Medical Policy Program Manager

Hispanic Alliance for Career Enhancement; Hartford (CT); On-site; USD 46,988 - 112,200; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a Medical Policy Project Manager to lead policy initiatives, governance, and operational coordination across business, clinical, compliance, technology, analytics, and operations. You will ensure compliant, accurate, and ready-to-implement medical policy solutions that improve payment accuracy and business performance.

The role emphasizes project execution, stakeholder engagement, reporting, meeting facilitation, and continuous process improvement within a collaborative

Qualifications

• 5+ years in healthcare, health plan operations, or policy roles.
• Strong PM skills: planning, milestones, risk/issue mgmt., governance docs.
• Familiarity with CMS or regulatory bodies preferred.
• Ability to lead through influence in a matrixed org.
• Excellent written and verbal communication; translate policy to leadership.
• Strong organization and time-management with confidential data handling.
• Proficiency with MS Office; experience with Smartsheet/Asana/Jira/Power BI is a plus.

Responsibilities

• Lead medical policy and pre-payment policy initiatives from intake through delivery.
• Engage stakeholders across clinical, compliance, legal, operations, and tech.
• Prepare status reports, dashboards, and leadership summaries highlighting risks and decisions.
• Facilitate governance meetings and doc decisions; track actions and follow-ups.
• Identify process improvements and post-implementation learnings.
• Coordinate special/ time-sensitive projects within agreed timelines.

Skills

Project management

Stakeholder engagement

Regulatory compliance

Cross-functional collaboration

Written and verbal communication

Documentation and reporting

Meeting facilitation

Education

Bachelor's degree in business/healthcare/related field

Project management certification (PMP/CAPM/Agile/Lean Six Sigma)

Tools

Microsoft Office Suite

SharePoint

Smartsheet

Asana

Jira

Power BI

Visio

Job description

CVS Health is seeking a Medical Policy Project Manager to lead policy initiatives, governance, and operational coordination across business, clinical, compliance, technology, analytics, and operations. You will ensure compliant, accurate, and ready-to-implement medical policy solutions that improve payment accuracy and business performance.

The role emphasizes project execution, stakeholder engagement, reporting, meeting facilitation, and continuous process improvement within a collaborative