Lead Director - Grievance & Appeals - PMO Lead

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.

The Director of Project Management serves as the PMO Lead for Strategic Initiatives within Grievance & Appeals. This role is responsible for leading complex, cross-functional program governance and execution with key partners across Grievance & Appeals, Utilization Management, Claims, Provider Operations, and other key business functions. The Director drives alignment, accountability, and performance management to deliver sustainable improvements with measurable outcomes.

• Lead complex, cross-functional strategic initiatives that support organizational priorities and business objectives.
• Establish and manage program governance frameworks, including operating cadences, decision-making processes, and accountability mechanisms.
• Partner with business and operational leaders to align priorities, resolve cross-functional challenges, and drive achievement of strategic objectives.
• Provide oversight of program execution, ensuring initiatives remain aligned to timelines, objectives, and expected outcomes.
• Monitor program performance, risks, dependencies, and issues, implementing mitigation strategies as needed.
• Influence decision-making and drive accountability in a highly matrixed environment.
• Lead governance forums and leadership reviews to support program progress and strategic alignment.
• Promote consistent application of project and program management best practices.

• Establish performance measures and reporting processes to track progress, outcomes, and value realization.
• Develop executive-level communications, presentations, and updates for leadership audiences.
• Translate complex information into clear insights and actionable recommendations.
• Ensure transparency regarding program status, risks, opportunities, and business impact.

• 10–15+ years of experience in program/project management, healthcare operations, consulting, or a related field; healthcare payer experience preferred.
• Demonstrated success establishing governance frameworks and leading complex, cross-functional programs with multiple concurrent work streams.
• Strong executive communication and presentation skills, with the ability to translate complex operational data into clear, actionable insights for senior leadership audiences.
• Experience driving organizational alignment and influencing stakeholders across a highly matrixed environment.
• Strong problem-solving, decision-making, and critical thinking skills.
• Demonstrated commitment to continuous learning, innovation, and a growth mindset.

• Familiarity with healthcare payer operations, including Grievance & Appeals, Utilization Management, Claims, Provider Operations, and root cause analysis methodologies.
• Project Management Professional (PMP) certification.

Bachelor's degree preferred/specialized training/relevant professional qualification.

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.