Sr Manager, Medicaid Compliance (National)
About the position Responsibilities • Initiate and manage the development and execution of national-level internal corrective action plans (iCAP) for Aetna's Medicaid business. • Track ongoing activities and progress against iCAP milestones and deadlines. • Maintain documentation and data within Aetna's designated governance, risk, and compliance (GRC) tool (Archer). • Review evidence of remediation completion prior to iCAP closure. • Assist in the review and update of Archer documentation of iCAPs and external CAPs across all markets. • Maintain knowledge of Aetna's Medicaid managed care state business practices and solutions. • Conduct research and develop recommendations for compliant business operations, processes, and policies. • Maintain positive relationships with internal and external constituents to communicate and influence compliant outcomes. • Participate in business working groups/committees for areas of responsibility. • Manage moderately to highly complex cross-functional and process improvement projects. • Develop compliance-related communications for internal partners and leadership. • Maintain an in-depth working knowledge of Medicaid managed care obligations and serve as a resource for education and decision-making. • Utilize systems and software for compliance tasks, including Microsoft products and Archer. • Conduct oversight and monitoring to evaluate compliance levels across the Medicaid business. • Provide training and guidance to less experienced team members. Requirements • 7+ years in a regulatory compliance position in managed care, health care, or insurance. • 5+ years of higher education experience. • 3+ years of Medicaid experience. • 3+ years of project management experience. Nice-to-haves • Bachelor's degree in Public Policy, Government Affairs, Health Care Administration, or Public Administration. • Master's degree or Juris Doctor. • Direct experience in Medicaid managed care compliance. Benefits • Full range of medical, dental, and vision benefits. • 401(k) retirement savings plan. • Employee Stock Purchase Plan. • Fully-paid term life insurance plan. • Short-term and long-term disability benefits. • Well-being programs. • Education assistance and free development courses. • CVS store discount and discount programs with partners. • Paid Time Off (PTO) and paid holidays. Apply tot his job