Executive Director, Appeals Tech & Transformation

CVS Health; Oklahoma; On-site; USD 132,000 - 303,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

Job summary

CVS Health is seeking an Executive Director, Appeals Process & Technology to lead a cross-functional program migrating Grievances & Appeals to a modern technology platform. You will shape strategy, oversee investment, and align Operations, Product, and Compliance teams to deliver scalable, compliant workflows.

You will partner with executive leaders to define success metrics, manage budgets, and drive continuous process improvement while ensuring regulatory and audit readiness across the

Qualifications

• 15+ years of leadership in healthcare payer or similar regulated environment.
• Experience leading leaders and large front-line teams.
• Experience leading major technology or platform initiatives with accountable outcomes.
• Strong ops experience across Grievances & Appeals, Utilization Management, Claims or related payer funcs.
• Operational acumen: workforce mgmt, workflow optimization, quality & compliance.
• Ability to influence senior leaders and communicate complex info clearly.

Responsibilities

• Define and execute migration of Aetna Grievances & Appeals processes to a modern tech platform.
• Lead platform migration strategy with DDAT and Operations partners.
• Oversee investment prioritization, budgets, and tracking of business benefits.
• Drive policies, workflows, and training coordination with Operations teams.
• Ensure quality, audit readiness, and compliance with plan sponsor requirements.
• Coordinate cross-functional alignment across Operations, Product, Technology and Compliance.

Skills

Leadership

Healthcare payer

Executive influence

Program management

Budget management

CMS knowledge

HIPAA compliance

Education

Bachelor's degree or equivalent experience

Advanced degree preferred

Job description

CVS Health is seeking an Executive Director, Appeals Process & Technology to lead a cross-functional program migrating Grievances & Appeals to a modern technology platform. You will shape strategy, oversee investment, and align Operations, Product, and Compliance teams to deliver scalable, compliant workflows.

You will partner with executive leaders to define success metrics, manage budgets, and drive continuous process improvement while ensuring regulatory and audit readiness across the