• Lead, structure and execute IT Governance consulting projects focused on process optimization, governance/management models, value chain and organizational structures. • Map, model and document IT processes using BPMN notation. • Conduct reviews and propose improvements to IT organizational structures to increase efficiency and strategic alignment. • Implement and monitor the execution of new IT Governance processes and controls, ensuring adherence and sustainability of solutions. • Apply and deploy IT frameworks and best practices such as COBIT and ITIL in real process and project contexts. • Develop and track performance and compliance indicators to measure governance effectiveness, IT process performance and organizational structure performance. • Promote an IT governance and process culture by training teams and disseminating knowledge. • Conduct interviews and facilitate workshops with stakeholders to map needs and identify opportunities. • Foster a culture of governance and compliance within IT, ensuring adherence to established processes and policies. • Prepare and deliver management and executive presentations to report on project deliverables and results. • Work across the entire value chain of processes, from data collection, organization and analysis to the design and implementation of data-driven strategic solutions.

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’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 – helping to simplify health care one person, one family and one community at a time. Position Summary Help us elevate our patient care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country. Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities. Develops, implements, and supports Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work. Services and strategies, policies and programs are comprised of network management, clinical coverage, and policies. Our Case Managers use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost effective outcomes. - Acts as a liaison with member/client /family, employer, provider(s), insurance companies, and healthcare personnel as appropriate. - Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care. - Interacts with members/clients telephonically or in person. May be required to meet with members/clients in their homes, worksites, or physician’s office to provide ongoing case management services. - Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client’s appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determination of eligibility for benefits as appropriate. - Communicates with member/client and other stakeholders as appropriate (e.g., medical providers, attorneys, employers and insurance carriers) telephonically or in person. - Prepares all required documentation of case work activities as appropriate. - Interacts and consults with internal multidisciplinary team as indicated to help member/client maximize best health outcomes. - May make outreach to treating physician or specialists concerning course of care and treatment as appropriate. - Provides educational and prevention information for best medical outcomes. - Applies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by individual insurance carriers and referral sources. - Conducts an evaluation of members/clients’ needs and benefit plan eligibility and facilitates integrative functions using clinical tools and information/data. - Utilizes case management processes in compliance with regulatory and company policies and procedures. - Facilitates appropriate condition management, optimize overall wellness and medical outcomes, appropriate and timely return to baseline, and optimal function or return to work. - Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes, as well as opportunities to enhance a member’s/client’s overall wellness through integration. - Monitors member/client progress toward desired outcomes through assessment and evaluation. Required Qualifications - Minimum 3-5 years clinical practical experience preference required - Minimum 2-3 years CM, discharge planning and/or home health care coordination experience - Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually - Ability to travel within a designated geographic area for in-person case management activities as directed by Leadership and/or as business needs arise - Excellent analytical and problem-solving skills - Effective communications, organizational, and interpersonal skills - Ability to work independently - Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications. - Efficient and Effective computer skills including navigating multiple systems and keyboarding - Must possess reliable transportation and be willing and able to travel up to 50% of the time in Elmwood park and surrounding areas. Mileage is reimbursed per our company expense reimbursement policy Preferred Qualifications Certified Case Manager Candidates that reside in or near 60707, 60639, 60171, 60634 Education Associates Required, Bachelor's preferred License: Active and unencumbered Registered Nurse License in the state of Illinois Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $66,575.00 - $142,576.00 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 – 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: - Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. - No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. - 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. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 04/03/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Overview HarmonyCares is a leading national value-based provider of in-home primary care services for people with complex healthcare needs. Headquartered out of Troy, Michigan, HarmonyCares operates home-based primary care practices in 14 states. HarmonyCares employs more than 200+ primary care providers to deliver patient-centered care under an integrated, team-based, physician-driven model.  Our Mission – To bring personalized, quality-based healthcare to the home of patients who have difficult accessing care.  Our Shared Vision – Every patient deserves access to quality healthcare.  Our Values – The way we care is our legacy. Every interaction counts. Go the extra mile. Empower and support each other.  Why You Should Want to Work with Us - Accountable Care Organization - 401K Retirement Plan - Paid Orientation and Training - Established in 11 states - A+ rated malpractice coverage with tail coverage - No holidays, no hospital rounds  More details about the benefits we offer can be found at https://careers.harmonycares.com/benefits. Responsibilities The Nurse Practitioner delivers annual risk assessment in a residential setting or telehealth, within the scope of practice for a Nurse Practitioner, as delegated by the Collaborative Physician.  Essential Duties and Responsibilities - Conduct comprehensive in-home health risk assessments to identify all active and chronic disease conditions, as well as determine all physical, mental, and social needs present at the time of the visit - Takes history, examines, determines diagnoses. - Provides written documentation of patient visit, per NCQA standards - Takes patient vital signs, as necessary. - Places case management referrals and communicates with PCP as necessary. - Communicates with patients, caregivers, agency nurses, other providers and vendors as necessary to assure proper diagnosis. - Performs all clinical duties while observing OSHA Universal Precautions - Maintains patient confidentiality - Attends required meetings and in-services and participates in committees, as requested - Participates in professional development activities and maintains professional licenses and affiliations In this role you may work with. . . - Teammates - Physicians - Medical Staff - Patients - Caregivers - Agency Nurses - Providers - Vendors Qualifications Required Knowledge, Skills, and Experience - Active/unrestricted nurse practitioner license to practice in coverage states - Board certification in one of the following: American Nurses Credentialing Center (ANCC), American Association of Nurse Practitioners (AANP) or National Commission on Certification of Physician Assistants (NCCPA) - Active BLS Certification - Current enrollment in Medicare/Medicaid - Must maintain a valid driver’s license and good driving record - Outstanding EHR skills Preferred Knowledge, Skills and Experience - Geriatric training/experience - Skill in teamwork and maintaining effective working relationships with patients, medical staff, and the public Conditions of this role to be aware of. . . - Adaptability to differing weather conditions and patients’ home/residential environments - Full range of body motion including handling/lifting patients.  Manual and finger dexterity, eye-hand coordination, normal visual acuity, normal hearing, standing, bending, walking and stair climbing - Regular lifting/carrying items weighing up to 50 pounds - Ability to ride in automobile or van up to 150 miles daily in urban and/or rural settings.  Ability to drive, if necessary Pay Transparency Individual compensation packages are based on various factors unique to each candidate, including skill set, experience, qualifications, and other job-related considerations.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description At Playlist, we're reimagining how technology can protect and empower businesses in the dynamic world of payments. As our Risk Manager, you'll be the strategic guardian of our payment ecosystem, transforming risk management from a compliance function into a critical business enabler. - Architect a comprehensive risk management framework that proactively identifies and mitigates operational, financial, regulatory, and reputational risks across the merchant lifecycle. - Design and implement sophisticated risk controls and scoring methodologies that balance business growth with robust protection, leveraging data-driven insights to make strategic decisions. - Lead merchant onboarding and ongoing monitoring processes, conducting thorough KYC/KYB reviews and enhanced due diligence to ensure the integrity of our payment ecosystem. - Monitor transaction activities to detect anomalies, fraud indicators, and emerging trends, maintaining compliance with card network performance thresholds. - Collaborate cross-functionally with Product, Engineering, Legal, and Operations teams to embed risk controls seamlessly into business processes. - Prepare and deliver compelling risk reports that translate complex data into actionable insights for executive leadership. - Serve as the primary risk liaison with sponsor bank partners, ensuring alignment with regulatory frameworks and partner expectations. - Develop and deliver internal training programs that elevate the organization's risk awareness and financial crime prevention capabilities. Qualifications - 5+ years of experience in risk management within payments, fintech, acquiring, or banking environments. - Deep understanding of Payment Facilitator (PayFac) models and sub-merchant oversight requirements. - Proven expertise in underwriting, transaction monitoring, and portfolio risk management. - Comprehensive knowledge of card network rules and chargeback monitoring programs. - Advanced analytical and investigative skills with the ability to interpret complex data sets. - Demonstrated experience working collaboratively with sponsor banks and regulatory bodies. - Strong communication skills that bridge technical complexity and strategic vision. Requirements - Professional certifications such as CAMS or CFE. - Experience building or scaling risk programs in high-growth environments. - Familiarity with BSA/AML obligations and financial crime frameworks. - Background in payment gateways and acquiring operations. Benefits - Competitive compensation. - Unlimited vacation. - Opportunity to make a meaningful impact in the payments landscape.