Primary Job Duties & Responsibilities
Develops and implements strategies to improve healthcare delivery, patient outcomes, and organizational performance.
Directs health service activities and operations by managing staff, budgets, and resources to ensure efficient workflow and employee adherence to quality and safety standards.
Delivers leadership and guidance to healthcare teams, including physicians, nurses, administrative staff, and other professionals.
Establishes quality control methods and quality improvement initiatives to enhance the overall quality of healthcare services.
Advocates for the needs and rights of patients within the organization by addressing patient concerns, resolving complaints, and implementing strategies to improve patient satisfaction and overall experience.
Collaborates with other departments, healthcare providers, and external stakeholders to foster meaningful partnerships and ensure seamless coordination of healthcare services.
Analyzes data related to health services, such as patient outcomes, utilization rates, and financial performance, and leverages this information to generate reports, identify areas for improvement, and make data-driven decisions.
Ensures compliance with healthcare regulations and policies, such as privacy laws, accreditation requirements, and safety standards.
Leads and mentors a team of healthcare professionals, providing guidance, and promoting professional development.
Candidate may reside anywhere in the US
Required:
5+ years medical coding and policy oversight at a managed care payer, specifically administering NCD/LCD policies
3 years leadership experience
Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) (aligns with medical policy + coding roles) required and/or obtained within one year of start date in role
Education
Bachelor's degree preferred/specialized training/relevant professional qualification.
Preferred:
Payment accuracy configuration experience with Lyric
Essential Qualifications
Adept at execution and delivery (planning, delivering, and supporting) skills
Adept at business intelligence
Adept at collaboration and teamwork
Mastery of problem solving and decision making skills
Mastery of growth mindset (agility and developing yourself and others) skills
Pay Range
The typical pay range for this role is:
$67,900.00 - $182,549.00
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: 10/09/2026
