Sr Manager - UM Innovation Delivery

CVS Health

1d•Remote

About The Position

The UM Innovation Team leads the implementation of strategic initiatives for the Utilization Management (UM) organization within Aetna’s Clinical Solutions Business Unit. The Sr. Manager, UM Innovation Delivery is accountable for driving multiple innovation efforts from concept through full‑scale implementation. This role partners closely with business stakeholders to define goals and collaborates with Technology and Delivery teams to design, implement, and operationalize solutions that support Clinical Interoperability, CMS commitments, and Center‑of‑Excellence business objectives. This position requires a strong blend of business acumen, technical understanding, and end‑to‑end project delivery expertise. The Sr. Manager is responsible for defining and prioritizing work, managing scope, mitigating risks, and ensuring clear communication across a highly matrixed environment.

Requirements

7+ years of experience as a Program and Project Delivery leader, or similar role delivering complex business or technical capabilities, in a matrix organization
Experience managing a Project Team in development of microservices and APIs in a cloud-native architecture (e.g., AWS, Azure, GCP).
Hands-on experience supporting the full business lifecycle: discovery, requirements, development, testing, and release.
Ability to translate business needs into clear and actionable capabilities and process documentation.
Familiarity with working alongside matrix teams such as architecture, development, and QA.
Strong and effective communication/collaboration skills across diverse stakeholder groups.
Ability to drive innovation in highly cross-functional environment.
Experience developing or supporting business requirements documents and process flows.

Nice To Haves

Familiarity with FHIR, X12 EDI, interoperability frameworks, and healthcare data integration standards.
Healthcare industry experience, preferably within Utilization Management or clinical operations.
Knowledge of clinical workflows, utilization review processes, and InterQual/MCG guidelines.
Experience working in a SAFe or other Scaled Agile delivery environment.

Responsibilities

Define, rationalize, and align priorities with a clearly articulated business rationale.
Partner and collaborate with cross‑functional teams—including key internal and external stakeholders—to develop, test, and implement innovative solutions.
Drive and manage innovation efforts through all stages, including ideation, solution development, and pilot execution, with an emphasis on scale, readiness, value realization, and ongoing monitoring.
Manage risks, develop mitigation strategies, facilitate working sessions, and deliver required analysis, reporting, and presentation materials.
Foster a culture that accelerates organizational strategy through our Heart At Work Behaviors by keeping customers and colleagues at the center of all efforts.
Define, prioritize, and rationalize innovation initiatives with a clear and measurable business rationale.
Lead delivery of innovation capabilities through all stages—ideation, solution design, development, pilot, launch, and value realization.
Work cross‑functionally with internal and external stakeholders to develop, test, refine, and implement innovative solutions.
Translate business goals into clear innovation capabilities, acceptance criteria, and technical requirements in partnership with clinical, business, and IT teams.
Identify opportunities to improve innovation capabilities, workflows, and user experience.
Assist in defining success metrics and reporting on performance and value delivered.