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, Waste & Error Operations is responsible for leading strategic, operational, and technology-driven initiatives that support Payment Integrity programs. This role oversees a multi-functional team and collaborates across business, operational, and technical organizations to drive program performance, automation, cost avoidance, and operational excellence.
The position serves as operational support for Itemized Bill Review (IBR), Facility Charge Review (FCR), and Non-par Negotiations programs. The role combines people leadership, strategic planning, program management, business process improvement, and technology implementation to deliver scalable solutions and measurable business results.
Responsibilities
• Lead and develop a high-performing team, including U.S.-based and offshore resources, to achieve operational and business objectives.
• Oversee end-to-end operations for Itemized Bill Review (IBR), Facility Charge Review (FCR), and Non-Participating Provider (Non-Par) Negotiations.
• Serve as an escalation point for complex members, provider, client, network, and compliance issues.
• Manage daily operations, workflow, inventory, and performance to ensure quality, productivity, and service-level objectives are met.
• Recruit, develop, coach, and retain talent through effective onboarding, training, performance management, and career development.
• Lead team meetings, conduct regular one-on-one meetings, communications, and training to reinforce priorities, expectations, and employee engagement.
• Drive process improvements and operational efficiencies through workflow optimization, automation, AI, and RPA initiatives.
• Support Payment Integrity and other strategic initiatives through planning, implementation, and operational execution.
• Lead operational projects from concept through deployment, ensuring sustainable outcomes and business value.
• Analyze performance data and develop recommendations that improve efficiency, reduce costs, and deliver measurable ROI.
• Prepare and present operational insights, reports, and recommendations to support leadership decision-making.
• Partner with Operations, IT, Analytics, Legal, Compliance, Network, and other stakeholders to successfully execute programs and initiatives.
• Support change management efforts by driving stakeholder engagement, process adoption, and operational readiness.
• Contribute to budget planning, resource prioritization, and investment decisions supporting business growth and transformation.
• Foster a culture of accountability, collaboration, continuous improvement, and regulatory compliance.
Required Qualifications
• 7+ years of work experience
• 2+ years of direct leadership/management experience supervising teams or equivalent Medical Claim Management experience
• 2+ years of experience with ACAS program and processes
• 2+ years of experience within the healthcare industry
• 1+ years of experience leading cross functional projects
• Intermediate level experience with Microsoft products; Excel and Word
• Strong analytical, problem-solving, and decision-making skills.
• Excellent verbal and written communication skills with the ability to present to leadership audiences.
• Experience managing multiple priorities and driving results in a fast-paced environment.
Preferred Qualifications
• Experience with Payment Integrity or Claims Operations
• Experience with QuickBase and SharePoint including creation and maintenance of
• Knowledge of healthcare claims auditing, reimbursement methodologies and provider payment processes.
• Experience with Payment Integrity or Claims Operations
• Experience with QuickBase and SharePoint including creation and maintenance of
• Knowledge of healthcare claims auditing, reimbursement methodologies and provider payment processes.
Education
Bachelor’s degree in business, Healthcare Administration or related field
Pay Range
The typical pay range for this role is:
$82,940.00 - $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: 09/10/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
