Senior COB & Payment Integrity Program Lead

CVSHealth; Farmington (CT); On-site; USD 68,000 - 199,000; Full time

Benefits offered by this job

Bonus program

Equity awards

Comprehensive benefits

Paid time off

Retirement savings

Wellness program

Job summary

CVS Health is seeking a Senior Manager, Project Management to lead Coordination of Benefits projects and drive performance improvements across Claims, Enrollment, Provider Services, and Operations. You will define scope, timelines, resources, and success metrics, while leveraging data analytics to identify trends and implement solutions that improve accuracy and efficiency.

You will directly manage staff, mentoring and developing teams, and serve as a liaison between business and operational

Qualifications

• 5+ years of leadership experience managing teams.
• 7+ years in Payment Integrity, Healthcare Operations, claims administration, COB regulations, Medicare or related healthcare functions.
• Experience leading large-scale, cross-functional projects and operational transformation initiatives.
• Strong knowledge of healthcare claims processing, COB regulations, Medicare Secondary Payer guidelines, NAIC rules.
• Experience developing and implementing business process improvements to reduce costs and improve quality.
• Experience with healthcare technology platforms and data visualization tools (Power BI, Tableau, Quickbase, ACAS, HRP).

Responsibilities

• Lead and oversee Coordination of Benefits projects and related operational initiatives.
• Define project scope, objectives, timelines, and resources.
• Manage staff day-to-day, coaching, performance management and development.
• Communicate project status, risks, and outcomes to leadership.
• Drive data-informed improvements to enhance operational performance and provider/member experience.

Skills

Leadership experience

Cross-functional leadership

Healthcare claims knowledge

Process improvement

Data analytics

Commercial insurance knowledge

Education

Bachelor's degree preferred

Tools

Power BI

Tableau

Quickbase

ACAS

HRP

Job description

CVS Health is seeking a Senior Manager, Project Management to lead Coordination of Benefits projects and drive performance improvements across Claims, Enrollment, Provider Services, and Operations. You will define scope, timelines, resources, and success metrics, while leveraging data analytics to identify trends and implement solutions that improve accuracy and efficiency.

You will directly manage staff, mentoring and developing teams, and serve as a liaison between business and operational