Analista Compliance overseeing ethics and privacy compliance activities at Kumon. Ensuring adherence to legal regulations and internal policies in a multinational education organization.
About the role
- Manage the Regulatory Resolution Team at CVS Health responsible for member and provider regulatory complaints. Overseeing team performance, regulatory responses, and maintaining effective stakeholder relationships.
Responsibilities
- Manage and lead a group of colleagues responsible for pulling together responses to member and provider regulatory complaints
- Oversee the scheduling, drafting, timeliness and quality of regulatory responses
- Proactively monitor team case load, status of response letters and associated due dates
- Interface and negotiate with state and federal regulators, as needed
- Build, maintain and promote positive and effective working relationships with internal and external stakeholders
- Identify opportunities to streamline processes and improve efficiencies within the RRT and key business partners
- Encourage staff to embrace new processes and identify change management opportunities within the team
- Hold team accountable for meeting goals, due dates and expectations, identifying areas of individual performance concerns and coaching opportunities
Requirements
- 7+ years of experience in health care industry or regulatory environment
- 5+ years of experience in claim and payment policies and administration, operational, and clinical policies
- Bachelor's degree required or equivalent years of related 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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