Appeals & Projects Manager - Compliance Lead

CVS Health; Washington (District of Columbia); On-site; USD 54,000 - 159,000; Full time

Job summary

CVS Health is seeking a capable leader for the Appeals team in the Washington, DC area. You will build and coach staff, validate project effectiveness using universe data, and present findings in team meetings to ensure compliance with regulatory and accreditation requirements.

The role requires strong communication, time management, and a minimum of two years’ supervisory experience, with collaboration across departments to drive high performance and accuracy.

Qualifications

• 3+ years in Appeals background.
• Proficiency with Microsoft Office.
• Knowledge of Appeals workflows and job aids.
• Strong communication skills and ability to give/receive feedback.
• Excellent time management skills.
• Minimum 2 years of supervisory experience.
• Ability to collaborate across teams.
• Strong analytical skills with accuracy and attention to detail.

Responsibilities

• Build and maintain a solid team through training, coaching and developing staff.
• Validate effectiveness of projects managed by appeals team through universe data validation.
• Facilitate and present at meetings within the Appeals team.
• Establish and maintain processes defining the overview and readiness of appeals to stay compliant with regulatory and accreditation requirements.
• Assess developmental needs and identify action plans to develop high-performing teams and individuals.
• Manage projects, identify trends and recommend solutions.
• Report capabilities related to audit requests and universe submissions.

Skills

Appeals

Microsoft Office

Communication

Time management

Supervisory experience

Collaboration

Analytical skills

Education

High School Diploma

Bachelor's degree

Tools

QuickBase

Job description

CVS Health is seeking a capable leader for the Appeals team in the Washington, DC area. You will build and coach staff, validate project effectiveness using universe data, and present findings in team meetings to ensure compliance with regulatory and accreditation requirements.

The role requires strong communication, time management, and a minimum of two years’ supervisory experience, with collaboration across departments to drive high performance and accuracy.