Head of UM Policy & Process Governance, Equity & Impact

CVS Health; Providence (RI); On-site; USD 100,000 - 232,000; Full time

Benefits offered by this job

Comprehensive benefits

Bonus eligibility

Equity awards

Job summary

CVS Health is seeking a Lead Director for UM Center of Excellence to lead enterprise governance of Utilization Management content and resources. You will establish standards, oversee policy development, and collaborate with Legal, Compliance, and Operational teams to ensure accurate, compliant guidance for frontline teams.

You will chair governance forums, drive intake and prioritization, and lead a multidisciplinary team responsible for policy management, job aids, and documentation templates.

Qualifications

• Experience leading enterprise policy, procedure, and content governance.
• Ability to translate regulatory and contractual requirements into usable guidance.
• Strong governance forums leadership and cross-functional collaboration.
• Experience with content lifecycle management and documentation standards.
• Knowledge of CMS, document templates, and workflow design.

Responsibilities

• Set strategy and standards for UM policy governance across lines of business.
• Lead development, publication, and annual review of UM policies and templates.
• Chair governance forums and define decision rights and escalation paths.
• Oversee content repositories, release discipline, and lifecycle management.
• Partner with Legal, Compliance, NCQA, Training, and other teams to maintain compliant guidance.

Skills

Policy governance

Stakeholder engagement

Executive communication

Team leadership

Strategic oversight

Analytics & metrics

Education

Bachelor's degree

Advanced degree preferred

Job description

CVS Health is seeking a Lead Director for UM Center of Excellence to lead enterprise governance of Utilization Management content and resources. You will establish standards, oversee policy development, and collaborate with Legal, Compliance, and Operational teams to ensure accurate, compliant guidance for frontline teams.

You will chair governance forums, drive intake and prioritization, and lead a multidisciplinary team responsible for policy management, job aids, and documentation templates.