Manager - Medicare Complaints Operations - Technical

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.

*Applicants can live anywhere in the United States*

Position Summary

As an Individual Contributor Manager of Medicare Complaints Operations - Technical, you will play a vital role in managing business operations and system initiatives that focus on streamlining complaint processes and maintaining data integrity.

The ideal candidate will possess strong analytical skills, a deep understanding of healthcare operations, and the ability to communicate complex data insights effectively to diverse audiences. Candidates should also be skilled in creating reports, dashboards, and visualizations tailored for a senior leadership audience, presenting data-driven insights clearly and concisely. This role is pivotal in driving continuous improvement and ensuring the organization meets its operational goals. The Manager of Medicare Complaints Operations - Technical will be a key player in fostering a culture of data-driven decision-making and continuous improvement.

You will be responsible for planning and monitoring internal projects from initiation to completion, ensuring they are delivered on time, within specifications, and within budget. Designing cross-functional solutions to address business challenges will also be a key aspect of your role. You will analyze trends and patterns to identify areas for improvement, efficiency gains, and opportunities for value creation. You will use statistical techniques, data mining, and predictive modeling to uncover patterns, trends, and correlations within the data. Additionally, you will apply critical thinking and problem-solving skills to derive meaningful insights that drive business decision-making. The Manager of Medicare Complaints Operations - Technical will continually explore innovative tools and approaches to improve data analysis and drive continuous improvement within the organization.

This role is essential for ensuring that our analytics capabilities are robust, reliable, and aligned with the strategic goals of the organization. The Manager of Business Analytics will be a key player in fostering a culture of data-driven decision-making and continuous improvement.

What you will do

• Collaborate with internal and external audit teams to provide necessary data and insights, ensuring compliance with regulatory standards and internal policies.
• Monitor and enhance the quality of Operational Management Tools (OMT) by implementing best practices and conducting regular assessments to identify areas for improvement.
• Generate and distribute regular reports on OMT metrics, providing actionable insights to stakeholders to support strategic decision-making.
• Manage user access to systems and tools, ensuring that team members have the necessary permissions to perform their roles effectively.
• Develop and maintain comprehensive reporting systems for vendor performance, ensuring timely and accurate data is available for management review.
• Participates in audit data universe gathering and analyzing.
• Lead the oversight of Corrective Action Plans (CAP) and implement self-monitoring processes to ensure compliance and continuous improvement within the analytics function.
• Evaluates evolving business requirements and recommends appropriate systems alternatives and/or enhancements to current systems.
• Prepares communications and makes presentations on system enhancements and/or alternatives.
• Conducts quantitative and qualitative analyses to assess business performance and identify opportunities for improvement.
• Design, develop, and maintain Quickbase applications to streamline data collection and reporting processes, ensuring that applications meet the evolving needs of the business.
• Compiles clear and comprehensive documentation, such as business requirement documents and use cases.
• Collects and analyzes business data to identify trends, patterns, and insights.
• Develops basic process maps, flowcharts, and diagrams to document as-is and to-be processes.
• Conducts meetings, workshops, and presentations to gather feedback and validate requirements.
• Actively contributes to team meetings, brainstorming sessions, and collaborative projects, including sharing ideas, providing feedback, and contributing to the overall goals and objectives of the team.
• Contributes to the development and maintenance of standardized templates, guidelines, and methodologies.
• Seeks opportunities to enhance their skills and knowledge through training and certifications.

Required Qualifications

• 3+ years of proven experience in business analytics, data management, or a related field, with a focus on analyzing unstructured data.
• Knowledge of statistical analysis techniques and tools.
• Proficient in using QuickBase, including building, editing, and repairing existing databases.
• Experience creating materials (dashboards, reports, presentations, etc.) for a senior leadership audience.
• Proficiency in analytics tools and software, including reporting platforms.
• Excellent problem-solving skills and critical thinking abilities.
• Strong collaboration and communication skills (both written and oral).
• Ability to work independently and collaboratively in a fast-paced environment across multiple teams.
• Excellent knowledge of Excel, Access, Visio, Word, and/or PowerPoint.
• Willingness to understand business needs and create strategies around them.
• Experience working in a data warehouse environment, with the ability to handle large data sets from multiple sources.
• Strong analytical skills with the ability to interpret complex data sets.
• Ability to prioritize work and perform independently.
• Proven track record of leading or managing large projects.
• 2+ years of experience with Medicare Advantage products.

Preferred Qualifications

• 5+ years of experience as a Data Analyst or in a similar role.
• Experience building, maintaining, and editing Tableau and Microsoft BI dashboards/reports.
• 5+ years of experience with Medicare Advantage products.
• Advanced degree in Business, Finance, Accounting, or Healthcare.
• 5+ years of experience in product management.

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:

$60,300.00 - $145,860.00

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 https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 10/17/2025

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