Senior Manager, Payment Integrity Rework & Escalations

CVS Health; Chicago (IL); On-site; USD 75,000 - 199,000; Full time

Job summary

CVS Health is seeking a Senior Manager for Payment Integrity COE Rework & Escalations in Chicago. You will own the centralized portfolio, coordinate cross-functional teams, and drive reporting, governance, and issue resolution to improve operational stability across the organization.

This leadership role requires a strong track record in program management, stakeholder facilitation, and healthcare payment integrity knowledge, with clear ownership and proactive escalation practices.

Qualifications

• 7–10 years of progressive experience in program, project management, process improvement, audit, provider reimbursement, analytics.
• Proven ability to coordinate complex, cross-functional initiatives with multiple owners, dependencies, and competing priorities.
• Strong ability to build and maintain trackers, dashboards, and governance materials.
• Excellent written, verbal, facilitation, organization, and presentation skills.

Responsibilities

• Lead centralized portfolio management for rework items and escalations with defined owners, action dates, and escalation paths.
• Coordinate structured working sessions to clarify issues, scope, impact, root cause, and required decisions.
• Develop recurring dashboards, scorecards, and executive reporting for PI COE activity and performance indicators.
• Identify risks, dependencies, and escalation points; elevate decision points with clear options and recommendations.
• Design governance cadence, templates, workflows, and logs to ensure consistency and accountability.

Skills

Program & project management

Data-driven decision making

Cross-functional coordination

Facilitation & presentation

Influence without authority

Healthcare domain knowledge

Education

Bachelor's degree

Tools

Excel

Power BI

SharePoint/Teams

Job description

CVS Health is seeking a Senior Manager for Payment Integrity COE Rework & Escalations in Chicago. You will own the centralized portfolio, coordinate cross-functional teams, and drive reporting, governance, and issue resolution to improve operational stability across the organization.

This leadership role requires a strong track record in program management, stakeholder facilitation, and healthcare payment integrity knowledge, with clear ownership and proactive escalation practices.