CVS Health

Lead Director - Grievance & Appeals - PMO Lead

CVS Health$100K — $231K *
Healthcare
8 - 10 years of experience
Job Overview by Ladders

Qualifications

  • 10-15+ years in program/project management, healthcare operations, consulting, or related field; healthcare payer experience preferred.
  • Proven track record in establishing governance frameworks and leading complex cross-functional programs.
  • Strong executive communication skills with the ability to distill complex data into actionable insights for leadership.
  • Experience in driving alignment and influencing stakeholders in a matrixed environment.
  • Exceptional problem-solving and critical thinking abilities.
  • Commitment to continuous learning and innovation.

Responsibilities

  • Lead cross-functional strategic initiatives aligned with organizational goals.
  • Establish and manage program governance frameworks and accountability mechanisms.
  • Collaborate with leaders to align priorities and resolve challenges.
  • Oversee program execution to ensure alignment with timelines and objectives.
  • Monitor program performance and implement risk mitigation strategies.
  • Influence decision-making in a matrixed environment and drive accountability.
  • Lead governance forums to support program progress and alignment.

Benefits

  • Comprehensive medical, dental, and vision coverage.
  • Paid time off to support work-life balance.
  • Retirement savings options for long-term security.
  • Wellness programs to promote physical and emotional well-being.
Full Job Description
Role Summary

The Director of Project Management serves as the PMO Lead for Strategic Initiatives within Grievance & Appeals. This role is responsible for leading complex, cross-functional program governance and execution with key partners across Grievance & Appeals, Utilization Management, Claims, Provider Operations, and other key business functions. The Director drives alignment, accountability, and performance management to deliver sustainable improvements with measurable outcomes.

Key Responsibilities

Program Governance & Execution (70%)
  • Lead complex, cross-functional strategic initiatives that support organizational priorities and business objectives.
  • Establish and manage program governance frameworks, including operating cadences, decision-making processes, and accountability mechanisms.
  • Partner with business and operational leaders to align priorities, resolve cross-functional challenges, and drive achievement of strategic objectives.
  • Provide oversight of program execution, ensuring initiatives remain aligned to timelines, objectives, and expected outcomes.
  • Monitor program performance, risks, dependencies, and issues, implementing mitigation strategies as needed.
  • Influence decision-making and drive accountability in a highly matrixed environment.
  • Lead governance forums and leadership reviews to support program progress and strategic alignment.
  • Promote consistent application of project and program management best practices.


Performance Management & Reporting (30%)
  • Establish performance measures and reporting processes to track progress, outcomes, and value realization.
  • Develop executive-level communications, presentations, and updates for leadership audiences.
  • Translate complex information into clear insights and actionable recommendations.
  • Ensure transparency regarding program status, risks, opportunities, and business impact.


Education & Essential Qualifications
  • 10-15+ years of experience in program/project management, healthcare operations, consulting, or a related field; healthcare payer experience preferred.
  • Demonstrated success establishing governance frameworks and leading complex, cross-functional programs with multiple concurrent workstreams.
  • Strong executive communication and presentation skills, with the ability to translate complex operational data into clear, actionable insights for senior leadership audiences.
  • Experience driving organizational alignment and influencing stakeholders across a highly matrixed environment.
  • Strong problem-solving, decision-making, and critical thinking skills.
  • Demonstrated commitment to continuous learning, innovation, and a growth mindset.


Preferred Qualifications
  • Familiarity with healthcare payer operations, including Grievance & Appeals, Utilization Management, Claims, Provider Operations, and root cause analysis methodologies.
  • Project Management Professional (PMP) certification.


Education

Bachelor's degree preferred/specialized training/relevant professional qualification.

Pay Range

The typical pay range for this role is:

$100,000.00 - $231,540.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 07/31/2026

About CVS Health

Omnicare provides comprehensive pharmaceutical services to patients and providers across the United States. As the market-leader in professional pharmacy, related consulting and data management services for skilled nursing, assisted living and other chronic care settings, Omnicare leverages its unparalleled clinical insight into the geriatric market along with some of the industry's most innovative technological capabilities to the benefit of its long-term care customers. Omnicare also provides key commercialization services for the bio-pharmaceutical industry through its Specialty Care Group.

CVS Health Careers

Joining CVS Health presents a unique opportunity to advance your career in a company where innovation, leadership, and growth go hand in hand. As a leader in the healthcare industry, CVS Health is more than just a pharmacy. We are a team of professionals dedicated to improving lives and optimizing health outcomes.

Work You’ll Do

At CVS Health, you will be part of a culture that values diversity and inclusivity, fostering an environment where every team member’s contribution is valued. Engage in meaningful work that directly impacts lives, driving innovation in healthcare services and solutions.

Explore Job Opportunities

Whether you’re looking for a position in pharmacy services, corporate leadership, or in-store management, CVS Health offers a variety of employment opportunities that will help you harness your skills and thrive professionally. Our job opportunities span across a wide range of professional fields and geographic locations, ensuring that your career at CVS Health aligns with your professional goals and lifestyle.

Internship Programs

Kickstart your career with CVS Health through our internship programs. These opportunities are designed for ambitious students eager to develop their skills in a real-world setting. Internships at CVS Health are not only about gaining work experience but also about making meaningful contributions to our ongoing projects.

Professional Growth and Development

CVS Health is committed to the professional growth of our employees. With access to cutting-edge technology, industry-leading experts, and comprehensive diversity training, our team members are equipped to lead and innovate. We support career advancement through professional development programs, leadership training, and opportunities for networking and internal mobility.

Benefits and Culture

Our employees enjoy a range of benefits that reflect our commitment to their well-being and success. From health and wellness benefits to professional development programs, CVS Health is dedicated to ensuring our team members have the resources they need. Our inclusive culture encourages collaboration and continuous learning, making CVS Health a place where you can grow and succeed.

Join Our Team

Ready to take the next step in your career? Explore the open positions at CVS Health that match your skills and interests. We are continuously hiring and looking for passionate, curious, and solution-driven team players.

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Don’t just look for a job. Look for a place where you can be a part of something bigger. Visit our careers page to find the position that’s right for you and join a team that values innovation and leadership in healthcare.

READ CAREERS BLOG

Stay ahead in your career with insights from those who know CVS Health best – our team. Learn from their experiences and get insider tips that can help you succeed in your next interview, craft a standout resume, and build a career you’re proud of at CVS Health.
Learn more about CVS Health
Size
300,000 employees
Market Cap
$122 billion
Industry
Net Income
$7.1 billion
Founded
1963
5 Year Trend
+10.5%
Revenue
$268.7 billion
NASDAQ

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