Senior Quality & Appeals Team Lead

CVS Health; New York (NY); On-site; USD 47,000 - 102,000; Full time

Job summary

CVS Health in New York, NY seeks a results-driven leader to oversee the Quality staff within the Appeals function. You will organize high-performing teams, partner with area managers, and drive monitoring and reporting processes to improve outcomes.

The role emphasizes staff development, cross-functional collaboration, and effective use of scorecards to validate team impact while mentoring through training initiatives and hiring support.

Qualifications

• 5+ years Medicare Appeals background.
• Microsoft Office experience.
• Knowledge of Appeals job aids/workflows.
• Strong communication skills with feedback ability.
• Excellent time management; regulatory/accreditation knowledge.
• Quality experience and leadership familiarity.

Responsibilities

• Oversight of Quality staff including organization and development of high performing teams.
• Work closely with functional area managers to ensure consistency in monitoring and reporting activities.
• Manage performance and resources for monitoring needs.
• Build and maintain a solid team through selecting, training, coaching and developing staff.
• Collaborate to build bridges, identify trends and recommend solutions.
• Validate effectiveness of the team through scorecards and monitoring.
• Facilitate and present at meetings within the Appeals team.
• May act as a liaison with other key business areas.
• May assist in development and facilitating new training.
• Participate in the hiring process of staff.

Skills

Medicare Appeals

Microsoft Office

Appeals workflows

Regulatory knowledge

Communication skills

Time management

Leadership

Quality experience

Education

High school diploma

Associate degree preferred

Tools

QuickBase

Job description

CVS Health in New York, NY seeks a results-driven leader to oversee the Quality staff within the Appeals function. You will organize high-performing teams, partner with area managers, and drive monitoring and reporting processes to improve outcomes.

The role emphasizes staff development, cross-functional collaboration, and effective use of scorecards to validate team impact while mentoring through training initiatives and hiring support.