• Administer and manage employee benefits programs, including health insurance, retirement plans, wellness programs, and other benefits. • Assist employees with benefits-related inquiries and provide guidance on plan options and enrollment processes. • Act as a point of escalation to assist employees with dependent eligibility verifications and processing qualified life event changes. • Collaborate with benefits providers and vendors to resolve issues and ensure optimal service delivery. • Ensure compliance with federal, state, and local regulations related to employee benefits. • Perform quality checks of benefits-related data and run ad-hoc benefit reports. • Assist in retirement and benefit plan compliance activities including annual retirement plan audits, IRS audits, non-discrimination testing, Form 5500 filings, and related communications. • Assist in the development and implementation of new benefit programs and initiatives. • Complete monthly invoice billing reconciliation and payment processes. • Help to identify and implement wellness programs to promote employee well-being and reduce healthcare costs. • Participate in various HR related special projects and other duties as assigned.

Overview Carenet Health is not authorized to hire in certain states due to internal business considerations: CA, CO, NY, NJ, NV, OR, WA, MD, RI, WV, AK, HI, CT, DE, VT, or Puerto Rico Are you a compassionate, self-motivated registered nurse with top-notch critical thinking and clinical skills? Seeking a challenging yet remote registered nurse position that keeps your abilities sharp? Imagine a fast-paced role engaging with patients through innovative channels, all from the comfort of your home. Join us in an organization poised for unprecedented growth, offering work-from-home options. With excellent coaching and support, you'll be part of a collaborative team of RNs across the country. If you're ready to contribute to a dynamic healthcare environment, apply now and shape the future of healthcare from the convenience of your home. Responsibilities The Care Advisor is a licensed Registered Nurse reporting to the Clinical Services team. They provide quality driven telephonic clinical assessments, health education, and utilization management services to a diverse population of callers/patients/members. A Care Advisor provides triage assessments to individuals or defined patient populations using telecommunications, in accordance with computer-based algorithms, protocols, and guidelines. The Care Advisor uses critical thinking, essential multitasking skills and effective communication. They use their clinical knowledge to assess, disposition, make recommendations for care, provide education and health information. Essential Duties and Responsibilities - Using the Nursing Process, provides nursing assessments within the standards outlined in the state Nurse Practice Act - Provides assessments to individuals or defined patient populations using telecommunications in accordance with computer-based algorithms, protocols, and guidelines - Using the defined process, adheres to nursing standards, company policies and shared principles when providing clinical assessments and health education - Uses the nursing process to identify patient care needs, risk and safety issues, educational opportunities, and appropriate health care referrals: - Processes calls based on Quality Management guidelines. - Demonstrates compliance with all product’s specific performance metrics - Regular, reliable attendance and timeliness - Must work 4 weekend shifts per month- either in every Saturday schedule or every other weekend. - Other duties as assigned Qualifications - Education: - Current, unrestricted, RN licensure in a compact state which is your state of residence. Licensure in other States as required by law or client contract will be assigned within 30 days of hire. - Must reside in a compact state and maintain a compact multistate license. - Current home state RN license in good standing. - Registered nurse is responsible and accountable for safe clinical practice, knowledgeable of customers and regulatory expectations in the clinical area. - Minimum of an associate degree from a two-year college or technical school or Diploma Nursing Program; BSN preferred. - CEU subscription provided at hire- use with Carenet Health email- RNs required to maintain mandatory number of credits per year to maintain all assigned license. - RN must attend training 100% of hours and must pass intra-training testing components. - Experience: - Minimum 3 years of Registered Nurse clinical experience. Experience in ER, adult and pediatric care, Medical/Surgical, Home Health and Hospice or other acute areas preferred. - Telephone triage experience and understanding of health benefit plans and the insurance industry are helpful, but not required. - Bilingual skills are a plus. - Functional/Technical Knowledge, Skills and Abilities Required: - Ability to apply clinical knowledge to effectively meet clinical business standards. - Fully competent in product delivery and business requirements. - Ability to run multiple computer programs at the same time. - Identify opportunities for improvement and recommend workable solutions. - Exercises judgement within defined practices and procedures to determine appropriate action. - Ability to determine when to escalate issues appropriately and in a timely manner. - Builds rapport with members and effectively influences member behavior. - Comprehensive communication (listening, reflection, and clarification) skills. - Manages time effectively. Must currently reside and have a Multi-State (compact) unrestricted RN license in one of the following states: AL, AR, CO, FL, GA, IA, ID, IN, KS, KY, LA, ME, MS, MO, MT, NE, NM, NC, ND, NH, OK, SC, SD, TN, TX, VA, WI, WYAbility to become licensed in additional states as requiredMore important information: Full-time positions available (36-40 hours per week)Your schedule will be evenings and will include at least two weekend days every two weeks. Differential pay may be earned for certain shifts.Training is 2-4 weeks, with the first two weeks during daytime hours. 100% Attendance is required. Training is done in a virtual, interactive classroom setting.For work-from-home positions, your home office must meet certain certification requirements that would be explained to you during the interview process. Compensation & Benefits At Carenet Health, we value the expertise and dedication of our team members, and we are committed to offering an appealing compensation package. The salary range for the Registered Nurse role is $34.00 per hour. In addition, we offer a comprehensive benefits package that includes health, dental, and vision insurance, a 401(k) plan with company match, paid time off (PTO) and holidays, flexible spending accounts (FSAs), employee wellness programs, and career development opportunities. Additional Information Note: Completion of assessments may be required before an applicant can move forward. Completing assessments must be done independently. Any discovery of unauthorized completion, whether during or after the hiring process, will result in disqualification or termination. Carenet Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other characteristic protected by law. Please note that we are not accepting resumes for this position from external staffing agencies or recruiters. To be considered for this role, please submit your application directly through our official career portal. Req no.: 5257 #INDclinical

• Direct the execution of HR compliance initiatives and projects, including scope definition, deliverable assignment, scheduling, issue resolution, and resource coordination. • Direct, develop and deliver change management strategies, communication plans, and end-user training related to HR compliance programs and initiatives. • Design, implement, and maintain HR policies and procedures to support ethical, legal, and compliant business practices; regularly update and maintain the Red Cross Employee Handbook. • Provide oversight of the Leaves of Absence and Accommodations team to ensure compliant administration, strong customer service, and alignment with workforce and business objectives. • Direct and govern the development and administration of Equal Employment Opportunity (EEO) and Affirmative Action (AA) programs, ensuring compliance with federal and state requirements. • Represent the organization with regulatory, enforcement, and community agencies as needed; oversee and direct AA/EEO education and training initiatives. • Design and implement reporting and analytics methodologies to meet regulatory, compliance, and business needs; analyze complex data to identify trends, gaps, and improvement opportunities. • Administer and continuously improve HR compliance monitoring and tracking systems to ensure accuracy, efficiency, and reliability. • Preside over all internal and external HR audits, including audit planning, stakeholder coordination, data review, findings analysis, and development of corrective action plans. • Serve as a people manager, interpreting and administering policies, processes, and procedures that impact teams and subordinate functions.

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 As a Senior Investigator you will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse. Routinely handles cases that are sensitive or high profile, those that are national in scope, complex cases, or cases involving multiple perpetrators or intricate healthcare fraud schemes. - Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business - Researches and prepares cases for clinical and legal review - Documents all appropriate case activity in case tracking system - Facilitates feedback with providers related to clinical findings - Initiates proactive data mining to identify aberrant billing patterns - Makes referrals, both internal and external, in the required timeframe - Facilitates the recovery of money lost as a result of fraud matters - Provides on the job training to new Investigators and provides guidance for less experienced or skilled Investigators. - Assists Investigators in identifying resources and best course of action on investigations - Serves as back up to the manager as necessary - Cooperates with federal, state, and local law enforcement agencies in the investigation and prosecution of healthcare fraud and abuse matters. - Demonstrates high level of knowledge and expertise during interactions and acts confidently when providing testimony during civil and criminal proceedings - Gives presentations to internal and external customers regarding healthcare fraud matters and Aetna's approach to fighting fraud - Provides input regarding controls for monitoring fraud related issues within the business uni Required Qualifications - Must live in the state of Ohio - 4+ years investigative experience in the area of healthcare fraud, waste and abuse matters. - Working knowledge of medical coding; CPT, HCPCS, ICD10 - Proficiency in Microsoft Office with advanced skills in Excel (must know how to do pivot tables). - Strong analytical and research skills. - Proficient in researching information and identifying information resources. - Strong verbal and written communication skills. - The ability to understand and analyze health care claims and coding - Ability to travel up to 10% (approx. 2-3x per year, depending on business needs) Preferred Qualifications - Previous Medicaid/Medicare investigatory experience - Previous Behavioral Health experience - Exercises independent judgement and uses available resources and technology in developing evidence, supporting allegations for fraud and abuse. - Credentials such as certification from the Association of Certified Fraud Examiners (CFE), or an accreditation from the National Health Care Anti-Fraud Association (AHFI) - Knowledge of Aetna's policies and procedures. - Knowledge and understanding of complex clinical issues. - Competent with legal theories. - Strong communication and customer service skills. - Ability to effectively interact with different groups of people at different levels in any situation. Education Bachelor's degree or equivalent experience ( A bachelor's degree, or an associate's degree with an additional four+ years working on health care fraud, waste, and abuse investigations and audits; Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $46,988.00 - $102,000.00 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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 05/18/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.