Lead Director – Clinical Innovation, Analytics Delivery

CVS Health Careers

. Evaluate Utilization Management performance, market trends, regulatory developments, and emerging technologies .

Posted 11/9/2026full-timeRemote • Connecticut • United StatesSenior💰 $100,000 - $231,540 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in strategic planning, portfolio management, and automation within healthcare, focusing on Utilization Management and operational improvement. Proven ability to lead cross-functional teams and drive enterprise transformation initiatives through data-driven decision-making and stakeholder engagement.

Highest-signal resume keywords

Strategic PlanningUtilization ManagementData VisualizationAI-Enabled WorkflowsEnterprise Portfolio Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Business AnalysisFinancial AnalysisData SynthesisSQLPythonPredictive AnalyticsNLPBusiness ModelingPerformance MeasurementKPI Development

Soft Skills

Analytical SkillsProblem-SolvingInterpersonal SkillsCommunication SkillsCoaching

Tools & Technologies

Cloud-Based Data PlatformsBusiness Rules EnginesDecision Support TechnologiesDashboardsAutomation Tools

Certifications & Qualifications

AHIP Certifications

Industry Keywords

HealthcareHealth InsuranceManaged CareUtilization ManagementPolicy ManagementCare ManagementQualityComplianceRegulatory ManagementProvider Networks

Tech Stack

Tools & technologies

CloudPythonSQL

About the role

Key responsibilities & impact

Evaluate Utilization Management performance, market trends, regulatory developments, and emerging technologies
Lead strategic analyses, business cases, and investment recommendations
Drive strategic portfolio planning for UM modernization initiatives, including opportunity assessment, prioritization, resource alignment, funding recommendations, and value realization tracking
Partner with Clinical Operations, Product, Technology, and Enterprise Innovation teams to execute a multi-year UM modernization roadmap
Identify, evaluate, and implement automation opportunities using AI, Generative AI, predictive analytics, NLP, business rules engines, and decision support technologies
Develop and monitor KPIs, dashboards, and performance measurement frameworks
Provide strategic oversight and governance for innovation pilots, proof-of-value assessments, and transformation initiatives
Advise senior leaders on UM strategy, operational performance, automation opportunities, and enterprise transformation priorities
Manage and develop a high-performing team through coaching, mentoring, and professional development

Requirements

What you’ll need

10+ years of experience leading strategic planning, business analysis, consulting, portfolio management, transformation, or innovation initiatives within healthcare, health insurance, or managed care organizations
Deep understanding of health plan operations including Utilization Management, Policy Management, Care Management, Quality, Compliance, Regulatory Management, Claims, and Provider Networks
Demonstrated experience developing and leading enterprise strategic initiatives from concept through implementation and value realization
Strong analytical and problem-solving skills, including business modeling, financial analysis, data synthesis, and development of executive-level recommendations
Proven success in enterprise portfolio management, strategic planning, and prioritization of complex initiatives
Experience with data visualization tools and advanced analytics technologies, including SQL, Python, and cloud-based data platforms
Strong understanding of automation, AI-enabled workflows, digital transformation, and technology-driven operational improvement
Expertise in developing business cases, defining success metrics, and measuring return on investment for strategic initiatives
Strong interpersonal and communication skills with the ability to effectively influence senior leaders and key stakeholders
Bachelor's Degree or equivalent work experience
AHIP certifications preferred

Benefits

Comp & perks

CVS Health bonus, commission or short-term incentive program in addition to base pay
Equity award program
Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being