Manager, Medicare Program Services

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

Are you an innovator self starter? Do you want to make a difference? Are you in search of a challenge? If you feel this describes you, please read about our company and position below!

As the Manager for Medicare Program Services, you are the liaison to business partners throughout the company to help communicate business projects with departments. These projects support operational changes based on Centers for Medicare & Medicaid Services (CMS) guidance. They also help improve existing business processes, address client requests or drive advancement of enterprise objectives. Your role is to provide subject matter expertise for our products and prevent unintended negative consequences. The Manager needs to be adept at managing various aspects of project planning, conducting risk analysis, articulating detailed and technical functional design requirements, participating in meaningful cross-functional dialogue on complex topics, and preparing project closure documents to adequately transition new functionality to operations.

Some of your responsibilities will include:
- Participating in IT projects to define business requirements
- Assessing and mitigating project risks
- Articulating the vision and purpose for changes in a meaningful way
- Serving as the accountable representative from the Transition Fill team
- Being responsible for the successful deployment of projects into operations
- Assisting in the design of project testing and validation to ensure results of projects meet expectations

In addition, your ability to assess accuracy of claims adjudication processes and benefit setup will be essential in this role. As part of the Transitional Fill Department you will be part of a creative and aggressive initiative aimed at transforming health care and pharmacy incorporating new information technologies and channels. We are looking for someone that has drive and can work cohesively with their colleagues.

**This is a work from home role and can be located anywhere in the US**

Required Qualifications

Required Qualifications

* 3+ years of Pharmacy Benefit Management, Medicare Part D or Medicaid experience
* 5 + years of experience using the RxClaim system
* 2+ years Project Management or Business Analyst experience
* Minimal Travel may be required for business support

Preferred Qualifications

* Experience writing business requirements and/or configuring benefits
* Expertise with MS Visio, Project, and SharePoint
* Experience with RX Claims is strongly preferred
* PMP Certification

Education

* Bachelor's degree is required; equivalent work experience may substitute

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$60,300.00 - $132,600.00

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 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

We anticipate the application window for this opening will close on: 03/20/2026

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