Lead Director - Claim Automation Product Manager

CVS Health is dedicated to building a world of health around every individual, fostering a connected and compassionate health experience. The Lead Director, Claim Automation Product Manager will drive the strategic vision for the claims automation portfolio, leading cross-functional teams to optimize claim processing and deliver innovative solutions that transform healthcare operations.

Responsibilities:

• Defines and socializes the product vision, strategy and roadmap in collaboration with the 5-in-the-box team; assesses and refines as needed
• Partners with business general manager and stakeholders to make decisions on investment priorities and develop business cases
• Translates customer and business and technology needs into short-term and long-term product strategy by creating Epics/initiatives defined to meet targeted outcomes
• Connects the roadmap to specific value drivers that contribute to business priorities, objectives and key results, and strategic programs
• Responsible for aligning roadmaps, backlogs, capacity, timelines, and commitments across the respective product areas needed to deliver
• Defines product objectives and key results (OKRs), aligned with business objectives, to evaluate progress towards outcomes
• Sets the direction for discovery work, ensuring that the product team is focused on continuous exploration
• Defines features (with input from other Product Management colleagues and functions), identifies dependencies, and works with teams to size ahead of future quarters
• Facilitates product-level ceremonies & meetings, including quarterly PI planning activities (when applicable), in partnership with the product leadership team
• Uses performance data to identify issues quickly, and develop new insights and hypotheses about product health, technical health, and customer feedback
• Tracks product objectives and key results (OKRs), aligned with business objectives, to understand progress towards outcomes and metrics, socializes progress, and consistently reinforces objectives and alignment with broader product portfolio outcomes
• Coordinates product launches, including beta testing, user feedback collection, and product documentation
• Ensures that incremental learnings from product discovery & delivery are prioritized in the backlog
• Facilitates the 5-in-the-box cross-functional product leadership team, including strong partnership with Business General Manager (GM)
• Ensures business strategies and targeted outcomes are well understood and socialized to product teams
• 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 with the unique blend of personality and skillset matches
• Champions strong product management and agile mindsets and values by actively communicating team wins and opportunities
• Establishes high performing teams by growing and coaching product management colleagues (Product Managers, Product Leads, Product Owners, etc.) and defining team norms on how teams working on this product operate
• Responsible for promoting and setting a customer-centric culture where all teams understand the current performance of the product, opportunities areas and the north star vision, and are monitoring and proactively reacting to key product health metrics and communicating updates
• Maintains working knowledge of end-to-end claims adjudication — from submission through adjudication, pend, resolution, and payment — across multiple lines of business
• Partners with claims operations leadership and frontline processing teams to identify workflow pain points and rework drivers that inform product priorities
• Tracks claims quality, rework rates, and processor productivity to ground product decisions in operational data
• 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
• 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)