Senior Manager, Encounter Program Operations

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 Senior Manager, Encounter Informatics leads five equally weighted functions for the encounter-processing portfolio: product ownership and delivery, testing and quality assurance, tactical reporting, data integrity, and market performance support. This leader converts enterprise, regulatory, customer, and operational needs into integrated roadmaps, test strategies, reporting solutions, data controls, and market action plans. The role directs cross-functional execution, develops talent, and is accountable for compliant delivery, reliable data, actionable insights, and measurable market outcomes.

Fundamental Job Components:

• Product ownership and delivery: Set product vision, strategy, roadmap, backlog, release plans, and outcome measures; balance value, risk, capacity, dependencies, and technical constraints.

• Testing and quality assurance: Direct functional, regression, integration, user acceptance, production-validation, and post-implementation testing, including traceability, acceptance criteria, and defect governance.

• Tactical reporting: Ensure timely, accurate, actionable operational and leadership reporting that supports issue management, regulatory commitments, and performance decisions.

• Data integrity: Lead data-quality controls, validation, reconciliation, monitoring, issue resolution, and remediation to ensure encounter data is complete, accurate, timely, traceable, and compliant.

• Market performance support: Partner with market leaders to monitor results, identify root causes, coordinate response plans, and deliver sustained improvement in encounter outcomes.

• Translate business, market, customer, and regulatory needs into capabilities, test scenarios, reporting requirements, data rules, acceptance criteria, and measurable outcomes.

• Lead portfolio governance, program increment and release planning, implementation readiness, production stabilization, risk mitigation, and corrective action.

• Establish balanced performance measures across delivery, testing, reporting, data quality, and market outcomes; provide concise executive and tactical updates.

• Align senior leaders, markets, operations, technology, engineering, architecture, quality, analytics, compliance, vendors, and end users to accelerate decisions and resolve barriers.

• Coach and develop Product Owners, project managers, analysts, testers, reporting professionals, and cross-functional partners; reinforce accountability, adoption, and continuous improvement.

The successful candidate demonstrates:

• Strategic and balanced leadership: Sets clear priorities and weighs value, quality, data risk, market impact, capacity, and technical constraints.

• People leadership: Builds accountable, high-performing teams through coaching, feedback, and talent development.

• Influence and communication: Aligns diverse stakeholders and converts complex issues into concise decisions and recommendations.

• Data and quality leadership: Uses testing, reporting, performance measures, and controls to identify risk and drive action.

• Execution and change leadership: Removes barriers, manages risk, drives adoption, and sustains improvement with integrity and sound judgment.

• 7 or more years of healthcare experience

• 5+ years People leadership: Builds accountable, high-performing teams through coaching, feedback, and talent development.

• ​8 or more years of experience in product ownership, product management, project or program management, business analysis, technology delivery, or a related field.

• 3 or more years leading complex enterprise initiatives, multiple Agile teams, a product portfolio, or product and delivery professionals.

• Advanced knowledge of Agile, Scrum, and SAFe practices; experience with Rally, Jira, Azure DevOps, or a comparable platform.

• Demonstrated success leading product strategy and backlogs, end-to-end testing, tactical reporting, data-integrity controls, market performance support, releases, and organizational change.

• Prior experience supporting Medicaid and Medicare programs, including healthcare payer operations, encounter data, or regulatory reporting.

• Strong executive presence with the ability to influence senior stakeholders, resolve competing priorities, and communicate complex topics clearly.

• Bachelor’s degree in a related field or an equivalent combination of education and relevant experience.

• SAFe Product Owner/Product Manager, Certified Scrum Product Owner, Project Management Professional, or comparable certification.

• Healthcare payer, claims, encounter data, consumer analytics, or regulated healthcare technology experience.

• Knowledge of encounter intake, validation, submission, reconciliation, data quality, and regulatory reporting.

• Experience leading professional staff and managing vendor-supported platforms or integrations in a matrixed environment.

• Master’s degree preferred.

We support a hybrid work environment. If selected and you live near a suitable work location, you may be expected to comply with the hybrid work policy. Under the policy, all hires for in-scope populations should be placed into a hybrid or office-based location, working onsite three days a week.

Aetna Service Operations office/hub locations will be discussed with the selected candidate.

Education

Bachelor's degree or equivalent work experience

Pay Range

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.

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.

Additional details about available benefits are provided during the application process and on Benefits Moments.

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