Senior Product Manager, Fraud & Abuse

Job not on LinkedIn

🔥 0 minutes ago

🦌 Connecticut – Remote

🦌 Connecticut – Remote

💵 $130.3k - $260.6k / year

⏰ Full Time

🟠 Senior

✅ Product Manager

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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

• Lead the ongoing development and expansion of Fraud, Waste, and Abuse products delivering over $200M in annual impact • Support CVS Health’s Payment Optimization Analytics objectives and revenue and ROI targets for analytics products • Own product vision, strategy, and performance • Identify and prioritize AI/ML integration opportunities • Translate market trends, user feedback, and competitive intelligence into product direction • Lead a cross-functional squad of data engineers, data scientists, and ideation team members • Define and document the squad’s problem, priorities, and tradeoffs • Develop and maintain roadmaps, backlogs, sprint plans, and demo materials • Facilitate stakeholder sessions, sprint planning, working sessions, and product demos • Evaluate AI/ML advancements for applicability to the product portfolio • Establish and monitor product performance, adoption, and business-impact KPIs • Develop data-driven business cases and secure stakeholder alignment and financial investment • Ensure timely, high-quality delivery of product enhancements meeting business and technical requirements

🎯 Requirements

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

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • CVS Health bonus, commission or short-term incentive program • Equity award program