Lead Director, Patient & Authorization Management, Provider Digital Experience & Operations

CVS Health • Hartford, CT

23h • $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. Position Summary The Lead Director, Patient & Auth Management for Provider Digital Operations is responsible for the strategic leadership and operational oversight of Aetna’s Patient and Authorization suite of provider-facing transactions. This role partners with the technology teams to develop strategy and roadmaps, ensuring exceptional provider experiences and operational excellence through performance management, compliance, and team leadership. This role is critical to driving improvements in provider experience, reducing rework, calls, and paperwork, and improving key metrics such as NPS. The Lead Director will be accountable for end-to-end thinking, cross-team collaboration, and resource alignment to deliver innovative solutions that enhance provider and colleague experiences.

Requirements

• 10+ years of healthcare experience, preferably working with network and provider-related operations and strategy.
• 5+ years leading and developing high functioning teams
• Adept at execution and delivery (planning, delivering, and supporting) skills
• Adept at business intelligence
• Adept at collaboration and teamwork
• Mastery of problem solving and decision making skills
• Mastery of growth mindset (agility and developing yourself and others) skills

Nice To Haves

• Experience with digital administrative transactions and/or self-service capabilities

Responsibilities

• Develop and execute comprehensive transaction strategies and roadmaps aligned with prioritized provider experience initiatives and workflow requirements
• Collaborate with senior management to define strategic objectives and investment priorities for transaction enhancements
• Oversee transaction performance, defect resolution, and be involved with incident response coordination
• Lead cross-functional teams to deliver projects and programs from initiation through completion, ensuring timely delivery within budget and scope
• Participate in monthly and quarterly health checks and business reviews with vendors
• Ensure ongoing compliance through annual security risk assessments, user entitlement validation, recertification, business continuity planning, and process documentation.
• Coordinate responses to compliance incidents, including potential PHI breaches and audits
• Identify project stakeholders, establish effective communication channels, and manage expectations.
• Monitor expenditures and ensure adherence to financial constraints throughout the project lifecycle
• Prepare and present progress reports to stakeholders and senior management
• Develop and implement mitigation strategies to minimize risks and ensure project success
• Identify opportunities for process improvement and implement best practices, lessons learned, and industry standards
• Provide leadership and guidance to project and program teams, assigning responsibilities, setting performance expectations, and motivating team members to achieve objectives.

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Director