Project Manager, Complaints & Appeals

CVS Health; Washington (District of Columbia); On-site; USD 54,000 - 159,000; Full time

Job summary

CVS Health is seeking a capable leader for the Appeals team in the Washington, DC area. You will build and coach staff, validate project effectiveness using universe data, and present findings in team meetings to ensure compliance with regulatory and accreditation requirements.

The role requires strong communication, time management, and a minimum of two years’ supervisory experience, with collaboration across departments to drive high performance and accuracy.

Qualifications

• 3+ years in Appeals background.
• Proficiency with Microsoft Office.
• Knowledge of Appeals workflows and job aids.
• Strong communication skills and ability to give/receive feedback.
• Excellent time management skills.
• Minimum 2 years of supervisory experience.
• Ability to collaborate across teams.
• Strong analytical skills with accuracy and attention to detail.

Responsibilities

• Build and maintain a solid team through training, coaching and developing staff.
• Validate effectiveness of projects managed by appeals team through universe data validation.
• Facilitate and present at meetings within the Appeals team.
• Establish and maintain processes defining the overview and readiness of appeals to stay compliant with regulatory and accreditation requirements.
• Assess developmental needs and identify action plans to develop high-performing teams and individuals.
• Manage projects, identify trends and recommend solutions.
• Report capabilities related to audit requests and universe submissions.

Skills

Appeals

Microsoft Office

Communication

Time management

Supervisory experience

Collaboration

Analytical skills

Education

High School Diploma

Bachelor's degree

Tools

QuickBase

Job description

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 ourselves accountable 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 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 in 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.

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+ years Project Management experience
• 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.

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 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.