Encounter SR. Project manager

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

The Sr. Manager Project Program Management (Sr. Project Manager) serves as the plan and state liaison related to encounter creation, submission, and resolution. Independently oversees day-to-day activities to ensure compliance with state contractual requirements for encounter submissions.  Accountable for monitoring daily workflow / activities including subcontracted vendors, revenue priorities and initiatives or projects. Leads the team in setting priorities while executing toward department goals. Drives overall team results in addition to continuous process improvements. Supports leadership with hiring, onboarding, training, and development of staff. 

• Independently leads routine and high visibility projects related to regulatory requirements, encounter system enhancements, conversions, and implementations.

• Leads and coordinates activities surrounding new business /expansions including the development of business/resource requirements, test plans, and documentation.

• Delegation of work assignments based on business needs.

• Initiates root cause analysis and collaborates with internal departments to develop solutions that impact encounter acceptance.

• Work with State/Federal regulators to define contractual requirements, remove barriers and resolve encounter rejections.

• Develop effective relationships with State/Federal regulators as well as all levels of internal leadership.

• Monitor subcontracted vendors performance and address deficiencies.

• Present technical information in a meaningful manner to internal and external stakeholders.

• Facilitate meetings, prepare, and update project plans, agendas, and meeting minutes.  

• Evaluate existing processes to identify opportunities to improve efficiency by developing and executing strategic plans.

• Provide coaching, developmental feedback and mentorship to team members.

• Tracks progress and communicates team performance and project status on a regular basis to leadership and business partners.

Required Qualifications

• 7+ years of healthcare experience

• 3+ years of leadership or project management experience.

• 3+ years of data interpretation/analysis experience and demonstrated ability to make sound decisions with available data. (SQL, Excel, Tableau)

• Strong verbal/written communication skills.

• Strong organizational skills and ability to independently coordinate multiple projects and priorities.

• Ability to translate technical requirements/processes to business partners.

• Medical/Pharmacy claim/encounter experience.

Preferred Qualifications

• EDI File experience.

• Experience in Health Care or Medicaid.

• Familiarity and/or certification in Agile Methodology.

• SQL programming.

• Inventory management experience.

We support a hybrid work environment. If selected and you live near a suitable work location, you may be expected to comply with the hybrid work policy. Under the policy, all hires for in-scope populations should be placed into a hybrid or office-based location, working onsite three days a week.

Aetna Service Operations office/hub locations will be discussed with the selected candidate.

Education
Bachelor’s 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 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: 06/13/2026

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