Appeals & Projects Manager: Lead Teams & Compliance

CVS Health; Connecticut; Hybrid; USD 54,000 - 159,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Job summary

CVS Health is seeking a capable Appeals Team Lead to build and mentor a strong staff, validate project effectiveness with data, and present during Appeals team meetings. You will help ensure readiness of appeals for regulatory and accreditation standards while coordinating development plans for high-performing teams and individuals.

The role emphasizes cross-team collaboration, project management, and data-driven decisions, with a focus on accuracy and regulatory compliance.

Qualifications

• 3+ years Appeals background required.
• Proficient with Microsoft Office applications.
• Knowledge of appeals job aids/workflows.
• Strong communication skills with the ability to provide and receive feedback.
• Excellent time management skills.
• 2+ years of supervisory experience.
• Ability to work collaboratively across teams.
• Strong analytical skills focusing on accuracy and 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 help remain compliant with regulatory and accreditation requirements.
• Assess developmental needs and identify action plans to support development of high performing teams and individuals.
• Manage projects, identify trends and recommend/act on solutions.
• Report capabilities related to audit requests and universe submissions.

Skills

Appeals background

Microsoft Office

Job aids/workflows

Strong communication

Time management

Supervisory experience

Collaboration across teams

Analytical skills

Project management

QuickBase

Training or leadership

CMS guidance

Medicare regulatory knowledge

Education

High school diploma or higher

Bachelor’s degree or equivalent experience

Tools

QuickBase

Job description

CVS Health is seeking a capable Appeals Team Lead to build and mentor a strong staff, validate project effectiveness with data, and present during Appeals team meetings. You will help ensure readiness of appeals for regulatory and accreditation standards while coordinating development plans for high-performing teams and individuals.

The role emphasizes cross-team collaboration, project management, and data-driven decisions, with a focus on accuracy and regulatory compliance.