISE Plan.</div><div>
b. Act as the primary liaison for the OhioRISE Plan in facilitating ODM-approved improvement initiatives that involve community-based organizations and necessitate outreach and engagement efforts that ensure broad participation, foster collaboration, and address community-specific needs effectively.</div><div>
c. Arrange regular, in-person meetings with ODM and other state funded community-based organizations, using these meetings to bolster the presence of the OhioRISE Plan as a trusted collaborative partner, share updates, discuss objectives, and strengthen collaboration.</div><div>
d. Develop and offer resources such as presentations, workshops, forums, and trainings for county or local child serving entities regarding the roles and responsibilities of the OhioRISE Plan.</div><div>
e. Lead internal Regional Teams, including primary responsibility for the development and monitoring of county profiles and all associated reporting.</div><div>
f. Engage with external partners (CMEs; county and child-serving entities; MCO Regional Coordinators) and internal partners (quality, utilization management, care coordination, network, and provider relations) to identify service and resource needs in local communities and collaborate with these partners to address the identified gaps.</div><div>
g. In partnership with ODM, establish stakeholder specific frameworks to include objectives, intended outcomes, and results.</div><div>
h. Facilitate and manage OhioRISE Plan participation at state-wide and community events within identified priority communities and in partnership with priority stakeholders.</div><div>
i. Act as priority system experts, providing specialized guidance and support to both internal and external partner</div> 
Required Qualifications
Must reside in Ohio<ul><li>
At least 5-7 years&rsquo; experience in a setting that includes services for or management of multi-system youth, work with local/community systems of care, and knowledge of Ohio&rsquo;s child-serving systems.</li><li>
Relevant experience related to child-serving systems and processes, public sector behavioral health care, and networking with experts in these fields.</li><li>
Demonstrated experience successfully implementing change in complex organizations.</li><li>
Demonstrated experience with large-scale initiatives with a high degree of complexity.</li><li>
Knowledge of Ohio&rsquo;s child-serving systems, including but not limited to public children services agencies, boards of developmental disabilities, county behavioral health authorities, hospitals, the education system, family and children first councils, and the juvenile justice system.</li><li>
Knowledge of key resources for children, youth and families in the State of Ohio.</li><li>
Knowledge of the management of multi-system youth.</li><li>
Relationship management skills</li><li>
Collaboration and teamwork skills</li><li>
Time management skills</li><li>
Data analysis skills</li><li>
Negotiation/influencing skills</li><li>
Change management skills</li><li>
Conflict resolution skills</li><li>
Critical thinking skills</li><li>
Oral, written, and presentation communications skills</li><li>
Customer service skills</li><li>
Personal computer operations, keyboard navigation, and MS Office Suite applications skills</li><li>
Ability to work with all levels of management</li><li>
Ability to complete additional tasks as directed by manager</li><li>
Ability to demonstrate regular and reliable attendance.</li><li>
Ability to travel, mostly in-state with personal vehicle. Qualified candidates must have reliable transportation, valid/active driver&rsquo;s license, and proof of vehicle insurance.</li></ul> 
Preferred Qualifications<ul><li>
Knowledge and experience with high fidelity wraparound and care coordination preferred.</li><li>
Knowledge of state Medicaid managed care market, regulations, and practices preferred.</li><li>
Knowledge of Ohio&rsquo;s behavioral health system preferred.</li><li>
Project management skills preferred.</li><li>
Strategic planning skills preferred.</li><li>
Regional management/coordination skills preferred.</li><li>
Experience working within the child welfare or children's behavioral health hospital setting preferred.</li><li>
Advanced degree</li></ul>
Counties that we prefer candidates to live within or be near:<ul><li>
Defiance, Fulton, Henry, Lucas, Mercer, Paulding, Putnam, Van Wert, Williams</li></ul> 
Education
Bachelor&rsquo;s degree or equivalent work experience
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$60,300.00 - $132,600.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits &ndash; investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul><li>
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li><li>
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li><li>
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li></ul>
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 03/27/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</div>

External Affairs Administrator

CenterWell

<div><h1 class="jobSectionHeader">Become a part of our caring community and help us put health first 
</h1>
The Specialty Operations Pharmacy Technician 2 supports Pharmacists in Specialty Rx medication preparation by dispensing Specialty Rx medications. The Specialty Operations Pharmacy Technician 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.
The Specialty Operations Pharmacy Technician 2 May contact physicians for prescriptions clarification and may enter prescription orders into the system. Also supports Pharmacists and Patients by ensuring adherence to Specialty Rx specific operational processes and programs developed to optimize health outcomes which includes effective communication with patients and providers. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, andworks under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.<h1 class="jobSectionHeader"> 
Use your skills to make an impact 

</h1>Required Qualifications 
Must have an active license with the Board of Pharmacy in the appropriate state. 
Certified Pharmacy Technician.
Schedule: Monday-Friday: 8 AM-4:30 PM EST
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. 

$40,000 - $52,300 per year 
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, &ldquo;Humana&rdquo;) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.<h1 class="jobSectionHeader"> 
About us 
</h1>
About CenterWell Pharmacy: CenterWell Pharmacy provides convenient, safe, reliable pharmacy services and is committed to excellence and quality. Through our home delivery and over-the-counter fulfillment services, specialty, and retail pharmacy locations, we provide customers simple, integrated solutions every time. We care for patients with chronic and complex illnesses, as well as offer personalized clinical and educational services to improve health outcomes and drive superior medication adherence.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation&rsquo;s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first &ndash; for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. 
 
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.</div>

Specialty Operations Pharmacy Technician 2 Pharm ops

<div><h1 class="jobSectionHeader">Become a part of our caring community and help us put health first 
</h1>
The Certified Pharmacy Technician takes in-bound phone calls from patients and providers. Enter prescription orders into the system. Also support Pharmacists and Patients by ensuring adherence to Specialty Rx specific operational programs developed to improve health outcomes which includes effective communication with patients and providers. Typically focus decisions on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follow standard practices that allow for some opportunity for interpretation/deviation and independent discretion.
Position Hours: An 8-hour shift Monday-Friday from 8am - 4:30pm EST<h1 class="jobSectionHeader"> 
Use your skills to make an impact 

</h1>Required Qualifications:<ul><li>
Must have an active license with the Board of Pharmacy in the state of residence (Ohio, Arizona or Florida)</li><li>
Must be certified by the Pharmacy Technician Certification Board (PTCB) or through ExCPT</li><li>
Experience as a Pharmacy Technician OR call center experience in a pharmacy or related call center setting</li><li>
Critical thinker who can anticipate member/customer needs and take initiative, ask the right questions and deliver the highest quality customer experience</li><li>
Problem solver who can find viable solutions that meets member/customer needs, absent from all ideal resources</li><li>
Moderate working knowledge of Excel</li></ul>
Preferred Qualifications:<ul><li>
Working knowledge of RxNova, CRM and/or ScriptMed</li><li>
Experience using multiple computer applications simultaneously and strong data entry skills</li></ul>
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. 

$40,000 - $52,300 per year 
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, &ldquo;Humana&rdquo;) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.<h1 class="jobSectionHeader"> 
About us 
</h1>
About CenterWell Pharmacy: CenterWell Pharmacy provides convenient, safe, reliable pharmacy services and is committed to excellence and quality. Through our home delivery and over-the-counter fulfillment services, specialty, and retail pharmacy locations, we provide customers simple, integrated solutions every time. We care for patients with chronic and complex illnesses, as well as offer personalized clinical and educational services to improve health outcomes and drive superior medication adherence.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation&rsquo;s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first &ndash; for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. 
 
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.</div>

Specialty Operations Pharmacy Technician

<div><h1 class="jobSectionHeader">Become a part of our caring community and help us put health first 
</h1>
Bring your unique talents and perspectives to CenterWell and help us bring better healthcare solutions to our members. At CenterWell, you&rsquo;ll have the opportunity to interact with members, provide professional advice, and enable positive outcomes in a growing organization and have the option to work at home. CenterWell&rsquo;s innovative approach to mail-order pharmacy solutions enables us to outpace the competition, with the well-being of our members in mind. Our innovative Pharmacy Solutions offers a cost-effective, easy way for our members to receive their medications without waiting in line and giving them back more time in their days to enjoy life. We&rsquo;re looking for people from a variety of healthcare backgrounds to join our growing pharmacy team and work with people at all levels of the industry. At CenterWell, you&rsquo;ll partner with people who care. Administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.<ul><li>
Provides resolution or outreach for resolution on prescriptions that are incomplete, invalid, or contain clinical issues preventing the fulfillment of the request</li><li>
Decisions based on interpretation of area/department policy and methods for completing assignments</li><li>
Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction</li><li>
Communicate with physician offices and hospitals via fax or telephone</li><li>
Responsible for researching and updating clarifications and denials on patient profiles</li><li>
Responsible for making or taking phones calls to and from providers, patients and/or retail pharmacies.</li></ul><h1 class="jobSectionHeader"> 

Use your skills to make an impact 

</h1>Required Qualifications
Candidates MUST reside in one of the following states: Texas, Arizona, Florida, or Ohio.<ul><li>
Must have an active Pharmacy Technician License in the state you reside</li><li>
1+ years of experience as a Pharmacy Technician in a retail, mail order or hospital pharmacy</li><li>
Ability to solve problems and encourage others in collaborative problem solving</li><li>
Self-directed, but also able to work well in a group</li><li>
A positive, proactive attitude, energetic, highly motivated and a self-starter</li><li>
Inbound/outbound call experience in any pharmacy setting
</li><li>Strong communication skills both written and verbal</li><li>
Great attention to detail</li><li>
Ability to handle multiple tasks simultaneously</li><li>
Ability to work accurately and efficiently while performing repetitive tasks</li><li>
Intermediate PC skills</li></ul>
Required Work Schedule:<ul><li>
Must have the flexibility to work any hours between 8:00am-8:00pm CST.</li></ul>
Preferred Qualification<ul><li>
High School Diploma or GED</li><li>
National Certification, PTCB/CPhT</li></ul>
Additional Information
**PLEASE MAKE SURE YOU ATTACH YOUR RESUME TO YOUR APPLICATION (PDF OR WORD FORMAT) **
Interview Process
As part of our hiring process for this opportunity, we will be using technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. 

$40,000 - $52,300 per year 
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, &ldquo;Humana&rdquo;) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.<h1 class="jobSectionHeader"> 
About us 
</h1>
About CenterWell Pharmacy: CenterWell Pharmacy provides convenient, safe, reliable pharmacy services and is committed to excellence and quality. Through our home delivery and over-the-counter fulfillment services, specialty, and retail pharmacy locations, we provide customers simple, integrated solutions every time. We care for patients with chronic and complex illnesses, as well as offer personalized clinical and educational services to improve health outcomes and drive superior medication adherence.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation&rsquo;s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first &ndash; for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. 
 
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.</div>

Dr. Call Mail Operations Pharmacy Technician

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