Senior Analyst, Complaints & Appeals (Project Management) - Remote

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 Senior Analyst, Project Management supports the Root Cause Corrective Action (RCCA) program by coordinating cross-functional issue resolution, supporting root cause analysis activities, tracking remediation efforts, and assessing operational and business impacts. This role partners closely with stakeholders across Claims, Grievances, Appeals, Compliance, Clinical, and Operational teams to identify recurring issue drivers, support governance activities, develop reporting and analytical solutions, and drive sustainable process improvements. Responsibilities include project coordination, stakeholder engagement, executive reporting, documentation management, and supporting leadership with data-driven recommendations that improve operational performance and member outcomes.

• →3-5 years of experience in healthcare operations
• →Strong analytical, problem-solving, and critical thinking skills with experience in root cause analysis, trend analysis, and process improvement.
• →Experience supporting governance programs, remediation tracking, issue management, and corrective action planning.
• →Proven ability to analyze data, quantify business impact, and develop actionable recommendations.
• →Experience creating executive-level reports, dashboards, presentations, and business communications.
• →Strong communication and stakeholder management skills, with the ability to explain complex issues to diverse audiences.
• →Demonstrated ability to support cross-functional initiatives, influence stakeholders, and drive results in a matrixed environment.
• →Advanced proficiency in Microsoft Excel, PowerPoint, and data analysis/reporting tools.
• →Ability to work independently, manage multiple priorities, and execute with minimal supervision.

• Proficiency with QuickBase or similar workflow management platforms
• Experience in Medicare Advantage, Part D, Commercial Appeals, Provider Appeals, Claims, Grievance, or CTM operations.
• Experience with governance, remediation tracking, root cause analysis, and operational improvement initiatives.
• Experience with reporting, analytics, automation, or business intelligence solutions.
• Experience supporting executive reporting and operational performance reviews.
• CAP, PMP, Lean Six Sigma, or related certification preferred.

Bachelor's degree preferred or equivalent combination of education, professional experience, and relevant healthcare operational expertise.

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. 
 

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.