Lead Director, Automation Transformation — Payment & Revenue Integrity & Grievances and Appeals

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.

Leads automation and AI transformation strategy across the Payment Integrity, Revenue Integrity, and Grievances and Appeals COEs. Builds and manages a team to ideate, prioritize, and oversee delivery of automation and agentic AI initiatives that improve claims accuracy, recovery, and appeals outcomes. Partners with COE and business leadership to align automation roadmaps to enterprise priorities, governance standards, and measurable business impact.

A Brief Overview

Leads a team to drive automation and AI-enabled transformation across Payment Integrity, Revenue Integrity, and Grievances and Appeals. Sets strategic direction for how automation and intelligent workflow opportunities are identified and scaled across these COEs, and ensures successful, on-time delivery through strong program oversight. Balances delivery accountability with team development, ensuring the group operates as a cohesive practice rather than three disconnected initiatives.

What you will do

• Leads and develops a team, setting priorities, allocating capacity across COEs, and holding the team accountable to delivery and quality standards.

• Sets the automation transformation strategy for Payment Integrity, Revenue Integrity, and Grievances and Appeals in partnership with COE leadership.

• Ideates and prioritizes automation opportunities across the three COEs, balancing near-term delivery with longer-term capability building.

• Oversees end-to-end delivery of automation initiatives, ensuring outcomes are achieved on time, within budget, and according to defined scope.

• Establishes and maintains strong working relationships with COE and business stakeholders, translating their priorities into an executable roadmap.

• Assesses roadblocks and dependencies, developing mitigation strategies to ensure successful delivery.

• Monitors program budgets, resourcing, and timelines across the portfolio, escalating tradeoffs and risks proactively.

• Reports progress, outcomes, and emerging opportunities to senior leadership, framing impact in terms of business value (accuracy, recovery, cycle time, appeals resolution).

• Builds team capability, coaching Senior Managers on both delivery oversight and people leadership as their own teams grow.

• Identifies and implements process improvements, lessons learned, and industry best practices across the automation lifecycle.

Minimum Requirements

• 10–15 years of experience in automation, process improvement, or program leadership, ideally within healthcare claims, payment integrity, or related operations

• Proven people leadership experience, including managing and developing managers or senior individual contributors

• Adept at translating business priorities into automation delivery roadmaps

• Adept at cross-functional collaboration with COE and business stakeholders at multiple levels

• Mastery of problem solving and decision making, particularly balancing competing priorities across multiple domains

• Mastery of growth mindset skills — agility, self-development, and developing others

Education

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

The typical pay range for this role is: