Business Compliance, Senior Manager Remote
Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand with heart at its center our purpose sends a personal message that how we deliver our services is just as important... as what we deliver.
Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
Position Summary
Prominent position that applies expertise in compliance, leadership, and communication skills to support, manage and help develop compliance strategies. Responsibilities include monitoring, investigating, training/education, enforcement, reporting, collaborating, and consulting with business leaders, and engaging with key stakeholders on compliance related issues to meet regulatory and legal obligations and prevent, detect, and mitigate compliance risks.
Leads a team of approximately seven compliance professionals responsible for the First Health, Aetna Signature Administrators, and American Health Holding Compliance Program.
Leads, implements, and maintains an effective Compliance program, including, but not limited to, risk assessment, auditing, and monitoring, maintaining effective compliance policies and procedures, and effective communication and training.
Manages multiple highly complex regulatory interactions including handling of DOI complaints, drafting regulatory correspondence, responding to regulatory inquiries, and negotiating resolution of regulatory matters requiring a sophisticated understanding of business processes and regulatory requirements.
Leads highly complex compliance business process reviews, corrective actions and other projects involving internal and external constituents.
Identifies and analyzes significant laws and regulations and impact on business operations
Oversees the preparation and filing of regulatory reports, client filings and responses to regulator inquiries
Maintains a central tracking for documents
Builds and maintains positive, productive relationships with internal and external constituents, and can remove significant barriers, drive decision-making, and influence ethical and compliant outcomes at all organizational levels necessary to accomplish goals.
Serves as an advisor to leadership on the state of emerging risks and opportunities relative to compliance. Provides advice and consultation to business partners and senior leaders, as needed, to implement appropriate processes and controls to sustain compliance consistent with Aetnas strategic direction.
Acts as resource and subject matter expert for colleagues and effectively guides teams to accomplish complex goals.
Required Qualifications
East or Central candidates (willing to work Eastern hours)
Minimum 7+ years experience in a regulatory compliance position
Healthcare experience and knowledge
Demonstrated working knowledge of Federal laws concerning health care and health insurance law including federal healthcare reform, HIPAA, ERISA, and federal mental health parity.
Demonstrated working knowledge of state insurance laws, and the relationship between state and federal laws.
Project Management, leading teams, implementing operational policies and procedures, and/or business consulting
Have or able to quickly develop an understanding of Aetna's products and services.
Preferred Qualifications
Utilization Review Accreditation Commission (URAC) & National Committee for Quality Assurance (NCQA accreditation)
Experience leading employees
Education
Bachelor's degree preferred/specialized training/relevant professional qualification.
JD Preferred
Pay Range
The typical pay range for this role is:
$67,900.00 - $174,200.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the companys equity award program.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Companys 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits
We anticipate the application window for this opening will close on: 05/19/2024
Apply Now
Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
Position Summary
Prominent position that applies expertise in compliance, leadership, and communication skills to support, manage and help develop compliance strategies. Responsibilities include monitoring, investigating, training/education, enforcement, reporting, collaborating, and consulting with business leaders, and engaging with key stakeholders on compliance related issues to meet regulatory and legal obligations and prevent, detect, and mitigate compliance risks.
Leads a team of approximately seven compliance professionals responsible for the First Health, Aetna Signature Administrators, and American Health Holding Compliance Program.
Leads, implements, and maintains an effective Compliance program, including, but not limited to, risk assessment, auditing, and monitoring, maintaining effective compliance policies and procedures, and effective communication and training.
Manages multiple highly complex regulatory interactions including handling of DOI complaints, drafting regulatory correspondence, responding to regulatory inquiries, and negotiating resolution of regulatory matters requiring a sophisticated understanding of business processes and regulatory requirements.
Leads highly complex compliance business process reviews, corrective actions and other projects involving internal and external constituents.
Identifies and analyzes significant laws and regulations and impact on business operations
Oversees the preparation and filing of regulatory reports, client filings and responses to regulator inquiries
Maintains a central tracking for documents
Builds and maintains positive, productive relationships with internal and external constituents, and can remove significant barriers, drive decision-making, and influence ethical and compliant outcomes at all organizational levels necessary to accomplish goals.
Serves as an advisor to leadership on the state of emerging risks and opportunities relative to compliance. Provides advice and consultation to business partners and senior leaders, as needed, to implement appropriate processes and controls to sustain compliance consistent with Aetnas strategic direction.
Acts as resource and subject matter expert for colleagues and effectively guides teams to accomplish complex goals.
Required Qualifications
East or Central candidates (willing to work Eastern hours)
Minimum 7+ years experience in a regulatory compliance position
Healthcare experience and knowledge
Demonstrated working knowledge of Federal laws concerning health care and health insurance law including federal healthcare reform, HIPAA, ERISA, and federal mental health parity.
Demonstrated working knowledge of state insurance laws, and the relationship between state and federal laws.
Project Management, leading teams, implementing operational policies and procedures, and/or business consulting
Have or able to quickly develop an understanding of Aetna's products and services.
Preferred Qualifications
Utilization Review Accreditation Commission (URAC) & National Committee for Quality Assurance (NCQA accreditation)
Experience leading employees
Education
Bachelor's degree preferred/specialized training/relevant professional qualification.
JD Preferred
Pay Range
The typical pay range for this role is:
$67,900.00 - $174,200.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the companys equity award program.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Companys 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits
We anticipate the application window for this opening will close on: 05/19/2024
Apply Now