Jobs in the United States

25+ jobs

Added 2 mins ago
VH
Registered Nurse (Quality Manager - Greenville)
Veterans Health Administration
Durham, NC
- $82,819 to $155,103 USD / year
Uses clinical knowledge and judgment to improve the quality of care at Durham VA Medical Center. Integrates and maintains a comprehensive Performance Improvement Program to improve the…
Added 2 mins ago
VH
Assistant Chief Registered Nurse
Veterans Health Administration
Garner, NC
- $105,596 to $181,488 USD / year
…Wake County Clinic(s), Clayton Clinic, Greenville Health Care Center, Morehead, and Cherry Point. Assists with organizing, directing, integrating, and evaluating the clinical,…
Added 2 mins ago
VH
Medical Support Assistant (Advanced)
Veterans Health Administration
Austin, TX
- $50,021 to $65,027 USD / year
…critical step to meet "Missed Opportunities" and other medical center performance measures such as "access to care". Continually works with the providers and nursing staff to change…
Added 2 mins ago
VH
Lead Program Analyst
Veterans Health Administration
Louisville, KY
- $74,678 to $97,087 USD / year
Responsible for collecting, collating and interpreting clinical data for the Associate Chief of Staff (ACOS)/GEC Service, GEC Administrative Officer (AO) and GEC Clinical Program Manager.
Added 2 mins ago
CP
Senior Economist
Consumer Product Safety Commission
District of Columbia, DC
- $143,913 to $187,093 USD / year
…research and analysis techniques when assessing economic or other data; and 3) service as a technical authority on economic or financial impacts or…
Added 5 mins ago
VH
Maintenance Mechanic
Veterans Health Administration
Charleston, SC
- $32 to $37 USD / hour
…support on maintenance-type projects throughout the medical center. The incumbent performs routine minor renovations, maintenance, and repairs to facilities, structures, equipment, and…
Added 5 mins ago
VH
Medical Support Assistant (Advanced)
Veterans Health Administration
Bonham, TX
- $55,646 to $72,339 USD / year
Added 5 mins ago
VH
Medical Support Assistant (Advanced)
Veterans Health Administration
Long Beach, CA
- $56,247 to $73,121 USD / year
Advanced knowledge of the technical health care process (including, but not limited to, scheduling across interdisciplinary coordinated care delivery and/or care in the community models and…
Added 5 mins ago
VH
Pharmacy Technician (Procurement/Inventory)
Veterans Health Administration
Tucson, AZ
- $76,381 to $99,291 USD / year
Provides PS management analysis of medication and supply usage data trends and knowledge of medications to make recommendations for adding or substituting various medications and supplies.
Added 5 mins ago
VH
Medical Support Assistant (Advanced)
Veterans Health Administration
Leavenworth, KS
- $54,307 to $70,599 USD / year
Runs data reports from VistA Radiology Package, Cerner, data dashboards (i.e. power bi) or Fileman to manage radiology scheduling lists. Validates the accuracy of exams, resolves issues,…
Added 7 mins ago
Technical Program Manager, Secure Connection Services (SCS), Tactical Edge Mission Engineering Group (TEMEG)
Amazon Development Center U.S., Inc.
Arlington, VA · Herndon, VA
Shape the future of secure communications for the world's most critical missions. As a Principal Technical Program Manager for SCS TEMEG, you'll define the strategy and lead customers and…
Added 7 mins ago
TS
Transportation Security Specialist (Vetting)
Transportation Security Administration
Springfield, VA
- $85,447 to $158,322 USD / year
Reviewing reports, policies, procedures, or program information to identify issues, recommend improvements and provide technical assistance or feedback to staff.
Added 7 mins ago
VH
Education Program Specialist
Veterans Health Administration
Coatesville, PA
- $82,289 to $106,982 USD / year
…required to successfully perform the duties of an Education Program Specialist. Examples of specialized experience are, but not limited to, coordinated education and training activities,…
Added 7 mins ago
VH
Supervisory Medical Records Technician (Inpatient Coder)
Veterans Health Administration
Remote, United States
- $67,970 to $88,356 USD / year
…Health Administration Service Line at the Puget Sound VA Medical Center. MRTs (Coder) are skilled in classifying medical data from patient health records in the hospital setting, and/or…
Added 7 mins ago
VH
Supervisory Medical Records Technician (Inpatient Coder)
Veterans Health Administration
Remote, United States
- $67,970 to $88,356 USD / year
…Health Administration Service Line at the Puget Sound VA Medical Center. MRTs (Coder) are skilled in classifying medical data from patient health records in the hospital setting, and/or…
Added 7 mins ago
AN
HR SPEC (MIL)
Air National Guard Units
Camp J T Robinson, AR
- $61,722 to $80,243 USD / year
…and staff members. Provides guidance and assistance on unit program(s) for which responsible. Provides training to supervisors on all military human resources issues. Analyzes data and…
Added 7 mins ago
VH
Social Services Assistant
Veterans Health Administration
San Diego, CA
- $57,641 to $74,935 USD / year
…when needed, assist them in linking up with a Social Worker or program that can be of most…
Added 7 mins ago
VH
Program Specialist
Veterans Health Administration
Hines, IL
- $68,999 to $89,703 USD / year
…education efforts to determine the effectiveness of the training program while keeping abreast of any changes or updates to directives related to scheduling. The incumbent provides…
Added 7 mins ago
DC
Store Associate
Defense Commissary Agency
Schofield Barracks, HI
- $38,011 to $49,417 USD / year
Reviewing stock levels and gathering inventory data in order to maintain the Computer Assisted Ordering (CAO) system.
Added 7 mins ago
VH
Equal Employment Manager
Veterans Health Administration
Albuquerque, NM
- $107,592 to $139,871 USD / year
The VA New Mexico Healthcare System is recruiting for an Equal Employment Manager (EEO) under the Office of the Executive Director. The incumbent manages the EEO program for the VA and is…
Added 7 mins ago
UC
Human Resources Assistant
U.S. Coast Guard
Baltimore, MD
- $46,610 to $75,059 USD / year
You will serve as a/an Human Resources Assistant and be responsible for providing administrative and technical support for processing a full range of staffing and personnel actions.
Added 7 mins ago
AF
Regional Child Care Program Specialist
Administration for Children and Families
Denver, CO
- $99,800 to $129,742 USD / year
Review and analyze program data; monitor compliance with regulations; conduct all phases of formal monitoring reviews, including pre-visit preparation, onsite reviews/interviews, and…
Added 7 mins ago
VH
Supervisory Interior Designer
Veterans Health Administration
Houston, TX
- $103,225 to $134,195 USD / year
Responsible for the direction and supervision of the Interior Design Section which performs professional, technical and administrative interior design work associated with the planning and…
Added 8 mins ago
Senior Research Associate (Farm Manager) (0097687T, CTAHR/CARES Kona)
University of Hawaii
Kealakekua, HI
Utilize Geographic Information Systems (GIS) databases, technical guides, and survey data to compute design specifications and land-use recommendations.
Added 9 mins ago
VH
Medical Support Assistant (Advanced)
Veterans Health Administration
Laguna Hills, CA
- $56,247 to $73,121 USD / year
Advanced knowledge of the technical health care process (including, but not limited to, scheduling across interdisciplinary coordinated care delivery and/or care in the community models and…

Senior Manager, Payment Integrity COE

Remote, United States

$75,400.00 - $199,144.00 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.

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Job details

Pay: $75,400.00 - $199,144.00 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.
Apply by: Nov 11, 2026
Experience: 7-10 years of progressive experience in program, project management, process improvement, audit, provider reimbursement, analytics.
Posting language: English
Posted: Nov 3, 2026

Original job description

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 The Senior Manager, Payment Integrity COE Rework & Escalations provides centralized program leadership for the intake, tracking, coordination, reporting, and resolution of rework and escalations across the Payment Integrity Center of Excellence. The role establishes a reliable operating rhythm, creates end-to-end visibility to status and risk, and ensures that owners, dependencies, decisions, and due dates are clearly documented and actively managed. This leader works across Payment Integrity, Claims, Clinical, Network, Product, Technology, Compliance, Legal, Finance, Operations, SIU, vendors, and other enterprise partners to move complex issues from intake through closure. The role converts fragmented updates into concise, decision-ready reporting, identifies recurring drivers and control gaps, and supports leaders in prioritizing corrective actions that reduce avoidable rework and improve operational stability.

Primary Responsibilities:

Rework & Escalation Portfolio Management Own the centralized portfolio of Payment Integrity rework items and escalations, including intake, categorization, prioritization, status management, aging, dependencies, risks, decisions, and closure evidence. Maintain a consistent source of truth for active work, ensuring each item has a defined business owner, accountable action owner, target date, current status, next step, and escalation path. Coordinate multiple concurrent workstreams and follow up on commitments to sustain momentum, remove barriers, and prevent unresolved items from becoming operational risks. Establish criteria and working norms for intake, triage, prioritization, handoffs, escalation, closure, and post-implementation monitoring. Cross-Functional Coordination & Issue Resolution Lead structured working sessions with business and technical partners to clarify the issue, scope, impact, root cause, interim controls, corrective actions, and decision needs. Connect the appropriate stakeholders across functional boundaries and coordinate activities when resolution requires multiple teams, vendors, systems, or processes. Identify stalled work, conflicting priorities, unclear ownership, resource constraints, and unresolved dependencies; elevate decision points with clear options and recommendations. Support sensitive or high-impact escalations with disciplined documentation, neutral facilitation, and timely communication. Reporting, Metrics & Executive Visibility Develop and maintain recurring dashboards, scorecards, portfolio summaries, aging reports, risk views, and leadership updates for rework and escalation activity. Define meaningful measures for intake volume, backlog, aging, cycle time, on-time actions, closure rate, recurrence, financial or operational impact, and other agreed performance indicators. Synthesize detailed updates into concise, decision-ready reporting that highlights progress, emerging trends, exceptions, risks, required decisions, and accountable owners. Ensure reporting definitions, data sources, status criteria, and calculation methods are documented and applied consistently. Root Cause, Corrective Action & Rework Reduction Partner with operational owners and subject matter experts to document root causes, contributing factors, failure points, and control gaps using practical process-improvement methods. Track corrective and preventive actions through implementation, validation, and sustained closure rather than administrative completion alone. Analyze patterns across rework and escalation activity to identify repeat drivers, systemic issues, high-friction handoffs, and opportunities for standardization or automation. Translate lessons learned into process, training, control, communication, governance, or technology recommendations. Governance & Operating Rhythm Design and facilitate a tiered governance cadence for working teams, functional leaders, and executive stakeholders, with clear agendas, pre-reads, decisions, actions, and follow-up. Maintain decision logs, action registers, risk and issue logs, milestone plans, and escalation records with appropriate version control and auditability. Develop standard templates, definitions, workflows, and job aids that improve consistency across the PI COE rework and escalation lifecycle. Promote accountability through transparent reporting, timely follow-up, defined service expectations, and fact-based escalation.

Stakeholder Communication & Change Enablement Build trusted partnerships with leaders, process owners, analysts, project teams, and external partners involved in rework prevention and escalation resolution. Prepare executive summaries, briefing materials, talking points, and recommendations tailored to the audience and decision required. Coordinate communication and readiness activities for process changes resulting from corrective actions, including stakeholder alignment, documentation, training, and transition support. Encourage a collaborative, no-blame approach that focuses on facts, accountability, sustainable fixes, and measurable outcomes. Team Leadership & Capability Building Lead, coach, and develop assigned employees or contractors supporting portfolio tracking, analysis, reporting, or coordination. Set clear expectations, prioritize work, review deliverables, and build repeatable capabilities that improve quality, responsiveness, and stakeholder experience. Create an inclusive environment that values transparency, disciplined execution, continuous improvement, and professional growth. Key Deliverables Centralized rework and escalation tracker with clear ownership, milestones, aging, risk, impact, and closure evidence. Recurring operational and executive-level portfolio reporting, including trends, exceptions, decisions, and recommended actions. Governance calendar and meeting artifacts, including agendas, pre-reads, action logs, decision logs, and follow-up summaries. Root-cause and corrective-action documentation for priority items, with validation of implemented solutions. Standard intake, triage, prioritization, escalation, reporting, and closure practices for the PI COE. Leadership-ready summaries of portfolio health, resource or dependency constraints, and opportunities to reduce recurring rework.

Required Qualifications 7-10 years of progressive experience in program, project management, process improvement, audit, provider reimbursement, analytics. Demonstrated experience coordinating complex, cross-functional initiatives with multiple owners, dependencies, and competing priorities. Strong ability to build and maintain trackers, action plans, dashboards, scorecards, executive summaries, and governance materials. Experience using data to identify trends, explain portfolio health, surface risk, and support prioritization and decision making. Excellent written, verbal, facilitation, organization, and presentation skills. Ability to establish structure in ambiguous situations, work independently, follow through on commitments, and appropriately escalate barriers. Proven ability to influence without direct authority and build productive relationships in a matrixed organization. Working knowledge of healthcare claims, payment integrity, reimbursement, audit, recovery, or related operational processes.

Preferred Qualifications Experience with Commercial, Medicare, Medicaid, Marketplace, or other healthcare payment models. Experience leading rework reduction, escalation management, root-cause analysis, corrective-action, operational governance, or continuous-improvement programs. Advanced proficiency with Microsoft Excel, PowerPoint, Word, Teams, and SharePoint; experience with Power BI, Visio, Planner, or comparable workflow and reporting tools. Experience coordinating vendor-related issues, service-level performance, implementation risks, or cross-enterprise handoffs. Knowledge of Lean, Six Sigma, SIPOC, RACI, ADKAR, Agile, or other structured process, change, and project-management practices. Professional certification such as CPC, CCS, CPMA, CFE, AHFI, PMP, Lean Six Sigma, or a related credential.

Education Bachelor's degree or equivalent combination of education and relevant experience.

Pay Range

The typical pay range for this role is:

$75,400.00 - $199,144.00 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.

We anticipate the application window for this opening will close on: 11/11/2026

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

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More about this job

Skills

Leadership
Reporting
Regulatory compliance
Prioritization
Documentation
Communication skills
Process improvement
Team leadership
Project management
Decision making
Presentation skills
Work independently
Root cause analysis
Microsoft Excel
Microsoft PowerPoint
Microsoft Word
Microsoft Teams
Microsoft SharePoint
Microsoft Power BI
Microsoft Visio
Workflow
Lean manufacturing
Agile
PMP

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