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Senior Advisor - Medicare FP&A

https://www.cvshealth.com/ Logo

CVS Health

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Location:
United States

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Category:

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Contract Type:
Employment contract

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Salary:

67900.00 - 182549.00 USD / Year
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Job Description:

The Senior Manager serves as a key leader responsible for ensuring the accuracy, compliance, and operational integrity of the organization's Medicare Part D programs -- Medicare Advantage, SSIC, DSNP, and MMP programs. Operating as a highly visible subject matter expert, this role manages critical CMS Part D reporting requirements, and provides strategic guidance on regulatory and financial matters that directly influence enterprise performance of Part D. This individual contributor role will routinely partner with Compliance, Finance, Audit, Pharmacy Operations, and external stakeholders including the PBM to resolve complex issues, strengthen operational controls, and ensure adherence to CMS standards for our Part D programs. The Senior Manager also contributes to automation, data governance, and ETL optimization initiatives to enhance efficiency and reliability of enterprise reporting and accuracy of Part D.

Job Responsibility:

  • Oversee annual and ongoing CMS Part D submissions, including PDE and HPMS attestation requirements
  • Ensure alignment with evolving CMS Part D guidance by coordinating with Compliance and Operational Integrity teams and our PBM
  • Lead and assist in annual reporting, testing, and validation efforts of Part D for PDE, claims, LEP, MSP, COB, and rebate workflows
  • Assist in managing resolution of Acumen PDE tickets, ensuring timely and accurate responses
  • Partner with Pharmacy Operations teams on PBM-related issues, including Service Warranty reviews and SWAT investigations
  • Provide mentorship and guidance to associates, fostering skills in analysis, regulatory compliance, and Medicare Part D operations
  • Collaborate with internal leaders and external partners to ensure consistent understanding of regulatory requirements for Part D
  • Synthesize complex data into clear, meaningful insights for senior leadership and Compliance partners
  • Lead analytical reviews related to CMS PDE submissions and reconciliations to paid claims data
  • Identify opportunities to optimize accuracy, improve internal controls, and streamline operational processes for Part D PDE submissions

Requirements:

  • 7+ years of professional experience
  • Strong financial reporting and financial analysis experience
  • Proficiency with SAS/SQL, Python, GCP, and advanced data management tools
  • Demonstrated ability to interpret complex datasets and translate findings into actionable recommendations
  • Strong analytical, mathematical, and problem-solving abilities
  • Bachelor's degree in Finance, Accounting, or a related discipline, or equivalent years of experience

Nice to have:

  • Experience in Medicare Part D accounting, financial operations, or regulatory compliance
  • 5+ years of Medicare Part D finance experience with expertise in data mining, analytics, and operational improvement
  • Experience supporting or leading compliance activities within a health plan or regulated environment
What we offer:
  • Medical, dental, and vision coverage
  • Paid time off
  • Retirement savings options
  • Wellness programs
  • Bonus, commission or short-term incentive program
  • Equity award program

Additional Information:

Job Posted:
April 24, 2026

Expiration:
April 27, 2026

Employment Type:
Fulltime
Work Type:
Remote work
Job Link Share:
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