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Claim Automation Product Manager

https://www.cvshealth.com/ Logo

CVS Health

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Location:
United States , Work at Home

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Contract Type:
Employment contract

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Salary:

144200.00 - 288400.00 USD / Year

Job Description:

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. The Lead Director, Technology Product Management for our Claim Automation Portfolio will lead the strategic roadmaps, capabilities, and Objective and Key results (OKRs) definition needed to optimize claim processing. This role requires deep familiarity with health plan claims operations, including the claims adjudication lifecycle, pend management, and rework reduction across multiple lines of business. Across multiple product teams, you are responsible for the overall success of the product, improving product health and driving value towards targeted outcomes, including engaging with and defining product roadmaps with key vendor partners.

Job Responsibility:

  • Leads the strategic roadmaps, capabilities, and Objective and Key results (OKRs) definition needed to optimize claim processing
  • Works closely with the Business General Manager (GM), Design, Engineering, and Data/Analytics as part of the Five in a Box cross-functional product leadership team
  • Leads a team of product management colleagues
  • Defines and socializes the product vision, strategy and roadmap
  • Partners with business general manager and stakeholders to make decisions on investment priorities
  • Translates customer and business and technology needs into short-term and long-term product strategy
  • Connects the roadmap to specific value drivers
  • Responsible for aligning roadmaps, backlogs, capacity, timelines, and commitments across respective product areas
  • Defines product objectives and key results (OKRs)
  • Sets the direction for discovery work
  • Defines features, identifies dependencies, and works with teams to size ahead of future quarters
  • Facilitates product-level ceremonies & meetings
  • Uses performance data to identify issues
  • Tracks product objectives and key results (OKRs)
  • Coordinates product launches
  • Ensures that incremental learnings from product discovery & delivery are prioritized
  • Facilitates the 5-in-the-box cross-functional product leadership team
  • Ensures business strategies and targeted outcomes are well understood and socialized
  • Understands market and customer needs through partnership with business & customer insight teams
  • Showcases the product teams' delivery and final output to stakeholders
  • Understands the hiring market to identify successful candidates
  • Champions strong product management and agile mindsets
  • Establishes high performing teams by growing and coaching product management colleagues
  • Responsible for promoting and setting a customer-centric culture
  • Maintains working knowledge of end-to-end claims adjudication
  • Partners with claims operations leadership and frontline processing teams
  • Tracks claims quality, rework rates, and processor productivity
  • Understands change management challenges of deploying new tooling into high-volume claims processing environments

Requirements:

  • 10+ years required experience in product management role
  • 5+ years required experience in software product management, with demonstrated success shipping software through multiple releases managing the entire lifecycle from discovery to launch in an agile environment
  • 10+ years of experience in technical product management, with focus around building technical products and services
  • 5+ years of experience in building and managing technical product teams using Agile framework
  • 5+ years of experience with large-scale modernization programs in technical capacity
  • 5+ years of experience in health plan claims operations, claims administration, or claims technology
  • Bachelor's degree or equivalent work experience

Nice to have:

  • Ability to drive cross functional teams to alignment in the midst of ambiguity
  • Strong decision making skills in fast moving environments
  • Experience leading product transformation within a large enterprise
  • Strong negotiation, organizational, management, analytical and people skills
  • Data-driven decision making and quantitative analysis skills
  • General understanding of core programming and computer science concepts, including cloud and AI/ML
  • Product Management and/or Agile Certifications
  • Experience with claims adjudication platforms in a payer environment
  • Understanding of claims automation, RPA, or AI-assisted decision support
  • Knowledge of multi-LOB claims operations (Medicare, Commercial, Medicaid)
What we offer:
  • Medical, dental, and vision coverage
  • Paid time off
  • Retirement savings options
  • Wellness programs
  • Bonus, commission or short-term incentive program
  • Equity award program

Additional Information:

Job Posted:
May 17, 2026

Expiration:
May 31, 2026

Employment Type:
Fulltime
Work Type:
Remote work
Job Link Share:

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