Senior Program Manager / Project Manager - Medicaid Claims

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

Drive Agile delivery of Medicaid initiatives, supporting business process and technology improvements across multiple lines of business. Responsible for implementing best practices, facilitating workstreams through change, and ensuring effective delivery of projects and initiatives that enhance provider experience. Partner closely with business and technology stakeholders to prioritize work, drive measurable outcomes, and address barriers to execution success. Provide practice leadership and peer mentorship to project and program managers, promoting a culture of accountability and continuous improvement.

What you will do:

• Lead enterprise delivery of multiple, highly complex business process and technology initiatives aligned to the Medicaid program, supporting all lines of business.

• Drive the end-to-end delivery of Medicaid projects, ensuring initiatives are completed on time, within scope, and deliver measurable results.

• Identify and resolve delivery obstacles and risks, proactively removing barriers to execution.

• Monitor performance metrics and use data to optimize processes, improve productivity, and ensure accountability for outcomes.

• Collaborate closely with business and technology partners to translate goals into actionable plans and deliverables.

• Lead process improvements and root cause analysis to ensure sustainable, repeatable execution success.

• Implement and reinforce best practices to maximize efficiency and responsiveness across workstreams.

• Provide practice leadership and peer mentorship to fellow delivery practitioners, contributing to a high-performance culture aligned to execution excellence.

Required Qualifications

• 7+ years of experience in delivery management, program management, project management and Agile practice leadership, with deep expertise in Scrum methodologies

• 5+ years of experience in healthcare claims processing, including adjudication, payment, and rework operations

• 2+ years of experience with strong communication and facilitation skills, including developing and delivering executive-level presentations using PowerPoint

• 2+ years demonstrating strong execution and delivery capabilities, with a focus on planning, risk mitigation, and stakeholder engagement

• 2+ years of proven success driving complex projects to completion on time and within defined scope

• 2+ years applying strong problem-solving and decision-making skills, with a demonstrated growth mindset

• 2+ years of experience supporting innovation initiatives, emerging technologies, and digital transformation efforts

• 2+ years of experience implementing and sustaining Agile practices in cross-functional team environments

• 2+ years of experience working with multiple software delivery methodologies, including Scrum, SAFe, and Waterfall

Preferred Qualifications

• Experience with Medicaid programs

• Agile (e.g., SM, RTE, SPC), PMP, or equivalent certifications

Education

• Bachelor's degree or equivalent work experience required

Pay Range

The typical pay range for this role is:

$106,605.00 - $284,280.00

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.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

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 (https://learn.bswift.com/cvshealth-mainland) .

We anticipate the application window for this opening will close on: 08/31/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran — committed to diversity in the workplace.