Medicare Claims Technology Product Management Director

CVS Health•New York, CT

3d•$144,200 - $288,400

About The Position

The Lead Director, Technology Product Management for Medicare Claims is accountable for shaping the strategy, roadmap, performance, and modernization of technology products and platforms supporting claims administration for more than 4 million Medicare members. As the organization transitions to a product operating model, this leader will establish and mature product structures, practices, accountabilities, and cross-functional ways of working to improve claims accuracy, automation, timeliness, reliability, compliance, and operating efficiency. The role partners with business, engineering, data, architecture, operations, delivery leaders, and strategic software vendors to translate claims, regulatory, operational, and technology needs into prioritized investments, aligned roadmaps, and measurable outcomes across a complex enterprise ecosystem. The Lead Director influences vendor roadmaps, aligns modernization priorities, manages dependencies, partners with release management on complex releases, and holds internal and external partners accountable for product performance and business outcomes. The role also leads and develops product management colleagues, strengthens product capabilities, and guides teams toward sustained accountability for product and business outcomes. The leader defines product vision, strategy, roadmaps, objectives, and key results; prioritizes investments and backlog work; guides discovery and product ceremonies; monitors product and technical health; coordinates launches and feedback; and facilitates cross-functional product leadership. The role also develops product management talent, coaches colleagues, establishes team norms, and promotes a customer-centric culture.

Requirements

10+ years of relevant experience in digital product management, healthcare technology, claims administration, or related product and technology leadership roles.
7+ years of software product management experience, with accountability for product strategy and the full product lifecycle from discovery through launch, adoption, and ongoing optimization.
5+ years of healthcare payer experience, including significant experience with claims administration products, platforms, operations, or transformation initiatives.
Demonstrated knowledge of the end-to-end claims lifecycle, such as benefit interpretation, adjudication, pricing, payment, adjustments, appeals, and financial reconciliation.
Demonstrated experience directly leading, developing, and coaching product management teams, including establishing accountability and building high-performing team cultures.
Ability to work primarily during Eastern Time business hours and support critical business or production needs when required.
Bachelor's degree or equivalent work experience.

Nice To Haves

Experience with Medicare Advantage claims, including CMS requirements, benefit configuration, provider reimbursement, claims accuracy, payment integrity, and regulatory compliance.
Ability to translate claims business rules, regulatory requirements, operational needs, and performance issues into product capabilities, roadmaps, and measurable outcomes.
Experience partnering across Claims Operations, Configuration, Provider, Finance, Compliance, Clinical, Engineering, and Data teams to improve claims outcomes.
Experience leading product strategy and execution for large-scale technology modernization involving cloud-based platforms, microservices architectures, legacy-system transformation, and complex enterprise dependencies.
Ability to influence senior business and technology leaders, align cross-functional teams, and guide prioritization and investment decisions in a complex, regulated environment.
Experience managing strategic technology vendor relationships, including roadmap alignment, performance expectations, dependencies, and accountability for outcomes.
Experience leading product or operating-model transformation within a large, matrixed enterprise.
Demonstrated use of data, quantitative analysis, and product performance measures to inform decisions and prioritize investments.
Working knowledge of cloud platforms, modern software architectures, and emerging technologies, including AI and machine learning.
Product management or Agile certifications.

Responsibilities

Define and socialize the product vision, strategy, and roadmap with the 5-in-the-box team, assessing and refining them as needed.
Partner with the business general manager and stakeholders to make investment-priority decisions and develop business cases.
Translate customer, business, and technology needs into short- and long-term product strategy and outcome-focused Epics or initiatives.
Connect roadmaps to value drivers, business priorities, objectives and key results, and strategic programs.
Align roadmaps, backlogs, capacity, timelines, and commitments across product areas.
Define product objectives and key results aligned with business objectives and evaluate progress toward outcomes.
Set direction for discovery work and ensure continuous exploration by the product team.
Define roadmap items and epics, identify dependencies, and work with teams to size future work.
Facilitate product-level ceremonies and meetings, including quarterly PI planning when applicable, in partnership with product leadership.
Use performance data to identify issues and develop insights and hypotheses about product health, technical health, and customer feedback.
Track and socialize progress against product objectives, outcomes, and metrics, reinforcing alignment with broader portfolio outcomes.
Coordinate product launches, including beta testing, user feedback collection, and product documentation.
Ensure learnings from product discovery and delivery are prioritized in the backlog.
Facilitate the 5-in-the-box cross-functional product leadership team, including partnership with the Business General Manager.
Ensure business strategies and targeted outcomes are understood and communicated to product teams.
Understand market and customer needs through partnership with business and customer insight teams.
Showcase product-team delivery and final outputs to stakeholders.
Identify successful candidates and develop, coach, and grow product management colleagues.
Champion product management and agile mindsets and values by communicating team wins and opportunities.
Establish high-performing teams and define team norms for people working on the product.
Promote a customer-centric culture in which teams understand product performance, improvement opportunities, and the north star vision, and monitor and respond to product health metrics.