Project Manager, Complaints & Appeals

CVS Health; New York (NY); Presencial; USD 54 000 - 159 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Health insurance

Retirement plan

Resumo da oferta

CVS Health in New York seeks an experienced supervisor for the Appeals team. You will build and maintain a high-performing line through training, coaching and staff development, and validate the effectiveness of projects managed by the team through data validation.

You will facilitate meetings, collaborate with business stakeholders to define processes for readiness and regulatory compliance, assess development needs, and drive action plans.

Qualificações

• 3+ years Appeals background
• Microsoft Office experience
• Knowledge of Appeals job aids/workflows
• Strong Communication skills - ability to provide and receive feedback
• Excellent time management skills
• 2+ years of supervisory experience
• Ability to work collaboratively across teams
• Strong analytical skills focusing on accuracy and attention to details

Responsabilidades

• Build and maintain a solid team through training, coaching and developing staff.
• Validate effectiveness of the different projects managed by appeals team through universe data validation.
• Facilitate and present at meetings within the Appeals team.
• Establish and maintain collaboration with the business, consistent processes defining the overview and readiness of appeals to help remain compliant with regulatory and accreditation requirements.
• Assess developmental needs and collaborate with others to identify and implement action plans that support the development of high performing teams and individuals.
• Manage projects and identify trends and recommends/acts on solutions.
• Report capabilities related to audit requests and universe submissions.

Conhecimentos

Appeals background

Microsoft Office

Appeals workflows

Communication skills

Time management

Supervisory experience

Collaboration

Attention to detail

Formação académica

High school diploma

Bachelor's degree

Ferramentas

QuickBase

CMS guidance

Descrição da oferta de emprego

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Job Summary

Build andmaintaina solid team through training,coachingand developing staff

Validate effectiveness of the differentprojectsmanaged by appealsteamthrough universe data validation.

Facilitate and present at meetings within the Appeals team.

Establish andmaintainin collaboration with the business, consistent processes defining the overview and readiness of appeals to helpremaincompliant with regulatory and accreditation requirements.

Assess developmental needs and collaborate with others toidentifyand implement action plans that support the development of high performing teams and individuals.

Manage projects andidentifytrends and recommends/acts on solutions.

Report capabilities related to audit requests and universe submissions.

Required Qualifications

• 3+ years Appeals background
• Microsoft Office experience
• Knowledge of Appeals job aids/workflows
• Strong Communication skills - ability to provide and receive feedback
• Excellent time management skills
• 2+ years of supervisory experience
• Ability to work collaboratively across teams
• Strong analytical skills focusing on accuracy and attention to details

Preferred Qualifications

• 2+ yearsProject Managementexperience
• QuickBase experience
• 2+ years training or leadership experience
• Knowledge of CMS guidance
• Product knowledge and experience with Appeals and Medicare Regulatory Requirements
• Appeals and MHK knowledge/experience

Education

• High school diploma or higher education
• Bachelor’s degree or equivalent experience

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$54,300.00 - $159,120.00

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.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

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.

We anticipate the application window for this opening will close on: 10/31/2026

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