Senior Manager in Regulation Best Interest Program overseeing business transformation initiatives and managing teams across multiple locations in the United States.
About the role
- Lead Director overseeing Medicaid compliance and external audits for CVS Health. Managing external regulatory audits and compliance communications with state Medicaid agencies.
Responsibilities
- Serving as the principal liaison to the state Medicaid agency for all external audits and escalated state matters
- Facilitating the preparation for and management of external audits conducted by state Medicaid and related agencies or partners through final report and corrective action plan closure
- Supervising the submission of all audit deliverables and ad hoc state requests or escalated issues
- Conducting comprehensive lessons learned evaluations following post-audit and develop proactive corrective actions with executive leaders
- Conducting research and develop recommendations to help executive leadership develop compliant business operations
- Independently developing compelling compliance related communications on behalf of the health plan
- Maintaining an in-depth working knowledge of the health plan’s contractual, regulatory, and program policy related obligations
- Designing and managing tools for tracking and handling complex state external audits
- Utilizing systems unique to job functions, including standard-issue software such as Microsoft products and compliance specific tools
- Maintaining positive, productive relationships with internal and external senior level constituents
- Providing training and guidance to less experienced team members
Requirements
- 10 years previous experience in Medicaid or Medicaid managed care
- 2+ years previous experience managing external audits
- 2+ previous management experience
- 5+ years regulatory compliance position in managed care, health care, or insurance or 3 years with Master’s Degree
- Ability to travel (up to 25% - including plane) to Texas for audit preparations and on-site reviews
- Regular and reliable attendance due to time sensitive nature of external deliverables and activities
Benefits
- Affordable medical plan options
- 401(k) plan (including matching company contributions)
- Employee stock purchase plan
- No-cost programs for all colleagues including 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
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