Senior Program Manager – Medicaid Claims

Job not on LinkedIn

🕒 August 11

🏈 Alabama, Connecticut, +28 more states – Remote

🏈 Alabama – Remote 🦌 Connecticut – Remote 🐊 Florida – Remote 🌽 Illinois – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦞 Maine – Remote 🌾 Nebraska – Remote 🗻 New Hampshire – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote ⚓ Rhode Island – Remote 🌴 South Carolina – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote ⛰️ West Virginia – Remote 🧀 Wisconsin – Remote

💵 $106.6k - $284.3k / year

⏰ Full Time

🟠 Senior

📋 Program Manager

👻 Ghost score 23%

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.

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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 enterprise delivery of multiple highly complex business process and technology initiatives aligned to the Medicaid program • Drive end-to-end delivery of Medicaid projects, ensuring completion on time, within scope, and with measurable results • Identify and resolve delivery obstacles and risks, proactively removing execution barriers • Monitor performance metrics and use data to optimize processes, improve productivity, and ensure accountability • Collaborate with business and technology partners to translate goals into actionable plans and deliverables • Lead process improvements and root cause analysis for sustainable, repeatable execution • Implement and reinforce best practices across workstreams • Provide practice leadership and peer mentorship to delivery practitioners • Support business process and technology improvements across multiple lines of business • Partner with stakeholders to prioritize work, drive measurable outcomes, and address execution barriers

🎯 Requirements

• 7+ years of experience in delivery management, program management, project management and Agile practice leadership, with deep expertise in Scrum methodologies • 5+ years of experience in healthcare claims processing, including adjudication, payment, and rework operations • 2+ years of experience with communication and facilitation, including developing and delivering executive-level presentations using PowerPoint • 2+ years of experience with planning, risk mitigation, and stakeholder engagement • 2+ years of proven success driving complex projects to completion on time and within defined scope • 2+ years of experience with problem-solving and decision-making skills • 2+ years of experience supporting innovation initiatives, emerging technologies, and digital transformation efforts • 2+ years of experience implementing and sustaining Agile practices in cross-functional team environments • 2+ years of experience working with Scrum, SAFe, and Waterfall methodologies • Bachelor’s degree or equivalent work experience required • Agile certifications such as SM, RTE, or SPC, PMP, or equivalent certifications preferred • Experience with Medicaid programs preferred

🏖️ 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