Appeals Project Manager | Training & Compliance Leader

CVS Health; City of Albany (NY); On-site; USD 34,000 - 159,000; Full time

Job summary

CVS Health is hiring for an Appeals leadership role in the Albany area. You will build and coach a high-performing team, validate project effectiveness, and facilitate Appeals meetings to ensure compliance with regulatory standards.

Responsibilities include establishing robust processes, identifying developmental needs, and guiding cross-team collaboration to deliver accurate, audit-ready universe submissions.

Qualifications

• 3+ years of Appeals background required.
• Experience executing and improving workflows within appeals or similar domain.
• Excellent written and verbal communication, feedback capability.
• Ability to manage time effectively and meet deadlines.
• 2+ years of supervisory experience required.

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 background

Strong communication

Time management

Supervisory experience

Cross-team collaboration

Analytical skills

Education

High school diploma

Bachelor's degree or equivalent experience

Tools

Microsoft Office

Job description

CVS Health is hiring for an Appeals leadership role in the Albany area. You will build and coach a high-performing team, validate project effectiveness, and facilitate Appeals meetings to ensure compliance with regulatory standards.

Responsibilities include establishing robust processes, identifying developmental needs, and guiding cross-team collaboration to deliver accurate, audit-ready universe submissions.