Medicare Quality & Appeals Manager

CVS Health Corporation; Harrisburg (Dauphin County); On-site; USD 47,000 - 102,000; Full time

Benefits offered by this job

Bonus eligible

Comprehensive benefits

Job summary

CVS Health is seeking a qualified leader to oversee Medicare Appeals staff and drive high‑performing teams. The role emphasizes regulatory compliance, process monitoring, and effective collaboration with cross‑functional managers to ensure timely and accurate outcomes.

The position requires strong communication, time management, and knowledge of appeals workflows, with an emphasis on mentoring staff and maintaining a professional, data‑driven environment.

Qualifications

• 5+ years Medicare Appeals experience or relevant background.
• Knowledge of appeals workflows and related job aids.
• Strong communication and collaboration skills to support stakeholders.
• Understanding of regulatory and accreditation requirements.

Responsibilities

• Oversee Quality staff and organize high performing teams.
• Collaborate with area managers to ensure monitoring/reporting consistency.
• Lead staff development: training, coaching, and mentoring.
• Participate in hiring and onboarding of new team members.
• Drive process improvements and present findings at forums.

Skills

Medicare Appeals

Communication

Time management

Regulatory knowledge

Appeals workflows

CMS guidance

Education

High school diploma or equivalent

Associate degree

Tools

Microsoft Office

Job description

CVS Health is seeking a qualified leader to oversee Medicare Appeals staff and drive high‑performing teams. The role emphasizes regulatory compliance, process monitoring, and effective collaboration with cross‑functional managers to ensure timely and accurate outcomes.

The position requires strong communication, time management, and knowledge of appeals workflows, with an emphasis on mentoring staff and maintaining a professional, data‑driven environment.