Appeals Project Manager & Team Leadership

CVS Health; Richmond (VA); On-site; USD 54,000 - 159,000; Full time

Job summary

CVS Health in Richmond, VA is seeking a dedicated professional to lead and grow an Appeals team. You will coach staff, validate project effectiveness, and present findings at team meetings to keep processes compliant with regulatory standards.

The role requires 3+ years in appeals, strong MS Office skills, and 2+ years of supervision, with a focus on accuracy, collaboration, and continuous improvement in a fast-paced healthcare environment.

Qualifications

• 3+ years of appeals background.
• Proficient in Microsoft Office.
• Knowledge of appeals job aids/workflows.
• Strong communication and feedback skills.
• Excellent time management.
• 2+ years of supervisory experience.
• Ability to work collaboratively across teams.
• Strong analytical skills with attention to detail.

Responsibilities

• Build and maintain a solid team through training, coaching and developing staff
• Validate effectiveness of the different projects managed by appeals team through universe data validation.
• Facilitate and present at meetings within the Appeals team.
• Establish and maintain in collaboration with the business, consistent processes defining the overview and readiness of appeals to help remain compliant with regulatory and accreditation requirements.
• Assess developmental needs and collaborate with others to identify and implement action plans that support the development of high performing teams and individuals.
• Manage projects and identify trends and recommends/acts on solutions.
• Report capabilities related to audit requests and universe submissions.

Skills

Appeals knowledge

Microsoft Office

Job aids/workflows

Communication skills

Time management

Supervisory experience

Collaboration across teams

Analytical skills

Education

High school diploma or higher

Bachelor's degree or equivalent experience

Job description

CVS Health in Richmond, VA is seeking a dedicated professional to lead and grow an Appeals team. You will coach staff, validate project effectiveness, and present findings at team meetings to keep processes compliant with regulatory standards.

The role requires 3+ years in appeals, strong MS Office skills, and 2+ years of supervision, with a focus on accuracy, collaboration, and continuous improvement in a fast-paced healthcare environment.