Executive Director, Appeals Process & Technology Greater Hartford, CT Area

The Company is seeking an Executive Director, Appeals Process & Technology to lead the strategy and execution of a complex program migrating grievance and appeals processes to a modern technology platform. The role will align business strategy with product roadmaps, guide platform migration, and coordinate work across operations, technology, compliance, medical, and other functions. Responsibilities include prioritizing investments, managing budgets and business cases, tracking outcomes, and ensuring policies, workflows, and training reflect new processes. The Executive Director will also lead quality assurance practices and use findings to improve operations while maintaining compliance and audit readiness. Candidates should have at least 15 years of leadership experience in a healthcare payer or similarly complex, regulated healthcare environment, including experience leading leaders and large operational teams. Demonstrated success delivering major technology initiatives while remaining accountable for operational results is required; experience in health plan operations such as appeals, utilization management, or claims is highly valued. Applicants should bring strong expertise in workflow optimization, quality, compliance, workforce management, investment prioritization, and cross-functional leadership, along with working knowledge of relevant healthcare regulations, privacy, and audit requirements. A bachelor’s degree or equivalent experience is required; an advanced degree is preferred.

Hiring Company

CVS Health