Health Plan Operations Leader

CVS Health; New Albany (OH); On-site; USD 75,000 - 199,000; Full time

Benefits offered by this job

Benefits package

Job summary

CVS Health in New Albany, OH, seeks an Operations Lead for Health Plan Market Operations to oversee day-to-day health plan operations and ensure regulatory compliance. You will coordinate with market leadership, enterprise partners, and regulators to drive operational excellence and successful member outcomes.

Responsibilities include establishing readiness processes, monitoring performance, mitigating risks, and guiding cross-functional teams to resolve issues with executive reporting and

Qualifications

• 7+ years in healthcare operations or related field.
• Experience leading cross-functional operational initiatives.
• Knowledge of CMS and state regulatory requirements.
• Ability to influence stakeholders without direct authority.

Responsibilities

• Provide operational oversight and coordination across health plan areas to support efficient service delivery.
• Lead cross-functional efforts to identify, prioritize, and resolve operational issues affecting members, providers, regulators, and business partners.
• Establish and maintain operational readiness processes for annual implementation activities (product launches, benefit changes, regulatory requirements, market expansions).
• Monitor regulatory changes and contract requirements to ensure timely operational implementation and ongoing compliance.
• Develop executive-level reporting and dashboards to communicate performance, readiness, risks, and mitigation plans.

Skills

Healthcare operations

Cross-functional leadership

Regulatory compliance

CMS knowledge

Executive reporting

Stakeholder influence

Operational readiness

Data analysis

Excel/PowerPoint

Education

Bachelor's degree

Tools

Excel

PowerPoint

Data analysis tools

Job description

CVS Health in New Albany, OH, seeks an Operations Lead for Health Plan Market Operations to oversee day-to-day health plan operations and ensure regulatory compliance. You will coordinate with market leadership, enterprise partners, and regulators to drive operational excellence and successful member outcomes.

Responsibilities include establishing readiness processes, monitoring performance, mitigating risks, and guiding cross-functional teams to resolve issues with executive reporting and