Senior Manager, Coordination of Benefits – Project Management

CVS Health Careers

. Lead and oversee Coordination of Benefits projects and operational initiatives .

Posted 11/3/2026full-timeHartford • Connecticut • United StatesSenior💰 $67,900 - $199,144 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in leading Coordination of Benefits projects and operational initiatives within healthcare, focusing on payment accuracy, compliance, and process efficiency. Proficient in data analytics, project management, and team leadership to drive organizational goals and improve operational effectiveness.

Highest-signal resume keywords

Leadership ExperiencePayment Integrity ExpertiseHealthcare Operations KnowledgeData Analytics ProficiencyProject Management Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Payment IntegrityHealthcare Claims ProcessingBusiness Process ImprovementFinancial Impact AssessmentOperational TransformationPerformance Metric DevelopmentCross-Functional Project LeadershipCompliance KnowledgeCost Reduction StrategiesWorkflow Management

Soft Skills

Exceptional Communication SkillsTeam LeadershipCoaching and MentoringCollaborationAccountability Promotion

Tools & Technologies

ACASHRPPower BITableauQuickbase

Industry Keywords

Coordination of BenefitsMedicareCommercial InsuranceClaims AdministrationNAIC RulesMedicare Secondary Payer GuidelinesVendor ManagementOffshore OperationsOperational Cost ReductionCustomer Satisfaction Improvement

Tech Stack

Tools & technologies

Tableau

About the role

Key responsibilities & impact

Lead and oversee Coordination of Benefits projects and operational initiatives
Improve payment accuracy, reduce overpayments, enhance compliance, and drive process efficiency
Manage a portfolio of complex, cross-functional projects
Collaborate with Claims, Enrollment, Provider Services, Operations, Technology, Analytics, and Vendor Management stakeholders
Define project scope, objectives, timelines, resource requirements, and success measures
Deliver initiatives on time, within budget, and aligned with organizational goals
Use data analytics and business intelligence to identify trends, assess risks, develop solutions, and implement process improvements
Directly manage staff through day-to-day leadership, coaching, performance management, and professional development
Establish team priorities, allocate resources, manage workload distribution, foster collaboration, and promote accountability and continuous improvement
Ensure team members have the tools, training, and support needed to achieve goals
Communicate project status, risks, and outcomes to leadership
Build relationships across the enterprise
Own strategic affordability initiatives, savings programs, recovery opportunities, and payment accuracy improvements
Lead financial impact assessments, forecasting, variance analysis, savings validation, and return-on-investment evaluations
Develop and monitor metrics for operational effectiveness, recoveries, cost avoidance, provider impact, and financial outcomes
Establish performance objectives, implementation priorities, operating plans, and long-term growth strategies
Oversee multiple concurrent initiatives while maintaining alignment with goals, timelines, quality requirements, and financial targets

Requirements

What you’ll need

5+ years of leadership experience managing teams, including performance management, coaching, employee development, and workforce planning
7+ years of experience in Payment Integrity, Healthcare Operations, claims administration, Coordination of Benefits, Medicare, Commercial Insurance, or related healthcare functions
Experience leading large-scale, cross-functional projects and operational transformation initiatives
Strong knowledge of healthcare claims processing, COB regulations, Medicare Secondary Payer guidelines, NAIC rules, and related payment integrity processes
Experience developing and implementing business process improvements that reduce operational costs, improve quality, and enhance customer satisfaction
Experience with healthcare technology platforms such as ACAS and HRP
Experience with reporting tools and data visualization solutions such as Power BI, Tableau, Quickbase, or similar applications
Bachelor's degree preferred; equivalent combination of education and relevant experience may be considered
Ability to collaborate with executive leadership, operational teams, vendors, providers, and external business partners
Experience leading organizational change management initiatives and driving adoption of new processes, workflows, and technologies
Exceptional written and verbal communication skills, including presenting complex information and recommendations to senior leaders
Knowledge of vendor management, offshore operations, workflow management, and performance metric development strongly preferred