Lead Director - Grievance & Appeals - PMO Lead

CVS HealthHartford, CT
$100,000 - $231,540

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. Role Summary The Director of Project Management serves as the PMO Lead for Strategic Initiatives within Grievance & Appeals. This role is responsible for leading complex, cross-functional program governance and execution with key partners across Grievance & Appeals, Utilization Management, Claims, Provider Operations, and other key business functions. The Director drives alignment, accountability, and performance management to deliver sustainable improvements with measurable outcomes.

Requirements

  • 10–15+ years of experience in program/project management, healthcare operations, consulting, or a related field; healthcare payer experience preferred.
  • Demonstrated success establishing governance frameworks and leading complex, cross-functional programs with multiple concurrent workstreams.
  • Strong executive communication and presentation skills, with the ability to translate complex operational data into clear, actionable insights for senior leadership audiences.
  • Experience driving organizational alignment and influencing stakeholders across a highly matrixed environment.
  • Strong problem-solving, decision-making, and critical thinking skills.
  • Demonstrated commitment to continuous learning, innovation, and a growth mindset.

Nice To Haves

  • Familiarity with healthcare payer operations, including Grievance & Appeals, Utilization Management, Claims, Provider Operations, and root cause analysis methodologies.
  • Project Management Professional (PMP) certification.

Responsibilities

  • Lead complex, cross-functional strategic initiatives that support organizational priorities and business objectives.
  • Establish and manage program governance frameworks, including operating cadences, decision-making processes, and accountability mechanisms.
  • Partner with business and operational leaders to align priorities, resolve cross-functional challenges, and drive achievement of strategic objectives.
  • Provide oversight of program execution, ensuring initiatives remain aligned to timelines, objectives, and expected outcomes.
  • Monitor program performance, risks, dependencies, and issues, implementing mitigation strategies as needed.
  • Influence decision-making and drive accountability in a highly matrixed environment.
  • Lead governance forums and leadership reviews to support program progress and strategic alignment.
  • Promote consistent application of project and program management best practices.
  • Establish performance measures and reporting processes to track progress, outcomes, and value realization.
  • Develop executive-level communications, presentations, and updates for leadership audiences.
  • Translate complex information into clear insights and actionable recommendations.
  • Ensure transparency regarding program status, risks, opportunities, and business impact.

Benefits

  • medical, dental, and vision coverage
  • paid time off
  • retirement savings options
  • wellness programs
  • other resources, based on eligibility
  • CVS Health bonus, commission or short-term incentive program
  • award target in the company’s equity award program
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