Medicare Claims Technology Product Management Director

9025 CVS Shared Services Resources LLC; Connecticut; Hybrid; USD 144,000 - 288,000; Full time

Benefits offered by this job

Comprehensive benefits package

Job summary

CVS Health is seeking a Lead Director, Technology Product Management for Medicare Claims to shape strategy, roadmap, and modernization of technology products supporting 4M+ Medicare members.

The role leads product teams, aligns with business and vendor partners, and drives outcomes across a complex enterprise.

Qualifications

• 10+ years in digital product management or related leadership roles.
• 7+ years in software product management with lifecycle ownership.
• 5+ years in healthcare payer experience with claims lifecycle knowledge.
• Proven leadership and coaching of product teams.
• Availability to work primarily during Eastern Time business hours.

Responsibilities

• Define and socialize product vision, strategy, and roadmap across product areas.
• Align roadmaps and backlogs with business objectives and OKRs.
• Lead cross-functional product leadership with key stakeholders (5-in-the-box).
• Grow and coach product management teams and foster a customer-centric culture.

Skills

Digital product management

Healthcare technology

Claims administration

Software product lifecycle

Leadership and coaching

Education

Bachelor's degree

Job description

Position Summary

The Lead Director, Technology Product Management for Medicare Claims is accountable for shaping the strategy, roadmap, performance, and modernization of the technology products and platforms that support claims administration for more than 4 million Medicare members. As the organization transitions to a product operating model, this leader will help establish and mature the product structure, practices, accountabilities, and cross-functional ways of working needed to improve claims accuracy, automation, timeliness, reliability, compliance, and operating efficiency. The Lead Director will partner closely with business, engineering, data, architecture, operations, and delivery leaders, as well as strategic software vendor partners, to translate claims, regulatory, operational, and technology needs into prioritized investments, aligned roadmaps, and measurable outcomes across a complex enterprise ecosystem. Given the significant role of vendor-provided platforms in the claims product, this leader will influence vendor roadmaps, align modernization priorities, manage critical dependencies, partner with release management on complex releases, and hold internal and external partners accountable for product performance and business outcomes. This role also leads and develops product management colleagues, strengthens product capabilities, and helps teams evolve from project- and delivery-oriented practices toward sustained accountability for product and business outcomes.

Product Vision, Strategy, and Roadmaps

Defines and socializes the product vision, strategy and roadmap in collaboration with the 5-in-the-box team; assesses and refines as needed. Partners with business general manager and stakeholders to make decisions on investment priorities and develop business cases. Translates customer, business and technology needs into short-term and long-term product strategy by creating Epics/initiatives defined to meet targeted outcomes. Connects the roadmap to specific value drivers that contribute to business priorities, objectives and key results, and strategic programs. Responsible for aligning roadmaps, backlogs, capacity, timelines, and commitments across the respective product areas needed to deliver. Defines product objectives and key results (OKRs), aligned with business objectives, to evaluate progress towards outcomes.

Product Backlog Ownership, Work Definition, and Prioritization

Sets the direction for discovery work, ensuring that the product team is focused on continuous exploration. Defines roadmap items/epics (with input from other Product Management colleagues and functions who further define features, etc.), identifies dependencies, and works with teams to size ahead of future quarters. Facilitates product-level ceremonies & meetings, including quarterly PI planning activities (when applicable), in partnership with the product leadership team.

Trend Monitoring, Product Performance, and Product Value

Uses performance data to identify issues quickly, and develop new insights and hypotheses about product health, technical health, and customer feedback. Tracks product objectives and key results (OKRs), aligned with business objectives, to understand progress towards outcomes and metrics, socializes progress, and consistently reinforces objectives and alignment with broader product portfolio outcomes. Coordinates product launches, including beta testing, user feedback collection, and product documentation. Ensures that incremental learnings from product discovery & delivery are prioritized in the backlog.

Cross-Functional Teaming and Stakeholder Management

Facilitates the "5-in-the-box" cross-functional product leadership team, including strong partnership with Business General Manager (GM). Ensures business strategies and targeted outcomes are well understood and socialized to product teams. Understands market and customer needs through partnership with business & customer insight teams. Showcases the product teams’ delivery and final output to stakeholders.

Grow and Develop the Team

Understand the hiring market to identify successful candidates with the unique blend of personality and skillset matches. Champions strong product management and agile mindsets and values by actively communicating team wins and opportunities. Establishes high performing teams by growing and coaching product management colleagues and defining team norms on how teams working on this product operate. Responsible for promoting and setting a customer-centric culture where all teams understand the current performance of the product, opportunities areas and the north star vision, and are monitoring and proactively reacting to key product health metrics and communicating updates.

Required Qualifications

• 10+ years of relevant experience in digital product management, healthcare technology, claims administration, or related product and technology leadership roles.
• 7+ years of software product management experience, with demonstrated accountability for product strategy and the full product lifecycle from discovery through launch, adoption, and ongoing optimization.
• 5+ years of healthcare payer experience, including significant experience with claims administration products, platforms, operations, or transformation initiatives, and demonstrated knowledge of the end-to-end claims lifecycle, such as benefit interpretation, adjudication, pricing, payment, adjustments, appeals, and financial reconciliation.
• Demonstrated experience directly leading, developing, and coaching product management teams, including establishing clear accountability and building high-performing team cultures.
• Ability to work primarily during Eastern Time business hours and support critical business or production needs when required.

Preferred Qualifications

• Experience with Medicare Advantage claims, including CMS requirements, benefit configuration, provider reimbursement, claims accuracy, payment integrity, and regulatory compliance.
• Demonstrated ability to translate claims business rules, regulatory requirements, operational needs, and performance issues into product capabilities, roadmaps, and measurable outcomes.
• Experience partnering across Claims Operations, Configuration, Provider, Finance, Compliance, Clinical, Engineering, and Data teams to improve claims outcomes.
• Experience leading product strategy and execution for large-scale technology modernization initiatives involving cloud-based platforms, microservices architectures, legacy-system transformation, and complex enterprise dependencies.
• Demonstrated ability to influence senior business and technology leaders, align cross-functional teams, and guide prioritization and investment decisions in a complex, regulated environment.
• Experience managing strategic technology vendor relationships, including roadmap alignment, performance expectations, dependencies, and accountability for outcomes.
• Experience leading product or operating-model transformation within a large, matrixed enterprise.
• Demonstrated use of data, quantitative analysis, and product performance measures to inform decisions and prioritize investments.
• Working knowledge of cloud platforms, modern software architectures, and emerging technologies, including AI and machine learning.
• Product management or Agile certifications.

Education

Bachelor's degree or equivalent work experience.

Pay Range

The typical pay range for this role is: $144,200.00 - $288,400.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments.

Application window

We anticipate the application window for this opening will close on: 11/30/2026

Compliance and DEI statements

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Our Work Experience

Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.