CVS Health

Complaint & Appeal Program Manager

CVS Health

Remote
Full-TimeDepends on ExperienceSenior LevelMasters
Job Description

Welcome to CVS Health - a company dedicated to helping people on their path to better health. As the Complaint & Appeal Program Manager, you will play a crucial role in ensuring that our customers receive the highest level of satisfaction and quality service. We are seeking a highly motivated and experienced individual who is passionate about resolving customer concerns and improving overall customer experience. As a member of our team, you will have the opportunity to make a meaningful impact on the lives of our customers. Are you ready to join us in our mission to make healthcare more accessible and effective for all? If so, read on for more information about this exciting opportunity.

  1. Develop and implement complaint and appeal resolution strategies to ensure the highest level of customer satisfaction.
  2. Manage and prioritize customer complaints and appeals in a timely and efficient manner.
  3. Collaborate with cross-functional teams to identify and address root causes of customer concerns.
  4. Monitor and analyze customer feedback to identify trends and areas for improvement.
  5. Establish and maintain strong relationships with internal and external stakeholders, including customers, vendors, and regulatory agencies.
  6. Ensure compliance with company policies, procedures, and regulatory requirements related to customer complaints and appeals.
  7. Provide regular updates and reports on complaint and appeal resolution metrics to leadership.
  8. Train and educate team members on effective complaint and appeal handling techniques.
  9. Continuously evaluate and improve the customer complaint and appeal process.
  10. Represent the company in a professional and empathetic manner when interacting with customers and resolving their concerns.
  11. Stay current with industry standards and best practices related to customer complaint and appeal management.
  12. Proactively identify opportunities to enhance customer experience and mitigate potential complaints.
  13. Foster a positive and inclusive work environment that encourages teamwork and collaboration.
  14. Participate in company initiatives and projects related to customer satisfaction and experience.
  15. Act as a role model for excellent customer service and represent the company's values and mission.
Where is this job?
This job opening is listed as 100% remote
Job Qualifications
  • Strong Knowledge Of Healthcare Regulations And Compliance: The Complaint & Appeal Program Manager Should Have A Deep Understanding Of Healthcare Regulations And Compliance Requirements, Including Hipaa, Medicare, And Medicaid.

  • Experience In Complaint And Appeals Management: A Successful Candidate Should Have A Proven Track Record Of Effectively Managing Complaint And Appeal Processes In A Healthcare Setting.

  • Excellent Communication And Interpersonal Skills: The Program Manager Must Be Able To Communicate Effectively With Various Stakeholders, Including Customers, Providers, And Internal Teams, To Resolve Complaints And Appeals In A Timely And Efficient Manner.

  • Leadership And Decision-Making Abilities: The Role Requires Strong Leadership Skills To Oversee A Team And Make Critical Decisions In A Fast-Paced Environment. The Program Manager Should Also Be Able To Prioritize Tasks And Manage Multiple Projects Simultaneously.

  • Analytical And Problem-Solving Skills: The Ability To Analyze Data, Identify Trends, And Implement Solutions To Improve The Complaint And Appeal Process Is Crucial For This Role. The Program Manager Should Also Be Able To Anticipate Potential Issues And Develop Strategies To Prevent Them.

Required Skills
  • Communication

  • Time Management

  • Attention to detail

  • Negotiation

  • Leadership

  • Conflict Resolution

  • customer service

  • Analytical Thinking

  • Organization

  • Problem-Solving

  • Adaptability

  • Decision-Making

Soft Skills
  • Communication

  • Conflict Resolution

  • Leadership

  • Time management

  • creativity

  • flexibility

  • Teamwork

  • Adaptability

  • Problem-Solving

  • Empathy

Compensation

According to JobzMall, the average salary range for a Complaint & Appeal Program Manager is between $70,000 to $110,000 per year. However, this can vary depending on factors such as location, experience, and specific industry. Some individuals in this role may earn higher salaries, up to $150,000 or more, particularly in industries such as healthcare or insurance. On the lower end, salaries may start at around $50,000 per year.

Additional Information
CVS Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
Required LanguagesEnglish
Job PostedFebruary 15th, 2024
Apply BeforeJune 21st, 2025
This job posting is from a verified source. 
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About CVS Health

CVS Health Corp. engages in the provision of health care services. It operates trough the following segments: Pharmacy Services, Retail or Long Term Care, and Corporate. The Pharmacy Services segment offers pharmacy benefit management solutions. The Retail or Long Term Care segment includes selling of prescription drugs and assortment of general merchandise. The Corporate segment involves in providing management and administrative services.

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