Medicare Claims Technology Product Management Director

CVS Health is hiring a Lead Director to shape the strategy, roadmap, performance, and modernization of technology products and platforms supporting Medicare claims administration. The role partners across business, engineering, data, operations, and vendors to improve claims outcomes and develop product management teams and practices.

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, 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 roadmap items/epics (with input from other Product Management colleagues and functions who further define features, etc.), 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 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

Requirements:

• 10+ years of relevant experience in digital product management, healthcare technology, claims administration, or related product and technology leadership roles
• 7+ years of software product management experience, with demonstrated accountability for product strategy and the full product lifecycle from discovery through launch, adoption, and ongoing optimization
• 5+ years of healthcare payer experience, including significant experience with claims administration products, platforms, operations, or transformation initiatives, and demonstrated knowledge of the end-to-end claims lifecycle, such as benefit interpretation, adjudication, pricing, payment, adjustments, appeals, and financial reconciliation
• Demonstrated experience directly leading, developing, and coaching product management teams, including establishing clear accountability and building high-performing team cultures
• Experience with Medicare Advantage claims, including CMS requirements, benefit configuration, provider reimbursement, claims accuracy, payment integrity, and regulatory compliance
• Demonstrated ability to translate claims business rules, regulatory requirements, operational needs, and performance issues into product capabilities, roadmaps, and measurable outcomes
• Experience partnering across Claims Operations, Configuration, Provider, Finance, Compliance, Clinical, Engineering, and Data teams to improve claims outcomes
• Experience leading product strategy and execution for large-scale technology modernization initiatives involving cloud-based platforms, microservices architectures, legacy-system transformation, and complex enterprise dependencies
• Demonstrated ability to influence senior business and technology leaders, align cross-functional teams, and guide prioritization and investment decisions in a complex, regulated environment
• Experience managing strategic technology vendor relationships, including roadmap alignment, performance expectations, dependencies, and accountability for outcomes
• Experience leading product or operating-model transformation within a large, matrixed enterprise
• Demonstrated use of data, quantitative analysis, and product performance measures to inform decisions and prioritize investments
• Working knowledge of cloud platforms, modern software architectures, and emerging technologies, including AI and machine learning
• Bachelor's degree or equivalent work experience
• Product management or Agile certifications