Director of UM Policy & Process Governance

CVS Health; Springfield (IL); On-site; USD 100,000 - 232,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Job summary

CVS Health is seeking a Lead Director for UM Center of Excellence to lead enterprise governance of UM policies, procedures, and content. You will drive strategy, standards, and cross‑functional collaboration across Commercial, Medicare, Medicaid, and other lines, shaping frontline guidance and enabling compliant, usable processes.

The role requires senior leadership, cross‑functional partnering, and a focus on measurable governance outcomes with a strong emphasis on compliance and operational

Qualifications

• Progressive leadership experience in healthcare operations or related field.
• Deep understanding of UM operations, policies, workflows, and frontline execution.
• Strong analytical and executive communication skills.

Responsibilities

• Set strategy and standards for UM policy governance across business lines.
• Lead development, approval, publication, and annual review of UM materials.
• Chair governance forums and ensure content accuracy, compliance, and usability.
• Oversee content repositories, intake, and change management across teams.

Skills

Executive leadership

Policy governance

Utilization Management

Stakeholder engagement

Analytical thinking

Education

Bachelor's degree

Job description

CVS Health is seeking a Lead Director for UM Center of Excellence to lead enterprise governance of UM policies, procedures, and content. You will drive strategy, standards, and cross‑functional collaboration across Commercial, Medicare, Medicaid, and other lines, shaping frontline guidance and enabling compliant, usable processes.

The role requires senior leadership, cross‑functional partnering, and a focus on measurable governance outcomes with a strong emphasis on compliance and operational