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
The Automation Team supports the implementation of strategic initiatives for the Utilization Management (UM) Clinical Services organization. These initiatives leverage advanced technologies such as artificial intelligence, rules engines, predictive analytics, intelligent character recognition, and cognitive AI to automate UM transactions, streamline workflows, and improve the experience for both providers and members. In addition, the team plays a key role in shaping and advancing the automation strategy by identifying high-impact opportunities, aligning initiatives with organizational goals, and driving continuous innovation and value realization.
This role is for a Project Manager within the Automation Team. The Project Manager will be responsible for supporting the delivery of multiple automation features from concept through implementation. They will also contribute to the strategic planning and prioritization of automation initiatives, ensuring alignment with business objectives and long-term transformation goals. The role works closely with business stakeholders to understand feature goals and partners with IT and architecture teams to define and deliver functional solutions. This includes documenting detailed business and technical requirements, user stories, and process flows to guide development efforts.
Key Accountabilities:
- Contribute to and support the product vision and roadmap for assigned automation features and initiatives.
- Translate business goals into user stories and acceptance criteria in collaboration with business and technical teams.
- Participate in backlog grooming, sprint planning, and prioritization to ensure timely delivery of high-quality features.
- Work with cross-functional teams including clinical, business, and IT partners to align on requirements and outcomes.
- Support tracking and communication of progress, risks, and issue resolution across features and projects.
- Identify opportunities to improve automation features, workflows, and user experience.
- Assist in defining success metrics and reporting on performance and value delivered.
Required Qualifications:
- 4–6 years of experience as a Project Manager, Product Owner, Sr. Business Analyst, or similar role delivering business or technical features in an Agile environment.
- Hands-on experience supporting the full project lifecycle: discovery, business case, requirements, development, testing, and release.
- Effective communication and collaboration skills across diverse stakeholder groups.
- Familiarity with working alongside technical teams such as architecture, development, and QA.
- Ability to manage multiple priorities in a dynamic, fast-paced environment.
- Experience developing or supporting business requirements documents and process flows.
- Experience in Managed Care or Healthcare
Preferred Qualifications:
- Experience in product development of microservices and APIs in a cloud-native architecture (e.g., AWS, Azure, GCP).
- Knowledge of FHIR, X12 EDI transactions, interoperability standards and other healthcare integration standards
- Strong understanding of Agile practices and experience using tools like Jira, Confluence, or similar platforms.
- Healthcare industry experience, especially in Utilization Management or clinical operations.
- Familiarity with clinical workflows, utilization review processes, and InterQual/MCG guidelines.
- Experience working in a SAFe or Scaled Agile environment
- Certified Scrum Product Owner (CSPO) or SAFe POPM (Product Owner/Product Manager) certified
Education:
- Bachelor’s degree in Business, Healthcare Administration, Computer Science, or a related field. Equivalent experience (6–8 years) in systems, technology, standards, and process improvement may be considered.
Sponsorship is not available for this position.
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$66,330.00 - $145,860.00This 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.
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
- 4-6 years of experience as a Project Manager, Product Owner, Sr. Business Analyst, or similar role delivering business or technical features in an Agile environment.
- Hands-on experience supporting the full project lifecycle: discovery, business case, requirements, development, testing, and release.
- Effective communication and collaboration skills across diverse stakeholder groups.
- Familiarity with working alongside technical teams such as architecture, development, and QA.
- Ability to manage multiple priorities in a dynamic, fast-paced environment.
- Experience developing or supporting business requirements documents and process flows.
- Experience in Managed Care or Healthcare.
- Bachelor's degree in Business, Healthcare Administration, Computer Science, or a related field (or equivalent experience).
- Experience in product development of microservices and APIs in a cloud-native architecture (e.g., AWS, Azure, GCP).
- Knowledge of FHIR, X12 EDI transactions, interoperability standards and other healthcare integration standards.
- Strong understanding of Agile practices and experience using tools like Jira, Confluence, or similar platforms.
- Healthcare industry experience, especially in Utilization Management or clinical operations.
- Familiarity with clinical workflows, utilization review processes, and InterQual/MCG guidelines.
- Experience working in a SAFe or Scaled Agile environment.
- Certified Scrum Product Owner (CSPO) or SAFe POPM certified.
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.
