Sr Manager – Business Consulting Position Available In Leon, Florida

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

• Position Summary
• Plans, monitors and manages internal projects from initiation through completion.

Secures required resources and uses formal processes and tools to manage resources, budgets, risks and changes. Manages projects to ensure on-time completion according to specifications and within budgeted costs. At the higher levels, incumbents manage large multifaceted projects; at lower levels, incumbents may be concerned with clearly identifiable elements or functions within a larger project. Typically, incumbents matched to this function are working towards or have achieved certification in project management. This position is part of the UM COE, that is responsible Clinical Services utilization management policies & procedures. Primary responsibilities of this position include management of people, the review of state, federal, Duals, CMS or Medicaid regulations; creating action plans to comply with regulations reviewed; working with operations areas to address actions needed to comply with regulations. Drafting/leading the implementation of changes that impact workflows that clinical teams use. The development of tools and resources to support existing and newly designed processes/program changes. The ability to identify efficiencies, respond to field inquiries and project manage process changes including ensuring that all project deliverables and due dates are met while focusing on quality are all components of this position. Must be able to address system interface, accrediting body requirements and collaborate across appropriate organizations during the design of newly identified processes. Support of system enhancements. The ability to conceptualize changes and contribute to system projects that impact UM staff is critical. Must be able to represent the team during project discussions. Serves as a subject matter expert during cross-functional project implementations. What you will do + Acts as a top-level specialist on project and program planning and develops comprehensive program plans that encompass objectives, deliverables, timelines, and resource allocation. + Adapts project and program plans to ensure alignment with business objectives and reinforce organizational standards. + Applies highly developed knowledge of financial management principles to manage cost estimation, tracking, and budget reporting for programs and projects. + Coaches’ junior-level project and program managers on how to utilize key performance indicators (KPIs) to measure progress and analyze project and program outcomes. + Coordinates knowledge sharing among project teams to highlight success stories and improve project and program management practices through insights. + Creates a continuous improvement plan for the project and program department to enhance delivery processes and outcomes. + Designs the change management protocol to effectively respond to obstacles that may arise during project and program lifecycles. + Utilizes data visualization tools and techniques to present project and program data in a visually appealing easily understandable format. + Participates in project/program team training and development activities to enhance project management skills and knowledge. The ideal candidate must have excellent communication skills as this position requires verbal presentations and writing of policy/process documents. Experience in giving verbal presentations and formal writing is required. Requires extensive collaboration with all levels of UM staff from Medical Directors to front line staff thus, management experience is critical. Project management experience preferred. Ideally, the candidate will have led project teams to implementation but, if not, project participation and meeting assigned project deliverables is sufficient.

• Required Qualifications
• + 7+ years of experience working within UM + 3+ Leadership experience + Commercial, Medicare & Medicaid experience + Project Management Professional/Certification, preferred + Adept at problem solving and decision-making skills + Adept at collaboration and teamwork + Adept at growth mindset (agility and developing yourself and others) skills + Adept at execution and delivery (planning, delivering, and supporting) skills •Preferred Qualifications•+ Nursing/Registered Nurse (RN) + Experience with MedCompass and/or UM Platforms + Proficient utilizing Microsoft Office Suite + Must have strong knowledge of claim coding (CPT/DRG, etc.

), provider networks, benefit designs, healthcare products/funding, medical management programs and business acumen. + Relationship management: Demonstrated relationship management skills at the senior level; capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously. +

Strategic Thinking:

Must have demonstrated ability to think strategically in an independent manner and ‘out of the box’ versus accepting the status quo.

• Education
• Bachelors degree or equivalent experience
• Pay Range
• The typical pay range for this role is: $67,900.

00 – $182,549.00 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 our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: +
• Affordable medical plan options,
• a •401(k) plan•(including matching company contributions), and an •employee stock purchase plan•.

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• No-cost programs for all colleagues
• including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. +
• Benefit solutions that address the different needs and preferences of our colleagues
• including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 05/05/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.