Manager, Business Compliance, CVS Health

CVS Health

Location:
United States

Category:
-

Contract Type:
Employment contract

Salary:

54300.00 - 159120.00 USD / Year

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Job Description:

Manager level position that applies expertise in compliance, legal and communication skills to support manage and develop compliant strategies. Responsibilities include monitoring, investigating training/education enforcement, reporting, collaborating and consulting with business leaders, engaging with key stakeholders on compliance related issues to meet regulatory and legal obligations to prevent, detect, and mitigate compliance risks.

Job Responsibility:

Supports the implementation and maintenance of an effective Compliance program supporting First Health, Aetna Signature Administrators, and American Health Holding
Prepares regulatory reports, regulatory filings and follow up activity
Manages regulatory complaint review and audit activities
Independently manages multiple complex regulatory interactions
Leads complex compliance business process reviews, corrective actions, and other projects
Independently develops strategy, processes, forms and related materials to meet complex regulatory and legal requirements
Builds and maintains positive, productive relationships with internal and external constituents
Independently identifies and assesses complex compliance issues and risks
Responds to complex requests for information within one's area of responsibility
Acts as a resource and subject matter expert for colleagues

Requirements:

5+ years' experience in a regulatory compliance position in healthcare
Demonstrated working knowledge of federal laws concerning healthcare and health insurance law, including federal healthcare reform, HIPAA, ERISA, No Surprise Act, and federal and state Mental Health Parity laws
Demonstrated working knowledge of state insurance laws and the relationship between state and federal laws
Ability to quickly develop an understanding of Aetna's Commercial and Wholesale business products and services
Ability to organize and lead important meetings with varying levels of leadership
Excellent written and verbal communication skills
Adept at problem solving and decision-making skills
Excellent collaboration skills and can thrive in a team setting
Bachelor's degree preferred or a combination of professional work experience and education

Nice to have:

Familiarity with provider directory requirements and laws
Experience with clinical operations – utilization management, case management, disease management
Experience with URAC and NCQA accreditation requirements
Experience collaborating with legal counsel to help advise internal and external customers

What we offer:

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
No-cost wellness screenings
Tobacco cessation and weight management programs
Confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access

Additional Information:

Job Posted:
September 13, 2025

Expiration:
October 04, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Manager, Business Compliance