Director, UM Innovation & Transformation

CVS Health; Hartford (CT); On-site; USD 100,000 - 232,000; Full time

Benefits offered by this job

Comprehensive benefits

Bonus eligibility

Equity program

Job summary

CVS Health is seeking a Lead Director, UM Innovation & Strategic Analysis to shape the strategic analysis portfolio and modernization of Utilization Management. The role partners with Clinical Operations, Product, Technology, and Enterprise Innovation to drive value through AI-enabled automation and data-driven insights.

The candidate will oversee governance, value realization, and multi-year roadmaps, while coaching a high-performing team and influencing senior leaders across the enterprise.

Qualifications

• 10+ years leading strategic planning, business analysis, consulting, portfolio management, transformation, or innovation initiatives in healthcare or related fields.
• Deep understanding of health plan operations including Utilization Management, Policy Management, Care Management, Quality and Compliance.
• Proven ability to develop and lead enterprise strategic initiatives from concept through value realization.
• Strong analytical and problem-solving skills with data-driven recommendations for executive audiences.
• Experience with data visualization tools and advanced analytics technologies (SQL, Python, cloud platforms).
• Knowledge of automation, AI-enabled workflows, digital transformation and operational improvement.
• Experience developing business cases, success metrics, and ROI measurement for strategic initiatives.
• Strong interpersonal and communication skills to influence senior leaders.

Responsibilities

• Define and drive strategic analysis portfolio, enterprise transformation priorities, and UM automation strategy.
• Develop business cases and investment recommendations shaping UM strategy.
• Lead multi-year UM modernization roadmap with prioritization and funding guidance.
• Collaborate with Clinical Operations, Product, Technology, and Enterprise Innovation.
• Identify and implement automation opportunities across UM using AI and analytics.
• Develop KPIs, dashboards, and value realization tracking for automation initiatives.
• Provide governance for pilots, value proofs, and transformation programs.
• Build relationships and advise senior leaders on UM strategy and execution.
• Coach and develop a high-performing team fostering innovation and accountability.

Skills

Strategic planning

Business analysis

Portfolio management

Transformation

Innovation leadership

Data visualization

Executive communication

Stakeholder management

Problem solving

Education

Bachelor's degree or equivalent

Master's degree preferred

Tools

SQL

Python

Cloud data platforms

Job description

CVS Health is seeking a Lead Director, UM Innovation & Strategic Analysis to shape the strategic analysis portfolio and modernization of Utilization Management. The role partners with Clinical Operations, Product, Technology, and Enterprise Innovation to drive value through AI-enabled automation and data-driven insights.

The candidate will oversee governance, value realization, and multi-year roadmaps, while coaching a high-performing team and influencing senior leaders across the enterprise.