Senior Product Manager, Fraud & Abuse
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Job Description
Senior Product Manager leading CVS Health’s Fraud, Waste, and Abuse analytics products. Driving AI/ML enhancements, payment optimization, ROI, and cross-functional delivery.
Responsibilities:
- Own the product vision, strategy, and performance for Fraud, Waste, and Abuse products
- Support CVS Health’s Payment Optimization Analytics objectives and revenue and ROI targets
- Monitor product performance and drive product enhancements
- Oversee deployment and scaling of advanced FWA analytics capabilities
- Identify and prioritize AI/ML integration opportunities
- Translate market trends, user feedback, and competitive intelligence into product direction
- Lead a cross-functional squad of data engineers, data scientists, and ideation team members
- Define the squad’s problems, priorities, tradeoffs, and product requirements
- Maintain the roadmap, backlog, sprint plans, and demo materials
- Facilitate stakeholder sessions, sprint planning, working sessions, and product demos
- Evaluate AI/ML advancements for applicability to the product portfolio
- Establish and monitor product performance, adoption, and business-impact KPIs
- Develop data-driven business cases and secure stakeholder alignment and financial investment
- Ensure timely, high-quality delivery of product enhancements meeting business and technical requirements
Requirements:
- 4+ years of experience in product management or product ownership
- 3+ years of experience within the healthcare industry
- Demonstrated experience managing product roadmaps and defining product requirements
- Proven ability to influence and collaborate effectively across cross-functional teams and senior stakeholders
- Ability to operate in ambiguity, translating evolving business objectives into clear, prioritized initiatives
- Experience leveraging AI/ML technologies to drive measurable business value
- Ability to analyze complex data and translate insights into actionable product strategy and business decisions
- Experience in Payment Integrity, with a focus on Fraud, Waste, & Abuse (FWA)
- Strong financial acumen, with the ability to assess business impact and drive value-based decisions
- Experience working within Agile product management frameworks and methodologies
- Working knowledge of healthcare claims processing, including end-to-end claims lifecycle
- Bachelor's degree or equivalent work experience with healthcare, claims processing, or vendor management
Benefits:
- CVS Health bonus, commission or short-term incentive program
- Equity award program
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being
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