CVS Health

Product Manager, Fraud & Abuse

CVS Health$92K — $203K *
US-Anywhere
+ 8 other locationsRemote
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 3+ years in product management or ownership
  • 3+ years in the healthcare sector
  • Experience managing product roadmaps
  • Ability to influence cross-functional teams
  • Skills in navigating ambiguity and defining clear initiatives
  • Experience with AI/ML technologies
  • Ability to analyze data and inform product strategy

Responsibilities

  • Own and define product vision and strategy for FWA analytics
  • Identify opportunities to integrate AI/ML into product offerings
  • Translate market trends and user feedback into actionable product direction
  • Lead a cross-functional team to drive product development
  • Define and document objectives and priorities for the team
  • Maintain product artifacts like the roadmap and sprint plans
  • Facilitate stakeholder and sprint planning sessions
  • Evaluate advancements in AI/ML for product enhancements
  • Establish KPIs for product performance and impact
  • Develop business cases for product capabilities

Benefits

  • Medical, dental, and vision coverage
  • Paid time off
  • Retirement savings options
  • Wellness programs
  • Resources for physical, emotional, and financial well-being
Full Job Description
As a Product Manager for Fraud & Abuse, you will lead the ongoing development and expansion of key Fraud, Waste, and Abuse (FWA) products that deliver over $200M in annual impact. In this role, you will directly support CVS Health's Payment Optimization Analytics objectives, contributing to the achievement of revenue and ROI targets for analytics products. You will be responsible for monitoring product performance, driving enhancements, and overseeing the deployment and scaling of advanced FWA analytics capabilities.

Key Duties will be:
  • Own the product vision, strategy, and performance, ensuring delivery of measurable business value and alignment with organizational goals
  • Identify and prioritize opportunities to integrate AI/ML capabilities into products to enhance accuracy, efficiency, and scalability
  • Translate market trends, user feedback, and competitive intelligence into actionable product direction, monitoring shifts to identify emerging opportunities and risks
  • Lead a cross-functional squad of data engineers, data scientists, and ideation team members, managing competing priorities and perspectives to keep the squad focused and moving forward
  • Define and document the "what" and "why" for the squad, including setting the problem, shaping priorities, and making tradeoffs clear
  • Develop and maintain core product artifacts including roadmap, backlog, sprint plans, and demo materials
  • Facilitate key forums including stakeholder sessions, sprint planning, working sessions, and product demos
  • Continuously evaluate advancements in AI/ML and assess applicability to enhance the product portfolio
  • Establish and monitor KPIs related to product performance, adoption, and business impact
  • Develop compelling, data-driven business cases for new product capabilities and enhancements, securing stakeholder alignment and financial investments to support strategic priorities
  • Ensure high-quality, timely delivery of product enhancements that meet defined business and technical requirements


Required Qualifications
  • 3+ years of experience in product management or product ownership
  • 3+ years of experience within the healthcare industry
  • Demonstrated experience managing product roadmaps and defining product requirements
  • Proven ability to influence and collaborate effectively across cross-functional teams and senior stakeholders
  • Ability to operate in ambiguity, translating evolving business objectives into clear, prioritized initiatives
  • Experience leveraging AI/ML technologies to drive measurable business value
  • Ability to analyze complex data and translate insights into actionable product strategy and business decisions


Preferred Qualifications
  • Experience in Payment Integrity, with a focus on Fraud, Waste, & Abuse (FWA)
  • Strong financial acumen, with the ability to assess business impact and drive value-based decisions
  • Experience working within Agile product management frameworks and methodologies
  • Working knowledge of healthcare claims processing, including end-to-end claims lifecycle


Education
  • Bachelor's degree or equivalent work experience with healthcare, claims processing, or vendor management


Anticipated Weekly Hours
40

Time Type
Full time

Pay Range

The typical pay range for this role is:

$92,700.00 - $203,940.00

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.

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: 08/31/2026

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.

Stay Connected

Keep up to date with the latest news, career tips, and industry insights from CVS Health. Personalize your experience by subscribing to job alert emails, tailored to your preferences and professional interests. Discover the rewarding opportunities that await at CVS Health, where your career development is always a priority.

Search CVS Health Jobs

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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