Executive Director, Coordination of Benefits & Recovery Operations

CVS Health•Hartford, CT

19d•Hybrid

About The Position

The Executive Director, Coordination of Benefits & Recovery Operations is responsible for setting and executing the operational strategy for the functions. This role applies deep knowledge of organizational strategy, regulatory requirements, and the external healthcare landscape to ensure financial performance, operational efficiency, and service excellence. The leader establishes policies, programs, and governance to consistently meet or exceed established KPIs and SLAs in partnership with business stakeholders.

Requirements

15+ years of progressive experience leading large-scale operations, including management of both direct and indirect FTEs.
Strong experience managing KPIs and SLAs in an operational environment.
Deep healthcare industry experience, specifically in cost containment and recovery-related operations.
Experience leading data‑driven recovery operations and/or Coordination of Benefits functions is highly preferred.
Ability to work Hybrid Model (in office Tuesday / Wednesday / Thursday)

Responsibilities

Lead Coordination of Benefits and Recovery Operations processes, ensuring alignment with overall business strategy
Establish organizational policies, goals, and operating standards based on industry best practices.
Drives analysis and forecasting of key financial and operational drivers; provide recommendations to adjust budgets and business plans based on membership growth and healthcare utilization trends.
Partner closely with Payment Integrity leadership to ensure workflows, dependencies, and handoffs across teams are aligned and optimized.
Provide executive oversight for consolidation, restructuring, and business transactions impacting Coordination of Benefits and Recovery Operations.
Ensure customer service standards are consistently met and all KPIs and SLAs are achieved.
Develop and implement methodologies that drive quality improvement, operational efficiency, and cost containment across products, services, and solutions.
Lead, coach, and develop teams through ongoing feedback and formal performance management processes, driving engagement, accountability, and high-performance culture.