Medicare Claims Technology Product Management Director

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🕒 vor 4 Tagen

🦌 Connecticut, Florida, +2 weitere Bundesländer – Remote

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💵 $144.200 - $288.400 / Jahr

⏰ Vollzeit

🔴 Experte

✅ Produktmanager

👻 Geisterscore 0%

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🗣️🇺🇸🇬🇧 Englisch erforderlich

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Logo of CVS Health

CVS Health

10.000+ Mitarbeiter

Gegründet 1963

🏥 Gesundheitswesen

⚕️ Krankenversicherung

🛒 Einzelhandel

Healthcare • Healthcare Insurance • Retail

CVS Health ist ein führendes amerikanisches Gesundheitsunternehmen, das sich der Verbesserung des Zugangs zu Gesundheitsdiensten und deren Erschwinglichkeit verschrieben hat. Das Unternehmen verfolgt einen umfassenden Ansatz, der Gesundheitsdienstleistungen, Krankenversicherungen und das Management von Apothekenleistungen umfasst. Durch seine Tochtergesellschaften, wie Aetna und CVS Caremark, bietet CVS Health eine Vielzahl von Dienstleistungen an, die Wohlbefinden, Krankheitsmanagement und erschwinglichen Versicherungsschutz für verschreibungspflichtige Medikamente erleichtern. CVS Health betreibt Apotheken in der Nachbarschaft, bietet Versandapothekendienste an und verwaltet Programme für Spezialmedikamente, um Gesundheitsversorgung für jeden bequem und zugänglich zu machen. Angetrieben von der Mission, Menschen mit wesentlichen Pflegediensten zu verbinden, ist CVS Health bestrebt, gesündere Gemeinschaften zu fördern und das Wohlbefinden aller Menschen zu unterstützen.

Beschreibung

• Shape the strategy, roadmap, performance, and modernization of technology products and platforms supporting Medicare claims administration for more than 4 million members • Establish and mature product structure, practices, accountabilities, and cross-functional ways of working under a product operating model • Partner with business, engineering, data, architecture, operations, delivery leaders, and strategic software vendors to translate needs into prioritized investments, aligned roadmaps, and measurable outcomes • Influence vendor roadmaps, align modernization priorities, manage critical dependencies, partner with release management on complex releases, and hold partners accountable for product performance and business outcomes • Lead and develop product management colleagues and evolve teams toward sustained accountability for product and business outcomes • Define and socialize product vision, strategy, roadmaps, investment priorities, business cases, Epics, initiatives, OKRs, backlogs, capacity, timelines, and commitments • Lead discovery work, define roadmap items and epics, identify dependencies, size future-quarter work, and facilitate product ceremonies and PI planning • Monitor product, technical, and customer health using performance data and quantitative insights • Coordinate product launches, beta testing, user feedback collection, and product documentation • Facilitate the 5-in-the-box cross-functional product leadership team and socialize business strategies and outcomes • Showcase product team delivery and final output to stakeholders • Recruit, grow, coach, and develop product management colleagues while establishing high-performing team norms and a customer-centric culture

🎯 Anforderungen

• 10+ years of relevant experience in digital product management, healthcare technology, claims administration, or related product and technology leadership roles • 7+ years of software product management experience, with accountability for product strategy and the full product lifecycle from discovery through launch, adoption, and ongoing optimization • 5+ years of healthcare payer experience, including significant experience with claims administration products, platforms, operations, or transformation initiatives • Demonstrated knowledge of the end-to-end claims lifecycle, including benefit interpretation, adjudication, pricing, payment, adjustments, appeals, and financial reconciliation • Experience directly leading, developing, and coaching product management teams • Ability to work primarily during Eastern Time business hours and support critical business or production needs when required • Experience with Medicare Advantage claims, including CMS requirements, benefit configuration, provider reimbursement, claims accuracy, payment integrity, and regulatory compliance • Ability to translate claims business rules, regulatory requirements, operational needs, and performance issues into product capabilities, roadmaps, and measurable outcomes • Experience partnering across Claims Operations, Configuration, Provider, Finance, Compliance, Clinical, Engineering, and Data teams • Experience leading large-scale technology modernization initiatives involving cloud-based platforms, microservices architectures, legacy-system transformation, and complex enterprise dependencies • Ability to influence senior business and technology leaders, align cross-functional teams, and guide prioritization and investment decisions in a complex, regulated environment • Experience managing strategic technology vendor relationships • Experience leading product or operating-model transformation within a large, matrixed enterprise • Demonstrated use of data, quantitative analysis, and product performance measures • Working knowledge of cloud platforms, modern software architectures, AI, and machine learning • Product management or Agile certifications • Bachelor's degree or equivalent work experience

🏖️ Vorteile

• CVS Health bonus, commission or short-term incentive program • Award target in the company’s equity award program • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being, based on eligibility

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