Senior Manager – Business Compliance

Job not on LinkedIn

🔥 13 hours ago

🏈 Alabama, Arizona, +42 more states – Remote

🏈 Alabama – Remote 🌵 Arizona – Remote 🏄 California – Remote ⛰️ Colorado – Remote 🦌 Connecticut – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦞 Maine – Remote 🦬 Montana – Remote 🌾 Nebraska – Remote 🎰 Nevada – Remote 🗻 New Hampshire – Remote 🏖️ New Jersey – Remote 🌶️ New Mexico – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🌾 North Dakota – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🌲 Oregon – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote ⚓ Rhode Island – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote ☕ Washington – Remote ⛰️ West Virginia – Remote 🧀 Wisconsin – Remote 🦬 Wyoming – Remote

💵 $67.9k - $199.1k / year

⏰ Full Time

🟠 Senior

🚔 Compliance

👻 Ghost score 0%

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Monitor and interpret new and evolving regulatory requirements and standards • Serve as liaison with CMS representatives, external contractors, legal counsel, and internal teams • Develop and maintain compliance oversight protocols • Identify operational and compliance gaps and implement mitigation plans • Collaborate with business leaders to maintain compliant policies and workflows • Partner with Quality and Audit teams for CMS responses and internal, NCQA, departmental, and mock audits • Use compliance reporting tools to track performance, identify trends, and escalate risks to executive leadership and business partners • Create and manage a long-term operational strategy for appeals and audit responses • Establish and lead cross-functional workgroups addressing compliance risks and regulatory requirements • Monitor ongoing compliance, conduct risk assessments, and assist with audits • Plan and execute projects related to compliance and regulatory requirements

🎯 Requirements

• 7+ years Medicare experience related to the duties and responsibilities specified or an equivalent combination of education and work experience • 7+ years of CMS audit, Medicare compliance or service operations experience • Ability to understand complex problems and collaborate with business leaders to plan, solve, and execute solutions • Experience working directly with CMS or other regulatory entities • Associate’s degree or equivalent work experience • Clinical licensure (RN) preferred

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program • Award target in the company’s 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