Senior Manager, Complaint & Appeals, CVS Health

CVS Health

Location:
United States, Work At Home

Category:
Customer Service

Contract Type:
Employment contract

Salary:

67900.00 - 149328.00 USD / Year

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Job Description:

Coordinate effective resolution of member or provider/practitioner appeals, complaints and grievances. Establish and maintain consistent policies and procedures defining the administration and resolution of appeals, complaints and grievances compliant with legislative, regulatory and accreditation requirements.

Job Responsibility:

Coordinate effective resolution of member or provider/practitioner appeals, complaints and grievances
Establish and maintain policies and procedures for appeals, complaints and grievances
Manage team productivity and resources
Serve as content model expert and mentor
Ensure compliance with federal and state requirements and quality measures
Identify trends involving non-clinical & clinical issues

Requirements:

3+ years supervisory experience
3+ years appeals and grievances experience
Bachelor's degree or 5 years equivalent work experience in Healthcare, Project Management, Audit, Systems Design

Nice to have:

Experience in research and analysis of claim processing
Experience working with managed and non-managed health care benefits

What we offer:

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
Wellness screenings
Tobacco cessation programs
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

Additional Information:

Job Posted:
September 12, 2025

Expiration:
September 21, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Senior Manager, Complaint & Appeals