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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.

Position Summary:

As a Product manager, you will provide technical, analytical, and business support for all assigned programs for Medicare, Medicaid, and Commercial products. Programs currently include End-Stage Renal Disease (ESRD), Hospice, Transplant, Transition Fill and Part D Vaccine Administration. You will be asked to develop business requirements used by clients to develop their own policies and procedures. You will work with benefit relationship managers, account teams, financial advisors to answer questions and support clients and their members who are affected by our programs. You will serve as a subject matter expert in programs assigned and be able to explain and present program functionality from a system logic perspective as well as a business program management.

You will accomplish this by:

+ Providing detailed and technical functional design requirements to internal and external business partners.

+ Producing and maintaining business process documentation, such as policies and procedures, job aides and work instructions.

+ Analyzing daily program reporting and RxClaim adjudication data to ensure program oversight

+ Identifying and reporting instances affecting performance guarantees and service level agreements

+ Providing root cause analysis through claim adjudication research and data trends

+ Supporting internal and external audits and ensuring audit responses are timely and accurate

Your success will be driven by your ability to provide strategic guidance to internal and external business partners, exhibiting a high level of accountability. Your contributions will ensure program compliance with all client & regulatory requirements. Your success will be measured through client satisfaction, timely completion of tasks and deliverables, and effective, accurate documentation.

**This is a work from home role. Candidates can live anywhere in the U.S.

**Required Qualifications** :

+ 3+ years of Pharmacy Benefit Management, Medicare Part D or Medicaid experience

+ 1+ years of project management or business analyst experience including the management of complex requirements

+ 1+ Experience with the RxClaim software system

+ Travel for business support less than 20% of the year

Preferred Qualifications

+ Reporting programs such as RxNavigator to review and develop reports

+ Microsoft Project software to create and maintain project plans

+ Strong analytical skills and problem-solving abilities

+ Attention to detail and accuracy

+ Negotiation and conflict resolutions skills across various levels of an organization

+ Highly organized and able to quickly prioritize multiple assignments

+ Strong interpersonal communication skills using active listening and open-ended questions to encourage others' points of view to influence

+ Effective verbal and written communication skills

+ Exercise creativity and innovation in achieving project results

+ Experience interacting with various levels of an organization, including senior leadership

+ Experience preparing and delivering presentations to clients

+ Analyze large data files to find root cause

+ Have regular and predictable attendance

+ Develop and maintain effective work relationships

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

We anticipate the application window for this opening will close on: 10/31/2025

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

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.