Lead Director of UM Innovation Delivery, CVS Health

CVS Health

Location:
United States, Work at Home

Category:
IT - Administration

Contract Type:
Employment contract

Salary:

100000.00 - 231540.00 USD / Year

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Job Description:

The Lead Director of UM Innovation Delivery is a critical leader and has responsible for managing and successfully driving initiatives that solves key business problems and creates new sources of value for Utilization Management within Aetna's Clinical Solutions business unit. This role leads the planning, execution, and delivery of complex high-impact initiative aligned to corporate goals, regulatory requirements and clinical best practices.

Job Responsibility:

Lead and manage strategic projects and programs from initiation to completion, ensuring on-time delivery, budget adherence, and alignment with defined scope and objectives
Drive transformation initiatives to modernize healthcare UM operations by aligning cross-functional teams (business, IT, architecture, operations) to deliver strategic goals and continuous improvement
Collaborate with senior leadership to define strategic plans, establish program objectives, and ensure alignment with organizational priorities
Set up and execute SAFe Agile trains
lead PI planning and sprint execution while coaching teams and leaders on agile methodologies and best practices
Define product features, prioritize MVPs, and develop delivery roadmaps for UM automation capabilities, including deployment of APIs, ODM Rules Engine, predictive models, and AI voice technologies
Oversee configuration and maintenance of business rules and automation tools to support scalable and efficient operations
Apply formal project management methodologies to manage timelines, risks, dependencies, and change controls
maintain detailed documentation, dashboards, and executive-level reporting
Monitor budgets and resource allocation to ensure financial accountability and maximize ROI
proactively develop mitigation strategies and contingency plans to address risks
Responsible for developing, motivating and managing a high-performing team members to meet organizational goals and objectives while effectively managing change
Contribute to a motivated work environment by working collaboratively and effectively with key stakeholders across Health Care Business and Aetna Clinical Solutions to achieve common goals

Requirements:

10+ years experience in healthcare project management with proven track record of leading large-scale, complex initiatives in healthcare insurance or managed care organization
Strong understanding within clinical and health plan operations and value creation methodologies including Utilization and Policy Management, Care Management and Coordination, Quality, Compliance and Regulatory Management
Successful experience in strategic planning, execution, and agile project portfolio management within healthcare industry
Expertise in technologies such as APIs, Microservices, Business Rules, Predictive Modeling, AI, NLP
High ability to consistently produce and create value and meet/exceed committed performance
Strong interpersonal and communication skills, effectively communicate key messages to executive leaders and internal/external stake holders
Strong verbal and written communication skills
proven ability to deliver presentations to senior leadership team members
Effectively lead and motivate teams to ensure high standards of performance and outcomes
Bachelor's Degree or equivalent work experience, Computer Science, Engineering, or related field preferred

Nice to have:

5+ years with demonstrated leadership and experience with the following: Innovation, generative AI, business process optimization, project portfolio management/consulting, strategic planning and risk management
Agile Certifications such as SAFe Agilist or CSPO
Health domain certifications such as AHIP certifications (Fundamentals of Healthcare Part A & B, AHM250)
Ability to manage and grow a team of individuals to achieve departmental goals at a rapid pace
Experience creating new capabilities and/or project offerings that result in new value
Conceptual and structured thinker that has a high degree to generate and translate concepts and ideas into effective strategies that achieve results
Ability to embrace change, uncertainly and shifting priorities and plans to accommodate broader changing objectives and demands
Master's Degree preferred

What we offer:

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
No-cost wellness screenings
No-cost tobacco cessation programs
No-cost weight management programs
Confidential counseling
Financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access
CVS Health bonus, commission or short-term incentive program
Equity award program

Additional Information:

Job Posted:
October 25, 2025

Expiration:
October 31, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Lead Director of UM Innovation Delivery