Director , Product Management - AI Claims Platform
About The Position
CVS Health's Analytics & Behavior Change (A&BC) is an organization working to solve some of the most challenging problems at the intersection of technology and healthcare. A&BC leverages advanced analytics, machine learning, modeling, and a hypothesis-driven approach to transform data into actionable, customer-centric insights to drive growth, improve health outcomes and access to health care across all our businesses in CVS Health. Our data teams build next generation data and machine learning platforms and products in the cloud that help CVS Health to make healthier happen for 100+ million customers. CVS Health is building the next generation of AI-powered tools that transform the fundamentals of claims service operations, including solutions such as AI-powered agentic claims advisor platform and auto adjudication systems and knowledge bases. We are looking for a Director, Product Management-AI Claims Platform to own this portfolio. You will set the “what” and “why” - define vision and roadmap, lead a team of Product Managers, each heading a dedicated cross-functional squad (agile development teams) to deliver measurable impact in a high-stakes enterprise environment. This is a rare opportunity to own a flagship AI product in healthcare from strategy through delivery — partnering closely with Business executives, Operations teams, Enterprise technology, Data science and Engineering, with strong visibility to senior leadership. This role requires operating with a high degree of autonomy while maintaining credibility across the 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.
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.
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
Benefits
- medical
- dental
- vision coverage
- paid time off
- retirement savings options
- wellness programs
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What This Job Offers
Job Type
Full-time
Career Level
Director
