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CVS Health in New York, NY seeks a results-driven leader to oversee the Quality staff within the Appeals function. You will organize high-performing teams, partner with area managers, and drive monitoring and reporting processes to improve outcomes.
The role emphasizes staff development, cross-functional collaboration, and effective use of scorecards to validate team impact while mentoring through training initiatives and hiring support.
Oversight of Quality staff including the organization and development of high performing teams.
Works closely with functional area managers to ensure consistency in monitoring and reporting activities.
Manages performance and resources for monitoring needs.
Build and maintain a solid team through selecting, training, coaching and developing staff.
Collaborate to build bridges, identify trends and recommend solutions.
Validate effectiveness of the team through scorecards and monitoring.
Facilitate and present at meetings within the Appeals team.
Flexibility to accommodate team needs with a solutions-based attitude.
Remain approachable, professional, and understanding of the human needs of your team.
Mentor the team regarding processes, problem resolution and critical thinking.
May act as a liaison with other key business areas.
May assist in development and facilitating new training.
Participate in the hiring process of staff.
Create a positive work space by recognizing team contributions, soliciting input, and assisting as needed.
5+ years Medicare Appeals backgroundMicrosoft Office experienceKnowledge of Appeals job aids/workflowsStrong Communication skills - ability to provide and receive feedbackExcellent time management skillsRequires working knowledge of regulatory and accreditation requirements, benefit plan and/or contractual arrangements.
2+ years Quality experienceQuickBase experienceTraining or leadership/management experienceKnowledge of CMS guidance
High school diploma, Associate degree preferred
The typical pay range for this role is:$46,988.00 - $102,000.00 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.
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 peopleWe 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.
Benefits Moments .
We anticipate the application window for this opening will close on: 10/18/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.