Lead Director, Software Development Engineering (Member Eligibility Services)

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.

CVS Health's exciting and impactful Claims Adjudication Software Engineering & Transformation organization is seeking a Director to lead the Eligibility portfolio for the PBM business, including the modernization of eligibility processing from legacy on-premises systems to a cloud-based data platform and API layer that serves member demographic and coverage data to enterprise consumers.

The Director leads a multi-team engineering organization covering platform and API engineering, client onboarding and data integration, legacy system operations, and quality assurance, and is accountable for delivery, production stability, and modernization across the portfolio.

This role reports to the Executive Director, Adjudication Software Engineering & Transformation.

Responsibilities

• Own strategy, delivery, architecture, and operational stability for the eligibility platform, APIs, client onboarding and data integration, and legacy eligibility systems.

• Lead the modernization of eligibility processing from legacy on-premises platforms to cloud-based data services, including migration of clients onto the modern platform and retirement of legacy components.

• Own release management, deployment safety practices, and incident response for production-critical services, including postmortems and corrective actions.

• Lead and develop a multi-team organization through managers and senior managers; build bench strength and successors for key technical and leadership roles.

• Manage production support and SLA adherence across all owned systems, working cross-functionally to resolve issues and communicate with business stakeholders.

• Partner with architecture and principal engineering on AI-enabled initiatives and integrate them into team planning and prioritization.

• Maintain strong Agile delivery and work-tracking practices across the organization.

• Manage vendor relationships and contingent staffing plans; oversee budget and resource allocation for the portfolio.

• Partner with peer directors across the Adjudication organization on shared modernization goals and platform strategy.

• Ensure compliance of systems and applications with company policies, standards, and regulatory requirements.
  

Required Qualifications

10+ years in Healthcare IT, including 2+ years at a Director or Senior Manager level leading application/system teams on cloud technologies including:

• Experience owning production-critical, high-availability APIs or systems, including release management and deployment safety.

• Strong client-facing production support: incident response, root-cause resolution, executive reporting, SLA adherence.

• Experience leading legacy-to-cloud modernization or data migration programs.

• Experience managing a mixed FTE/contingent workforce.

• Ability to lead cross-functional initiatives and influence without direct authority.

• Proficient in cloud engineering fundamentals - scalable, secure API and datastore design.

• Experience applying AI technologies in engineering or operations.
  

Preferred Qualifications

• Experience with client onboarding or migration programs at scale.

• Experience establishing Agile delivery and work-tracking practices across teams.

• Knowledge of CMS Medicare and PBM regulatory context.

• Strong stakeholder communication and negotiation skills across engineering, product, and business leadership.
  

Education

Bachelor's degree in Computer science, information systems, or related field, or equivalent work experience.

The typical pay range for this role is: