Director , Product Management - AI Claims Platform

CVS Health•New York, ID

1d•$144,200 - $288,400

About The Position

CVS Health's Analytics & Behavior Change (A&BC) organization is focused on solving complex problems at the intersection of technology and healthcare. A&BC utilizes advanced analytics, machine learning, modeling, and a hypothesis-driven approach to transform data into actionable, customer-centric insights that drive growth and improve health outcomes and access to healthcare across all CVS Health businesses. Our data teams develop next-generation data and machine learning platforms and products in the cloud to help CVS Health make healthier happen for over 100 million customers. CVS Health is developing AI-powered tools to revolutionize claims service operations, including an AI-powered agentic claims advisor platform, auto-adjudication systems, and knowledge bases. This role is for a Director, Product Management-AI Claims Platform, who will own this portfolio. The individual will define the vision and roadmap, lead a team of Product Managers, each managing a dedicated cross-functional agile squad, to deliver measurable impact in a high-stakes enterprise environment. This is a unique opportunity to lead a flagship AI product in healthcare from strategy to delivery, collaborating with business executives, operations teams, enterprise technology, data science, and engineering, with significant visibility to senior leadership. The role requires a high degree of autonomy and credibility across stakeholders.

Requirements

10+ years in Product Management, with clear progression to Senior / Director-level scope and a track record of owning products end-to-end.
5+ years of experience turning complex, ambiguous policy or business rules into reliable product logic in partnership with subject-matter experts.
5+ years leading through influence in complex, matrixed organizations, creating clarity and momentum amid ambiguity.
3+ years’ hands-on experience building AI or other advanced-analytics powered workflow-automation products in real operational environments, including human-in-the-loop systems where accuracy and trust matter.
3+ years of experience with healthcare claims, adjudication systems, or other complex, policy-driven operational workflows.
3+ years demonstrating skills as a first-principles thinker who can get to the root of hard problems and translate them into a clear strategy executives can act on.
3+ years of exceptional executive communication — able to distill complex tradeoffs into crisp, compelling narratives for VP+ audiences.
Bachelor's degree required, preferably in a quantitative, analytical, or technical field (e.g., Data Science, Statistics, Computer Science, Health Informatics, Economics, or related discipline).

Nice To Haves

Familiarity with claims adjudication systems and business rules engines.
Demonstrated ability to design and evolve how a product organization operates.
Fluency with the latest ML and agentic approaches, with a clear point of view on where human oversight belongs, guardrails and evaluation strategy.
Change-management and adoption-strategy experience for enterprise tools and software.
MBA or advanced degree preferred.

Responsibilities

Own the product vision and multi-horizon roadmap for AI-powered claims decision-support and auto adjudication platform, identifying, shaping and prioritizing capabilities.
Translate complex, nuanced claims policies and business operational workflows into a clear, prioritized technology product strategy across Aetna’s commercial and government lines of businesses.
Ensure user-centric design and anchor the product strategy and scope to maximize impact and support future scaling.
Make confident, well-reasoned product decisions amid ambiguity, driving momentum and impact without waiting for perfect information.
Frame investment decisions and tradeoffs for senior executives in terms of measurable outcomes.
Serve as the primary product voice across a highly matrixed enterprise, partnering with business, enterprise technology, data science and engineering, and program leadership.
Shape how a fast-scaling product organization operates — clarifying roles, decision-making, and ways of working across product life cycle activities.
Build durable, scalable partnerships with business and subject-matter experts to ensure alignment of vision.
Shape business case and supporting budgeting, investment committee review, and finance reporting processes.
Anticipate and resolve adjacent portfolio dependencies and competing priorities, keeping the broader effort aligned and moving.
Be primary point of engagement for senior business stakeholders and tailor communication by audience and goals, whether aligning product strategy, driving commercial decisions, or unblocking delivery and anticipating misalignment before it surfaces.
Lead delivery across the portfolio including roadmap, prioritization, milestone, and impact accountability, through a team of product managers, setting clear direction and growing the team while stepping in to perform hands-on product responsibilities when needed.
Identify and resolve cross-squad and cross functional interdependencies and prioritization trade-offs.
Responsible for setting, measuring, and leading the team to accomplish product adoption, user change management and business impact goals.
Engage credibly in technical discussions, ensuring solution feasibility and traceability to business and customer requirements.
Partner closely with engineering and data science on the product’s intelligence engine, data foundations, validation and testing systems, coordinating resolution with broader Enterprise partners.