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CVS Health
Work at Home, Connecticut, United States
(on-site)
Posted
22 hours ago
CVS Health
Work at Home, Connecticut, United States
(on-site)
Job Type
Full-Time
Industry
Other
Job Function
Other
Claim Automation Product Manager
The insights provided are generated by AI and may contain inaccuracies. Please independently verify any critical information before relying on it.
Claim Automation Product Manager
The insights provided are generated by AI and may contain inaccuracies. Please independently verify any critical information before relying on it.
Description
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.The Lead Director, Technology Product Management for our Claim Automation Portfolio will lead the strategic roadmaps, capabilities, and Objective and Key results (OKRs) definition needed to optimize claim processing. This role requires deep familiarity with health plan claims operations, including the claims adjudication lifecycle, pend management, and rework reduction across multiple lines of business. Across multiple product teams, you are responsible for the overall success of the product, improving product health and driving value towards targeted outcomes, including engaging with and defining product roadmaps with key vendor partners.
You will work closely with the Business General Manager (GM), Design, Engineering, and Data/Analytics as part of the "Five in a Box" cross-functional product leadership team and serve as the main point of contact with other stakeholders such as architects, tech-ops, security, etc. to ensure overall cohesion for the Claim Automation portfolio, including alignment with claims operations leadership across all lines of business. You will lead a team of product management colleagues, creating a positive team culture through development and coaching.
Product Vision, Strategy, and Roadmaps
- Defines and socializes the product vision, strategy and roadmap in collaboration with the 5-in-the-box team; assesses and refines as needed
- Partners with business general manager and stakeholders to make decisions on investment priorities and develop business cases
- Translates customer and business and technology needs into short-term and long-term product strategy by creating Epics/initiatives defined to meet targeted outcomes
- Connects the roadmap to specific value drivers that contribute to business priorities, objectives and key results, and strategic programs
- Responsible for aligning roadmaps, backlogs, capacity, timelines, and commitments across the respective product areas needed to deliver
- Defines product objectives and key results (OKRs), aligned with business objectives, to evaluate progress towards outcomes
Product Backlog Ownership, Work Definition, and Prioritization
- Sets the direction for discovery work, ensuring that the product team is focused on continuous exploration
- Defines features (with input from other Product Management colleagues and functions), identifies dependencies, and works with teams to size ahead of future quarters
- Facilitates product-level ceremonies & meetings, including quarterly PI planning activities (when applicable), in partnership with the product leadership team
Trend Monitoring, Product Performance, and Product Value
- Uses performance data to identify issues quickly, and develop new insights and hypotheses about product health, technical health, and customer feedback
- Tracks product objectives and key results (OKRs), aligned with business objectives, to understand progress towards outcomes and metrics, socializes progress, and consistently reinforces objectives and alignment with broader product portfolio outcomes
- Coordinates product launches, including beta testing, user feedback collection, and product documentation
- Ensures that incremental learnings from product discovery & delivery are prioritized in the backlog.
Cross-Functional Teaming and Stakeholder Management
- Facilitates the 5-in-the-box cross-functional product leadership team, including strong partnership with Business General Manager (GM)
- Ensures business strategies and targeted outcomes are well understood and socialized to product teams
- Understands market and customer needs through partnership with business & customer insight teams
- Showcases the product teams' delivery and final output to stakeholders
Grow and Develop the Team
- Understands the hiring market to identify successful candidates with the unique blend of personality and skillset matches
- Champions strong product management and agile mindsets and values by actively communicating team wins and opportunities
- Establishes high performing teams by growing and coaching product management colleagues (Product Managers, Product Leads, Product Owners, etc.) and defining team norms on how teams working on this product operate
- Responsible for promoting and setting a customer-centric culture where all teams understand the current performance of the product, opportunities areas and the north star vision, and are monitoring and proactively reacting to key product health metrics and communicating updates
Claims Administration & Operations Domain
- Maintains working knowledge of end-to-end claims adjudication - from submission through adjudication, pend, resolution, and payment - across multiple lines of business
- Partners with claims operations leadership and frontline processing teams to identify workflow pain points and rework drivers that inform product priorities
- Tracks claims quality, rework rates, and processor productivity to ground product decisions in operational data
- Understands change management challenges of deploying new tooling into high-volume claims processing environments
Required Qualifications
- 10+ years required experience in product management role
- 5+ years required experience in software product management, with demonstrated success shipping software through multiple releases managing the entire lifecycle from discovery to launch in an agile environment
- 10+ years of experience in technical product management, with focus around building technical products and services.
- 5+ years of experience in building and managing technical product teams using Agile framework
- 5+ years of experience with large-scale modernization programs in technical capacity.
- 5+ years of experience in health plan claims operations, claims administration, or claims technology
Preferred Qualifications
- Ability to drive cross functional teams to alignment in the midst of ambiguity
- Strong decision making skills in fast moving environments
- Experience leading product transformation within a large enterprise
- Strong negotiation, organizational, management, analytical and people skills
- Data-driven decision making and quantitative analysis skills
- General understanding of core programming and computer science concepts, including cloud and AI/ML
- Product Management and/or Agile Certifications
- Experience with claims adjudication platforms in a payer environment
- Understanding of claims automation, RPA, or AI-assisted decision support
- Knowledge of multi-LOB claims operations (Medicare, Commercial, Medicaid)
Education
Bachelor's degree or equivalent work experience
Pay Range
The typical pay range for this role is:
$144,200.00 - $288,400.00
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.
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: 05/31/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Job ID: 83764612
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