Sr Manager - UM Innovation Delivery
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AI Summary
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.
*Fully remote position, however, will be expected to work Eastern Standard time zone.*
Position Summary:
The UM Innovation Team leads the implementation of strategic initiatives for the Utilization Management (UM) organization within Aetna’s Clinical Solutions Business Unit. The Sr. Manager, UM Innovation Delivery is accountable for driving multiple innovation efforts from concept through full‑scale implementation. This role partners closely with business stakeholders to define goals and collaborates with Technology and Delivery teams to design, implement, and operationalize solutions that support Clinical Interoperability, CMS commitments, and Center‑of‑Excellence business objectives.
This position requires a strong blend of business acumen, technical understanding, and end‑to‑end project delivery expertise. The Sr. Manager is responsible for defining and prioritizing work, managing scope, mitigating risks, and ensuring clear communication across a highly matrixed environment.
The role will:
- Define, rationalize, and align priorities with a clearly articulated business rationale.
- Partner and collaborate with cross‑functional teams—including key internal and external stakeholders—to develop, test, and implement innovative solutions.
- Drive and manage innovation efforts through all stages, including ideation, solution development, and pilot execution, with an emphasis on scale, readiness, value realization, and ongoing monitoring.
- Manage risks, develop mitigation strategies, facilitate working sessions, and deliver required analysis, reporting, and presentation materials.
- Foster a culture that accelerates organizational strategy through our Heart At Work Behaviors by keeping customers and colleagues at the center of all efforts.
Key Accountabilities:
- Define, prioritize, and rationalize innovation initiatives with a clear and measurable business rationale.
- Lead delivery of innovation capabilities through all stages—ideation, solution design, development, pilot, launch, and value realization.
- Work cross‑functionally with internal and external stakeholders to develop, test, refine, and implement innovative solutions.
- Translate business goals into clear innovation capabilities, acceptance criteria, and technical requirements in partnership with clinical, business, and IT teams.
- Identify opportunities to improve innovation capabilities, workflows, and user experience.
- Assist in defining success metrics and reporting on performance and value delivered.
Required Qualifications
- 7+ years of experience as a Program and Project Delivery leader, or similar role delivering complex business or technical capabilities, in a matrix organization
- Experience managing a Project Team in development of microservices and APIs in a cloud-native architecture (e.g., AWS, Azure, GCP).
- Hands-on experience supporting the full business lifecycle: discovery, requirements, development, testing, and release.
- Ability to translate business needs into clear and actionable capabilities and process documentation.
- Familiarity with working alongside matrix teams such as architecture, development, and QA.
- Strong and effective communication/collaboration skills across diverse stakeholder groups.
- Ability to drive innovation in highly cross-functional environment.
- Experience developing or supporting business requirements documents and process flows.
Preferred Qualifications
- Familiarity with FHIR, X12 EDI, interoperability frameworks, and healthcare data integration standards.
- Healthcare industry experience, preferably within Utilization Management or clinical operations.
- Knowledge of clinical workflows, utilization review processes, and InterQual/MCG guidelines.
- Experience working in a SAFe or other Scaled Agile delivery environment.
Education
- Bachelor’s degree in Business, Healthcare Administration, Computer Science, or a related field preferred
- Equivalent experience (6–8 years) in systems, technology, standards, or process improvement may be considered.
Pay Range
The typical pay range for this role is:
$75,400.00 - $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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
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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