Senior Manager – Project Program Management

This is a fully remote position, open to applicants in Illinois.

📋 Description

• Oversee the design, planning, piloting, and execution of automation and technology solutions from initial concept to final implementation.

• Collaborate with stakeholders, product owners, architects, and engineering teams to convert business requirements into scalable technical solutions, user stories, acceptance criteria, and delivery timelines.

• Manage and prioritize the product backlog effectively.

• Facilitate PI planning, sprint planning, backlog refinement, and various Agile ceremonies.

• Foster collaboration among business, operations, clinical, and technology teams.

• Oversee requirements, dependencies, and business outcomes.

• Create and maintain business requirements, process flows, outcome measurements, dashboards, roadmaps, and governance documentation.

• Track progress, mitigate risks, resolve issues, and provide updates and executive-level reporting.

• Assess solution designs, architectural decisions, and implementation strategies.

• Engage with engineers, architects, and technical stakeholders concerning APIs, integrations, rules engines, microservices, EDI, and enterprise technology platforms.

⛳️ Requirements

• A minimum of 8 years of experience leading complex technology deliveries, enterprise programs, product initiatives, or large-scale UM Innovation utilizing AI/GenAI technologies.

• Experience in the healthcare payer industry is essential, particularly in Utilization Management, Prior Authorization, Clinical Operations, Claims, Care Management, or related fields.

• Proven success in partnering with Architecture, Engineering, Product, Operations, and vendor organizations.

• In-depth knowledge of SDLC, Agile, and SAFe methodologies, along with release management, quality assurance, testing, and deployment practices.

• Experience in leading enterprise solutions across hybrid environments, encompassing multi-cloud, SaaS, vendor-hosted, and legacy platforms.

• Strong understanding of the .NET and Java ecosystems, microservices, APIs, and distributed systems.

• Experience managing technical dependencies, integration strategies, solution roadmaps, and cross-functional delivery teams.

• Experience in conducting solution design sessions, architecture reviews, technical governance, and implementation planning.

• Ability to interpret architecture diagrams, data flows, sequence diagrams, and integration patterns.

• Working knowledge of RESTful APIs, JSON, OpenAPI/Swagger, and API lifecycle management.

• Experience utilizing API testing and validation tools such as Postman.

• Familiarity with API Gateway technologies, microservices patterns, event-driven architecture, and messaging frameworks.

• Understanding of FHIR, HL7, and the Documentation Requirements Lookup Service (DTR).

• Knowledge of healthcare EDI transactions, including 278, 837, 835, and 270/271.

• Experience in implementing, supporting, or optimizing business rules and decision automation platforms.

• Strong understanding of decision tables, decision trees, business rule authoring, and automated decision services.

• Experience with IBM Operational Decision Manager (ODM) or similar rules engine platforms.

• Ability to design and support configurable business rules with minimal or no code alterations.

• Bachelor’s degree in business, Information Technology, Computer Science, Healthcare Administration, or a related field; equivalent experience of 6–8 years will be accepted.

• Preferred: Certifications such as SAFe POPM, SAFe Agilist, Agile, PMP, or related credentials.

• Preferred: Experience with healthcare automation, workflow modernization, AI-enabled, or digital transformation initiatives.

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program.

• Equity award program.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources to support physical, emotional, and financial well-being.