Executive Director, Appeals Tech & Process

CVS Health; Hartford (CT); On-site; USD 132,000 - 303,000; Full time

Job summary

CVS Health in Hartford, CT is seeking an Executive Director, Appeals Process & Technology to lead a cross-functional program migrating Grievances & Appeals processes to a modern technology platform, driving efficiency and compliance.

The role requires an operator who influences at the executive level, builds high-performing teams, and partners with Product, Technology, Compliance and Operations to deliver scalable solutions and measurable business outcomes.

Qualifications

• 15+ years of leadership experience within a healthcare payer or similarly complex, regulated healthcare environment.
• Proven experience leading leaders and large‑scale, front‑line operational teams.
• Demonstrated experience leading significant technology or platform initiatives.
• Strong health plan operations experience (Grievances & Appeals, Utilization Management, Claims, Medicare, or related payer functions).
• Strong operational acumen including workforce management, workflow optimization, and compliance.
• Proven ability to lead complex initiatives across Operations, Product, Technology, Compliance, Medical/Clinical, and other enterprise functions.
• Experience developing business cases, prioritizing investments, managing budgets, and using data to drive decisions.
• Working knowledge of CMS, state regulatory requirements, HIPAA, privacy, and audit readiness.
• Executive presence with the ability to influence senior leaders.

Responsibilities

• Align business strategy with product vision, roadmaps, and lifecycle decisions to optimize workflows and reporting capabilities.
• Define and communicate the long-term business strategy for technology products supporting A&G teams, including KPIs and success measures.
• Provide executive guidance to ensure business requirements are integrated into technology delivery plans.
• Lead platform migration strategy, planning, and execution with DDAT and Operations leaders.
• Serve as a matrix leader across A&G, Technology, Compliance, Operations, Medical, Claims and other partners.

Skills

Healthcare leadership

Operations excellence

Executive influence

Budget management

Program management

Education

Bachelor's degree

MBA or related advanced degree

Job description

CVS Health in Hartford, CT is seeking an Executive Director, Appeals Process & Technology to lead a cross-functional program migrating Grievances & Appeals processes to a modern technology platform, driving efficiency and compliance.

The role requires an operator who influences at the executive level, builds high-performing teams, and partners with Product, Technology, Compliance and Operations to deliver scalable solutions and measurable business outcomes.