Claim Automation Product Manager

CVS Health•Hartford, CT

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. The Lead Director, Technology Product Management for our Claim Automation Portfolio will lead the strategic roadmaps, capabilities, and Objective and Key results (OKRs) definition needed to optimize claim processing. This role requires deep familiarity with health plan claims operations, including the claims adjudication lifecycle, pend management, and rework reduction across multiple lines of business. Across multiple product teams, you are responsible for the overall success of the product, improving product health and driving value towards targeted outcomes, including engaging with and defining product roadmaps with key vendor partners. You will work closely with the Business General Manager (GM), Design, Engineering, and Data/Analytics as part of the “Five in a Box” cross-functional product leadership team and serve as the main point of contact with other stakeholders such as architects, tech-ops, security, etc. to ensure overall cohesion for the Claim Automation portfolio, including alignment with claims operations leadership across all lines of business. You will lead a team of product management colleagues, creating a positive team culture through development and coaching.

Requirements

10+ years required experience in product management role
5+ years required experience in software product management, with demonstrated success shipping software through multiple releases managing the entire lifecycle from discovery to launch in an agile environment
10+ years of experience in technical product management, with focus around building technical products and services.
5+ years of experience in building and managing technical product teams using Agile framework
5+ years of experience with large-scale modernization programs in technical capacity.
5+ years of experience in health plan claims operations, claims administration, or claims technology

Nice To Haves

Ability to drive cross functional teams to alignment in the midst of ambiguity
Strong decision making skills in fast moving environments
Experience leading product transformation within a large enterprise
Strong negotiation, organizational, management, analytical and people skills
Data-driven decision making and quantitative analysis skills
General understanding of core programming and computer science concepts, including cloud and AI/ML
Product Management and/or Agile Certifications
Experience with claims adjudication platforms in a payer environment
Understanding of claims automation, RPA, or AI-assisted decision support
Knowledge of multi-LOB claims operations (Medicare, Commercial, Medicaid)

Responsibilities

Defines and socializes the product vision, strategy and roadmap in collaboration with the 5-in-the-box team; assesses and refines as needed
Partners with business general manager and stakeholders to make decisions on investment priorities and develop business cases
Translates customer and business and technology needs into short-term and long-term product strategy by creating Epics/initiatives defined to meet targeted outcomes
Connects the roadmap to specific value drivers that contribute to business priorities, objectives and key results, and strategic programs
Responsible for aligning roadmaps, backlogs, capacity, timelines, and commitments across the respective product areas needed to deliver
Defines product objectives and key results (OKRs), aligned with business objectives, to evaluate progress towards outcomes
Sets the direction for discovery work, ensuring that the product team is focused on continuous exploration
Defines features (with input from other Product Management colleagues and functions), identifies dependencies, and works with teams to size ahead of future quarters
Facilitates product-level ceremonies & meetings, including quarterly PI planning activities (when applicable), in partnership with the product leadership team
Uses performance data to identify issues quickly, and develop new insights and hypotheses about product health, technical health, and customer feedback
Tracks product objectives and key results (OKRs), aligned with business objectives, to understand progress towards outcomes and metrics, socializes progress, and consistently reinforces objectives and alignment with broader product portfolio outcomes
Coordinates product launches, including beta testing, user feedback collection, and product documentation
Ensures that incremental learnings from product discovery & delivery are prioritized in the backlog.
Facilitates the 5-in-the-box cross-functional product leadership team, including strong partnership with Business General Manager (GM)
Ensures business strategies and targeted outcomes are well understood and socialized to product teams
Understands market and customer needs through partnership with business & customer insight teams
Showcases the product teams’ delivery and final output to stakeholders
Understands the hiring market to identify successful candidates with the unique blend of personality and skillset matches
Champions strong product management and agile mindsets and values by actively communicating team wins and opportunities
Establishes high performing teams by growing and coaching product management colleagues (Product Managers, Product Leads, Product Owners, etc.) and defining team norms on how teams working on this product operate
Responsible for promoting and setting a customer-centric culture where all teams understand the current performance of the product, opportunities areas and the north star vision, and are monitoring and proactively reacting to key product health metrics and communicating updates
Maintains working knowledge of end-to-end claims adjudication — from submission through adjudication, pend, resolution, and payment — across multiple lines of business
Partners with claims operations leadership and frontline processing teams to identify workflow pain points and rework drivers that inform product priorities
Tracks claims quality, rework rates, and processor productivity to ground product decisions in operational data
Understands change management challenges of deploying new tooling into high-volume claims processing environments