# Operations Lead

**Company**: CVS Health
**Location**: Hartford
**Experience**: senior
**Job type**: full-time
**Salary**: $75,400.00 - $199,144.00
**Category**: Healthcare
**Industry**: Healthcare

**Apply**: https://cvshealth.wd1.myworkdayjobs.com/en-US/CVS_Health_Careers/job/Hartford-Farmington-Ave-Atrium/Operations-Lead--DUAL-Program-Management_R1062853?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/job/operations-lead-1d6ad335-927/

## Description

We're building a world of health around every individual , shaping a more connected, convenient and compassionate health experience.

Under the direction of the Lead Director, Health Plan Market Operations, the Operations Lead is responsible for overseeing day-to-day health plan operations, ensuring operational readiness, regulatory compliance, and effective execution of strategic initiatives across Integrated Plans.

**Responsibilities**

- Provide operational oversight and coordination across health plan functional areas to support efficient and compliant service delivery.

- Lead cross-functional efforts to identify, prioritize, and resolve operational issues affecting members, providers, regulators, and business partners.

- Establish and maintain operational readiness processes for annual implementation activities, including product launches, benefit changes, regulatory requirements, and market expansions.

- Monitor operational performance, service levels, regulatory requirements, and business outcomes, escalating risks and developing remediation strategies as needed.

- Develop and maintain operational workplans, readiness trackers, risk logs, and reporting tools to support leadership visibility and accountability.

- Drive issue management processes, facilitating cross-functional discussions to identify root causes, implement corrective actions, and prevent future operational impacts.

- Partner with enterprise shared services teams, including claims, enrollment, member services, care management, provider services, and compliance, to ensure seamless operational execution.

- Support state, CMS, NCQA, and internal audit activities through coordination of documentation, evidence collection, remediation planning, and progress reporting.

- Monitor regulatory changes and contract requirements to ensure timely operational implementation and ongoing compliance.

- Develop executive-level reporting and presentations that communicate operational performance, readiness status, risks, issues, and mitigation plans.

- Act as a trusted operational subject matter expert and primary point of contact for internal and stakeholders regarding Integrated Plan operations.

- Support financial remediation efforts by identifying operational drivers of financial performance and partnering with business owners to implement corrective actions.

- Maintain strong relationships with market leaders, executive leadership, enterprise partners, regulators, and community stakeholders to support business objectives and member outcomes.

- Provide operational leadership during critical incidents, readiness events, and regulatory escalations, coordinating action plans and ensuring timely resolution.

- Support additional Health Plan Market Operations activities and provide cross-functional support as business needs require.

**Required Qualifications**

- 7+ years of healthcare operations, managed care, health plan administration, regulatory compliance, or related experience.

- 5+ years of experience leading cross-functional operational initiatives and driving organizational outcomes.

- Experience supporting Dual Eligible Special Needs Plans (D-SNP), FIDE, HIDE, MLTSS.

- Strong knowledge of CMS, state regulatory requirements, health plan operations, and audit readiness processes.

- Experience developing executive-level reports, presentations, and operational performance dashboards.

- Demonstrated ability to influence stakeholders and drive issue resolution without direct authority.

- Experience leading operational readiness, implementation, or transformation initiatives.

- Strong analytical, problem-solving, and decision-making skills.

- Excellent verbal, written, and presentation communication skills.

- Advanced proficiency in Microsoft Excel, PowerPoint, and data analysis tools.

- Bachelor's degree in Business Administration, Healthcare Administration, Public Health, Operations Management, or related field, or equivalent combination of education and experience.

**Benefits**

- Medical, dental, and vision coverage.

- Paid time off.

- Retirement savings options.

- Wellness programs.

**Pay Range**

$75,400.00 - $199,144.00

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## Skills

### Required
- healthcare operations
- managed care
- health plan administration
- regulatory compliance
- Microsoft Excel
- PowerPoint
- data analysis

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