Lead Director - Grievance & Appeals - PMO Lead

Program Governance & Execution

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

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.
• 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.

Pay

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.