Senior Product Manager, Fraud & Abuse

9025 CVS Shared Services Resources LLC; Connecticut; Hybrid; USD 130,000 - 261,000; Full time

Benefits offered by this job

Bonus program

Equity awards

Comprehensive benefits

Job summary

CVS Health is seeking a Senior Product Manager for Fraud & Abuse to own and scale FWA analytics products delivering substantial annual impact. You will lead cross-functional squads of data engineers and scientists, drive AI/ML enhancements, and define strategy, roadmaps, and KPIs aligned with business goals.

Responsibilities include prioritizing initiatives, translating market signals into product direction, and ensuring timely, high-quality deliveries in a demanding healthcare setting.

Qualifications

• 4+ years of experience in product management or product ownership.
• 3+ years of experience within the healthcare industry.
• Experience managing product roadmaps and defining product requirements.
• Ability to influence and collaborate across cross-functional teams and senior stakeholders.
• Operate effectively in ambiguity and translate evolving objectives into prioritized initiatives.
• Experience leveraging AI/ML technologies to drive measurable value.
• Analyze complex data and translate insights into strategy and decisions.

Responsibilities

• Own the product vision, strategy, and performance to deliver measurable business value.
• Identify and prioritize opportunities to integrate AI/ML capabilities into products.
• Translate market trends and feedback into actionable product direction and monitor risks.
• Lead a cross-functional squad of data engineers, data scientists, and ideation team members.
• Define and document the 'what' and 'why' for the squad and set priorities.
• Develop and maintain core product artifacts: roadmap, backlog, sprint plans, demos.
• Facilitate stakeholder sessions, sprint planning, and product demos.
• Evaluate AI/ML advancements and assess applicability to the product portfolio.
• Establish and monitor KPIs related to performance and impact.
• Build data-driven business cases for new capabilities and secure investment.
• Ensure high-quality, timely delivery of enhancements.

Skills

Product management

Healthcare industry

Roadmap development

Cross-functional collaboration

Ambiguity handling

AI/ML experience

Data-driven decisions

Education

Bachelor's degree

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 a Senior Product Manager for Fraud & Abuse, you will lead the ongoing development and expansion of key Fraud, Waste, and Abuse (FWA) products that deliver over $200M in annual impact. In this role, you will directly support CVS Health’s Payment Optimization Analytics objectives, contributing to the achievement of revenue and ROI targets for analytics products. You will be responsible for monitoring product performance, driving enhancements, and overseeing the deployment and scaling of advanced FWA analytics capabilities.

Key Duties will be:

• Own the product vision, strategy, and performance, ensuring delivery of measurable business value and alignment with organizational goals
• Identify and prioritize opportunities to integrate AI/ML capabilities into products to enhance accuracy, efficiency, and scalability
• Translate market trends, user feedback, and competitive intelligence into actionable product direction, monitoring shifts to identify emerging opportunities and risks
• Lead a cross-functional squad of data engineers, data scientists, and ideation team members, managing competing priorities and perspectives to keep the squad focused and moving forward
• Define and document the "what" and "why" for the squad, including setting the problem, shaping priorities, and making tradeoffs clear
• Develop and maintain core product artifacts including roadmap, backlog, sprint plans, and demo materials
• Facilitate key forums including stakeholder sessions, sprint planning, working sessions, and product demos
• Continuously evaluate advancements in AI/ML and assess applicability to enhance the product portfolio
• Establish and monitor KPIs related to product performance, adoption, and business impact
• Develop compelling, data-driven business cases for new product capabilities and enhancements, securing stakeholder alignment and financial investments to support strategic priorities
• Ensure high-quality, timely delivery of product enhancements that meet defined business and technical requirements

Required Qualifications

• 4+ years of experience in product management or product ownership
• 3+ years of experience within the healthcare industry
• Demonstrated experience managing product roadmaps and defining product requirements
• Proven ability to influence and collaborate effectively across cross-functional teams and senior stakeholders
• Ability to operate in ambiguity, translating evolving business objectives into clear, prioritized initiatives
• Experience leveraging AI/ML technologies to drive measurable business value
• Ability to analyze complex data and translate insights into actionable product strategy and business decisions

Preferred Qualifications

• Experience in Payment Integrity, with a focus on Fraud, Waste, & Abuse (FWA)
• Strong financial acumen, with the ability to assess business impact and drive value-based decisions
• Experience working within Agile product management frameworks and methodologies
• Working knowledge of healthcare claims processing, including end-to-end claims lifecycle

Education

Bachelor's degree or equivalent work experience with healthcare, claims processing, or vendor management.

Pay Range

The typical pay range for this role is: $130,295.00 - $260,590.00 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.

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: 12/04/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.