Project Manager, Complaints & Appeals

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. Job Summary:    Build and maintain a solid team through training, coaching and developing staff  Validate effectiveness of the different projects managed by appeals team through universe data validation.  Facilitate and present at meetings within the Appeals team.  Establish and maintain in collaboration with the business, consistent processes defining the overview and readiness of appeals to help remain compliant with regulatory and accreditation requirements.  Assess developmental needs and collaborate with others to identify and implement action plans that support the development of high performing teams and individuals.  Manage projects and identify trends and recommends/acts on solutions.  Report capabilities related to audit requests and universe submissions.      Required Qualifications   3+ years Appeals background  Microsoft Office experience  Knowledge of Appeals job aids/workflows  Strong Communication skills - ability to provide and receive feedback  Excellent time management skills  2+ years of supervisory experience  Ability to work collaboratively across teams  Strong analytical skills focusing on accuracy and attention to details      Preferred Qualifications   2+ years Project Management experience  QuickBase experience  2+ years training or leadership experience  Knowledge of CMS guidance  Product knowledge and experience with Appeals and Medicare Regulatory Requirements  Appeals and MHK knowledge/experience      Education    High school diploma or higher education  Bachelor's degree or equivalent experience Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $54,300.00 - $159,120.00 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.    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: 10/31/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.