LD Director, UM Innovation Delivery

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.

This position is remote. Qualified candidates can live anywhere in the contiguous United States.

Position Summary
The Lead Director of UM Innovation Delivery is a critical leader and has responsible for managing and successfully driving initiatives that solves key business problems and creates new sources of value for Utilization Management within Aetna's Clinical Solutions business unit. This role leads the planning, execution, and delivery of complex high-impact initiative aligned to corporate goals, regulatory requirements and clinical best practices. The ideal candidate will have deep domain expertise in health insurance, strong product management skills, and a proven track record of delivering large-scale, customer-facing solutions.

• Lead and manage strategic projects and programs from initiation to completion, ensuring on-time delivery, budget adherence, and alignment with defined scope and objectives.
• Drive transformation initiatives to modernize healthcare UM operations by aligning cross-functional teams (business, IT, architecture, operations) to deliver strategic goals and continuous improvement.
• Collaborate with senior leadership to define strategic plans, establish program objectives, and ensure alignment with organizational priorities.
• Set up and execute SAFe Agile trains; lead PI planning and sprint execution while coaching teams and leaders on agile methodologies and best practices.
• Define product features, prioritize MVPs, and develop delivery roadmaps for UM automation capabilities, including deployment of APIs, ODM Rules Engine, predictive models, and AI voice technologies.
• Oversee configuration and maintenance of business rules and automation tools to support scalable and efficient operations.
• Apply formal project management methodologies to manage timelines, risks, dependencies, and change controls; maintain detailed documentation, dashboards, and executive-level reporting.
• Monitor budgets and resource allocation to ensure financial accountability and maximize ROI; proactively develop mitigation strategies and contingency plans to address risks
• Responsible for developing, motivating and managing a high-performing team members to meet organizational goals and objectives while effectively managing change.
• Contribute to a motivated work environment by working collaboratively and effectively with key stakeholders across Health Care Business and Aetna Clinical Solutions to achieve common goals.

Required Qualifications

• 10+ years experience in healthcare project management with proven track record of leading large-scale, complex initiatives in healthcare insurance or managed care organization
• Strong understanding within clinical and health plan operations and value creation methodologies including Utilization and Policy Management, Care Management and Coordination, Quality, Compliance and Regulatory Management
• Successful experience in strategic planning, execution, and agile project portfolio management within healthcare industry 
• Expertise in technologies such as APIs, Microservices, Business Rules, Predictive Modeling, AI, NLP.
• High ability to consistently produce and create value and meet/exceed committed performance
• Strong interpersonal and communication skills, effectively communicate key messages to executive leaders and internal/external stake holders.
• Strong verbal and written communication skills; proven ability to deliver presentations to senior leadership team members
• Effectively lead and motivate teams to ensure high standards of performance and outcomes

Preferred Qualifications

• 5+ years with demonstrated leadership and experience with the following: Innovation, generative AI, business process optimization, project portfolio management/consulting, strategic planning and risk management.
• Agile Certifications such as SAFe Agilist or CSPO.
• Health domain certifications such as AHIP certifications (Fundamentals of Healthcare Part A & B, AHM250).
• Ability to manage and grow a team of individuals to achieve departmental goals at a rapid pace
• Experience creating new capabilities and/or project offerings that result in new value; Conceptual and structured thinker that has a high degree to generate and translate concepts and ideas into effective strategies that achieve results
• Ability to embrace change, uncertainly and shifting priorities and plans to accommodate broader changing objectives and demands

Education

Bachelor's Degree or equivalent work experience, Computer Science, Engineering, or related field preferred.

Master's Degree preferred

Pay Range

The typical pay range for this role is:

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.

• 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 

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