Senior Analyst, Complaints & Appeals – Project Management

CVS Health

. Lead and manage cross-functional projects within scope, timeline, and budget .

Posted 10/21/2026full-timeConnecticut • United StatesSenior💰 $46,988 - $112,200 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in healthcare operations, focusing on root cause analysis, process improvement, and governance program support. Proficient in data analysis, reporting, and stakeholder management to drive operational effectiveness and compliance.

Highest-signal resume keywords

Healthcare Operations ExperienceRoot Cause AnalysisGovernance Program SupportData Analysis and ReportingProject Management Methodologies

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Root Cause AnalysisTrend AnalysisProcess ImprovementData AnalysisOperational EffectivenessReporting EnhancementsIssue ManagementCorrective Action PlanningQuantitative AnalysisContinuous Improvement Practices

Soft Skills

Analytical SkillsProblem-Solving SkillsCritical Thinking SkillsCommunication SkillsStakeholder Management Skills

Tools & Technologies

Microsoft ExcelMicrosoft PowerPointData Analysis ToolsQuickBaseBusiness Intelligence Solutions

Certifications & Qualifications

CAPPMPLean Six Sigma

Industry Keywords

Medicare AdvantagePart DCommercial AppealsProvider AppealsClaimsGrievanceCTM Operations

Tech Stack

Tools & technologies

PMP

About the role

Key responsibilities & impact

Lead and manage cross-functional projects within scope, timeline, and budget
Coordinate the Root Cause Corrective Action (RCCA) program and monitor corrective-action remediation
Support root cause analysis, issue identification, validation, trend analysis, corrective-action planning, and recommendations
Quantify issue impact and analyze operational data for leadership reporting
Support governance activities and evaluate corrective-action effectiveness and sustainability
Identify operational defects, process gaps, compliance risks, and control weaknesses
Collaborate with Operations, Compliance, Clinical, Claims, Appeals, Provider/Network, Product, Technology, and Configuration teams
Support process optimization, regulatory compliance, reporting enhancements, operational effectiveness, and reduction of recurring issue drivers
Develop and maintain process documentation, governance materials, job aids, training resources, and operational guidance
Assist with project planning, risk identification, milestone tracking, and stakeholder communications
Monitor project and remediation activities, escalate execution risks, and provide status updates
Apply project management methodologies, governance standards, and continuous improvement practices

Requirements

What you’ll need

3-5 years of experience in healthcare operations
Strong analytical, problem-solving, and critical thinking skills
Experience with root cause analysis, trend analysis, and process improvement
Experience supporting governance programs, remediation tracking, issue management, and corrective action planning
Ability to analyze data, quantify business impact, and develop actionable recommendations
Experience creating executive-level reports, dashboards, presentations, and business communications
Strong communication and stakeholder management skills
Ability to support cross-functional initiatives and influence stakeholders in a matrixed environment
Advanced proficiency in Microsoft Excel, PowerPoint, and data analysis/reporting tools
Ability to work independently, manage multiple priorities, and execute with minimal supervision
Proficiency with QuickBase or similar workflow management platforms preferred
Experience in Medicare Advantage, Part D, Commercial Appeals, Provider Appeals, Claims, Grievance, or CTM operations preferred
Experience with governance, remediation tracking, root cause analysis, and operational improvement initiatives preferred
Experience with reporting, analytics, automation, or business intelligence solutions preferred
Experience supporting executive reporting and operational performance reviews preferred
CAP, PMP, Lean Six Sigma, or related certification preferred
Bachelor's degree preferred or equivalent combination of education, professional experience, and relevant healthcare operational expertise

Benefits

Comp & perks

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