Associate Manager - Quality

CVS Health Corporation; Pennsylvania; Hybrid; USD 47,000 - 102,000; Full time

Benefits offered by this job

Medical, dental, vision benefits

Paid time off

Retirement savings options

Wellness programs

Employee discounts

Job summary

CVS Health Corporation is seeking a Quality Manager to oversee the Medicare Appeals team, drive performance, and ensure rigorous monitoring and reporting. You will mentor staff, coordinate with functional managers, and lead process improvements to support compliant, high-quality appeals operations.

The role requires extensive Medicare Appeals experience, strong communication, and proven leadership. A steady, solutions-focused approach helps you guide the team toward optimal decisions in a

Qualifications

• Requires 5+ years in Medicare Appeals.
• Proficient in Microsoft Office applications.
• Knowledge of Appeals workflows and job aids.
• Strong communication skills with feedback ability.
• Excellent time management and prioritization.
• Familiarity with regulatory and accreditation requirements.

Responsibilities

• Oversee Quality staff and develop high-performing teams.
• Coordinate with area managers to ensure consistent monitoring/reporting.
• Manage performance and resources for monitoring needs.
• Recruit, train, and mentor staff; build a strong team.
• Collaborate to identify trends and propose solutions.
• Validate team effectiveness with scorecards and monitoring.
• Present at Appeals team meetings and drive process improvements.
• Be flexible to accommodate team needs with a solutions-based approach.
• Remain approachable and professional, addressing human needs.
• Mentor on processes, problem resolution and critical thinking.
• Liaise with other key business areas as needed.
• Assist in developing and facilitating new training.
• Participate in staff hiring processes.
• Create a positive workspace by recognizing contributions and soliciting input.

Skills

Medicare Appeals

Microsoft Office

Appeals workflows

Communication

Time management

Regulatory knowledge

Education

High school diploma / Associate degree preferred

Tools

QuickBase

Job description

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Position Summary

• 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.

Required Qualifications

• 5+ years Medicare Appeals background
• Microsoft Office experience
• Knowledge of Appeals job aids/workflows
• Strong Communication skills - ability to provide and receive feedback
• Excellent time management skills
• Requires working knowledge of regulatory and accreditation requirements, benefit plan and/or contractual arrangements.

Preferred Qualifications

• 2+ years Quality experience
• QuickBase experience
• Training or leadership/management experience
• Knowledge of CMS guidance

Education

High school diploma, Associate degree preferred

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

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 people

We 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.

Additional details about available benefits are provided during the application process and on 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.