Senior Manager, Medicare Product Implementation

CVS Health; California (MO); Hybrid; USD 68,000 - 199,000; Full time

Job summary

CVS Health is seeking a Senior Manager, Medicare Product Implementation to lead end-to-end implementation and operational execution of Medicare Advantage programs. You will coordinate with internal stakeholders and vendor partners to ensure compliant, timely delivery and strong member experience.

You will develop implementation plans, manage requirements, and monitor performance, while addressing benefit configurations, eligibility issues, and regulatory inquiries to continuously improve program

Qualifications

• 7+ years of work experience with 5+ years working with Medicare Advantage including supplemental benefits and regulations.
• Experience managing projects and implementations.
• Experience leading complex cross-functional initiatives that include collaboration and teamwork.
• Experience with execution and delivery, including planning, delivering, and problem solving.
• Experience with project/program management including creating and maintaining project plans.
• Experience managing competing priorities in a matrixed environment.
• Experience working with vendors and external business partners.
• Experience is highly organized and detail oriented.

Responsibilities

• Lead end-to-end implementation and ongoing operations for Medicare Advantage programs.
• Develop, maintain, and manage key implementation deliverables and documentation.
• Facilitate regular project meetings and drive cross-functional execution.
• Partner with internal and vendor teams to align requirements and experiences.
• Monitor performance, identify trends, and resolve operational issues.
• Ensure compliance with CMS regulations and support audits.
• Prioritize work across programs and provide clear updates to leadership.
• Support bid-related activities and other duties as assigned.

Skills

Medicare Advantage experience

Project management

Cross-functional leadership

Vendor management

Communication skills

Education

Bachelor's degree or equivalent experience

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.

Position Summary

As the Senior Manager, Medicare Product Implementation, you will lead the end-to-end implementation and operational execution of assigned Medicare Advantage programs in coordination with internal stakeholders and external provider and/or vendor partners. You will be responsible for gathering and analyzing requirements, developing implementation plans, ensuring programs are implemented accurately, delivered compliantly, and maintained/operationalized effectively to support both business objectives and member experience including resolving benefit and member issues, and continuously improving program performance.

Responsibilities include

• Act as a top-level specialist and lead end-to-end implementation and ongoing operations for assigned Medicare Advantage programs, ensuring successful implementation, readiness for annual go-live, successful year-over-year delivery, and program operational effectiveness.
• Develop, maintain, and manage key implementation deliverables, including project plans (establish timelines, identify milestones, track progress, identify risks, develop mitigation strategies, track performance metrics, and resource engagement), along with documentation of business and eligibility requirements, member journeys, operational workflows, and benefit crosswalks.
• Facilitate and lead regular project and implementation meetings to drive cross-functional execution across strategy, compliance, eligibility, customer service, member materials, contracting, and other internal and external partners - providing updates and performance metrics to leadership and key stakeholders, addressing inquiries and resolving issues, and ensuring alignment, accountability, and timely delivery of project and program milestones.
• Partner closely with internal and vendor teams to develop program requirements ensuring alignment between benefit intent, design, member experience including benefit access while maintaining strong working relationships.
• Monitor program performance, member access, and utilization while identifying trends, root causes, and opportunities for improvement; identify and resolve operational issues related to eligibility, vendor processes, benefit configuration, and member experience.
• Ensure programs are implemented and operated in compliance with CMS regulations, filed benefit intent, and internal policies; support audits, attestations, and regulatory inquiries.
• Serve as the subject matter expert, make informed decisions and prioritize work across multiple programs and competing deadlines, providing input on operational feasibility, program design, and continuous improvement opportunities.
• Create and maintain a culture of collaboration and cross-functional teamwork, ensuring effective communication and coordination across departments and with leadership.
• Support bid-related activities including strategic discussions, benefit data entry, validation, change tracking, and quality assurance.
• Other duties as assigned.

Required Qualifications

• 7+ years of work experience with 5+ years working with Medicare Advantage including supplemental benefits and regulations.
• Experience managing projects and implementations.
• Experience leading complex cross-functional initiatives that include collaboration and teamwork.
• Experience with execution and delivery (planning, delivering, and supporting) including problem solving, decision making and communication (verbal and written).
• Experience with project/program management including creating and maintaining project plans.
• Experience managing competing priorities in a matrixed environment.
• Experience working with vendors and external business partners.
• Experience in a role that required you to be highly organized and detail oriented.

Preferred Qualifications

• Experience with CMS Flexibilities - SSBCI and Uniformity Flexibility, or provider-based Medicare programs.
• Experience supporting audits or compliance reviews.
• Experience working with spending card based benefits.

Education

• Bachelor's degree or equivalent experience required.

Pay Range

The typical pay range for this role is:

$67,900.00 - $199,144.00

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.

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: 09/17/2026

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