Senior Manager – Corporate Compliance

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🔥 3 minutes ago

🦀 Maryland – Remote

🦀 Maryland – Remote

💵 $82.9k - $182.5k / year

⏰ Full Time

🟠 Senior

🚔 Compliance

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

Healthcare Insurance • Retail • Wellness

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

• Serve as the Compliance Officer for Aetna's Maryland Medicaid health plan • Act as the primary contact with the Maryland Medicaid agency for compliance and contract-related matters • Track, monitor, and submit required regulatory reports and responses on time • Lead preparation and coordination for state audits, including corrective action plans and issue resolution • Manage all aspects of the Medicaid compliance program • Research regulatory requirements and provide recommendations to support compliant business practices • Draft and coordinate responses to inquiries and requests from state Medicaid agencies • Maintain expert knowledge of Medicaid regulations, contracts, and program requirements • Serve as a compliance resource for staff, providing guidance, education, and training • Maintain compliance tools, risk assessments, reporting systems, and tracking processes • Identify compliance risks, conduct monitoring activities, and recommend corrective actions • Support business teams in developing solutions to address compliance concerns • Utilize compliance management tools, including Microsoft Office and Archer • Build and maintain strong relationships with internal and external stakeholders • Provide guidance and coaching to less experienced team members • Perform other duties as assigned

🎯 Requirements

• 7+ years of compliance experience in healthcare, managed care, insurance, or a related field • Candidates with an advanced degree may qualify with 5+ years of relevant experience • Project management experience • Experience with Medicaid or Medicaid managed care programs • Experience supporting audits or regulatory reviews • Bachelor's degree in Public Policy, Government Affairs, Healthcare Administration, Public Administration, or a related field • Master's degree or Juris Doctor (JD)

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families