Regulatory Resolution Team Manager handling regulatory inquiries and complaints for CVS Health. Ensuring compliance and member satisfaction through thorough reviews and communication with stakeholders.
Responsibilities
Review and draft all responses to member and provider regulatory complaints.
Work collaboratively across multiple internal stakeholders and experts to ensure accurate and complaint responses.
Strategically manage complex complaints to resolution, escalating to leadership as appropriate.
Ensure responses are consistent with internal policies, state and federal requirements.
Ensure responses are concise, accurate and written with an eye towards the regulator recipient.
Ensure responses are timely and complete, meeting all regulatory due dates.
Requirements
5+ years of experience in health care industry or regulatory environment.
3+ years of experience in claim and payment policies and administration, operational, and clinical policies.
Expert technical and written communication skills.
Excellent problem solving and decision-making skills, including taking initiative to resolve complex issues and discern relevant information.
Strong skills in interpreting state and federal requirements.
Ability to prioritize work in a fast-paced environment.
Bachelors degree required or equivalent years of relevant experience.
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.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
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