Medicare Claims Technology Product Management Director

Job not on LinkedIn

🔥 5 minutes ago

🦌 Connecticut, Florida, +2 more states – Remote

🦌 Connecticut – Remote 🐊 Florida – Remote 🗽 New York – Remote ⚔️ Virginia – Remote

💵 $144.2k - $288.4k / year

⏰ Full Time

🔴 Lead

✅ Product Manager

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• 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

🎯 Requirements

• 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

🏖️ Benefits

• 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