Project Manager, Complaints & Appeals
CVS Health•New York, VT
•$54,300 - $159,120
About The Position
CVS Health is hiring a Project Manager, Complaints & Appeals, to support its goal of creating a more connected, convenient, and compassionate health experience. The role manages projects and supports the Appeals team by validating project effectiveness through universe data validation, reporting capabilities related to audit requests and universe submissions, and maintaining processes that support regulatory and accreditation compliance. The position also contributes to team performance through training, coaching, development, collaboration, and meeting facilitation.
Requirements
- At least 3 years of Appeals experience.
- Microsoft Office experience.
- Knowledge of Appeals job aids and workflows.
- Strong communication skills, including the ability to provide and receive feedback.
- Excellent time-management skills.
- At least 2 years of supervisory experience.
- Ability to work collaboratively across teams.
- Strong analytical skills, with accuracy and attention to detail.
- High school diploma or higher education.
Nice To Haves
- At least 2 years of project management experience.
- QuickBase experience.
- At least 2 years of training or leadership experience.
- Knowledge of CMS guidance.
- Product knowledge and experience with Appeals and Medicare regulatory requirements.
- Appeals and MHK knowledge or experience.
- Bachelor's degree or equivalent experience.
Responsibilities
- Build and maintain a strong team through training, coaching, and developing staff.
- Validate the effectiveness of projects managed by the Appeals team through universe data validation.
- Facilitate and present at meetings within the Appeals team.
- Collaborate with the business to establish and maintain consistent processes defining the overview and readiness of appeals, supporting regulatory and accreditation compliance.
- Assess developmental needs and collaborate with others to identify and implement action plans that support high-performing teams and individuals.
- Manage projects, identify trends, and recommend or act on solutions.
- Report capabilities related to audit requests and universe submissions.
Benefits
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources, based on eligibility
- Eligibility for a CVS Health bonus, commission, or short-term incentive program
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
High school or GED
