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.
Job Summary:
Administers project and process management initiatives, overseeing their execution and ensuring adherence to established standards and guidelines.
Advises the general manager and senior leadership on project and process management strategies, providing insights and recommendations to drive organizational success.
Aligns project and process management activities with the organization's overall business objectives and strategic direction.
Approves project plans, budgets, and resource allocations, ensuring their alignment with project objectives and organizational priorities.
Communicates strategically across the organization, fostering effective collaboration and alignment between project teams, stakeholders, and top management.
Contributes to top-level decision making by providing project and process management expertise and insights, supporting the achievement of strategic goals.
Controls all project and process management systems, resources, and activities, ensuring efficient and effective project delivery and process optimization.
Counsels project teams and stakeholders, offering guidance and support to overcome challenges and achieve project goals.
Defines programs and methodologies for project and process management, establishing best practices and frameworks to enhance project performance and efficiency.
The Lead Director will be responsible for leading a team of analysts dedicated north star initiatives focusing on reducing overturns. This role will leverage data-driven insights to inform strategic decision-making and drive continuous improvement initiatives. The ideal candidate will possess strong analytical skills, a deep understanding of appeals and claims, and the ability to communicate effectively to stakeholders at all levels.
Key Responsibilities:
- Data Management and Reporting:
- Collaborate with data analysts to ensure the accurate collection and analysis of relevant data to support root cause investigations.
- Develop and present comprehensive reports and dashboards that summarize findings, insights, and recommendations for stakeholders.
- Cross-Functional Collaboration:
- Partner with various departments (e.g., operations, finance, clinical) to identify areas for improvement and ensure alignment with organizational goals.
- Facilitate cross-functional workshops and meetings to discuss findings and collaboratively develop action plans.
- Continuous Improvement Initiatives:
- Lead initiatives aimed at addressing identified root causes, implementing solutions that enhance operational efficiency and effectiveness.
- Monitor the impact of implemented solutions and adjust strategies as necessary to achieve desired outcomes.
- Education:
- Bachelor’s degree
Required Experience:
- 5+ years of experience in appeals and claims operations, data analysis, or a related field, with at least 5 years in a leadership role.
- 5+ years in Project or program management
- Proven track record of managing teams and driving continuous improvement initiatives in a complex, matrixed organization.
- Skills:
- Strong analytical and problem-solving skills, with the ability to interpret and present complex data.
- Excellent communication and interpersonal skills, with the ability to influence and engage stakeholders at all levels.
- Proficiency in data analysis tools and software (e.g., SQL, Tableau, Power BI, Excel).
- Attributes:
- High emotional intelligence and the ability to build trust-based relationships.
- Strong bias for action and results-oriented mindset.
- Ability to navigate ambiguity and balance competing priorities effectively.
Preferred Qualifications:
- Experience in the healthcare, insurance, or financial services industries.
- Knowledge of quality improvement methodologies (e.g., Six Sigma, Lean) and their application in root cause analysis.
Pay Range
The typical pay range for this role is:
$100,000.00 - $231,540.00
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’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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Skills Required
- Bachelor's degree
- 5+ years of experience in appeals and claims operations, data analysis, or a related field, with at least 5 years in a leadership role
- 5+ years in project or program management
- Proven track record of managing teams and driving continuous improvement initiatives in a complex, matrixed organization
- Proficiency in data analysis tools and software (SQL, Tableau, Power BI, Excel)
- Strong analytical and problem-solving skills (ability to interpret and present complex data)
- Excellent communication and interpersonal skills with ability to influence stakeholders
- High emotional intelligence, bias for action, and ability to navigate ambiguity
- Experience in the healthcare, insurance, or financial services industries
- Knowledge of quality improvement methodologies (e.g., Six Sigma, Lean) and root cause analysis
What We Do
CVS Health is the leading health solutions company that delivers care in ways no one else can. We reach people in more ways and improve the health of communities across America through our local presence, digital channels and our nearly 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses and nurse practitioners. Wherever and whenever people need us, we help them with their health – whether that’s managing chronic diseases, staying compliant with their medications, or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day.
