Senior Manager, Corporate Compliance

Serve as market compliance officer for assigned Special Needs Plans (SNPs) Track, analyze, research, interpret, communicate, and monitor applicable CMS and state regulations and government contract requirements Develop recommendations, direction, and escalation to ensure implementation and integration of program requirements complies with federal and state-specific requirements and the CVS Code of Conduct Lead and implement an effective Compliance Program, including risk assessment, auditing and monitoring, and corrective action oversight Develop and manage compliance strategies, programs, and processes Support and facilitate compliance and contract-related communications and interactions with regulators Develop or assist with strategic written responses to compliance-related regulatory inquiries Lead and support external regulatory reviews and audit activities conducted by CMS and state Medicaid agencies or partners Prepare for and manage external audits through final report and corrective action plan closure Build and maintain relationships with senior internal and external stakeholders to drive decision-making and influence compliant outcomes Monitor and audit according to the Medicare Compliance Work Plan Utilize and maintain information in Microsoft products and compliance tools such as Archer Lead and support broader compliance initiatives and other assigned projects Requirements 7+ years experience in Medicare or Medicare Advantage government healthcare program compliance or regulatory work 2+ years of Project Management experience Ability to travel up to 10% Extensive knowledge of Medicare and Medicaid compliance programs and rules, including rules applying to special needs plans Experience in validation, auditing and monitoring, root cause analysis and corrective action oversight Outstanding time management and project management Proficient in utilization of information systems Mastery in complex regulatory rule analysis and clear communication of requirements to support business stakeholders Mastery of problem solving and decision making skills Adept at execution and delivery skills Adept at collaboration and teamwork in matrixed environments Bachelor's Degree required; equivalent work experience may substitute Preferred: extensive knowledge of Medicare and Medicaid compliance programs and rules, including rules applying to integrated duals plans and other special needs plans Core Competencies Demonstrates extensive knowledge of Medicare and Medicaid compliance programs, including special needs plans, and possesses strong project management skills to lead compliance initiatives and audits effectively. Capable of clear communication and collaboration with stakeholders to ensure adherence to regulatory requirements. Highest-signal resume keywords Medicare Compliance Medicaid Compliance Project Management Regulatory Analysis Auditing and Monitoring ATS Optimization Keywords Hard Skills Compliance Program Development Risk Assessment Corrective Action Oversight Root Cause Analysis Regulatory Inquiry Response Time Management Information Systems Utilization Soft Skills Problem Solving Decision Making Collaboration Teamwork Industry Keywords Special Needs Plans CMS Regulations Government Contract Requirements Medicare Advantage Integrated Duals Plans Tools & Technologies Microsoft Products Archer Compliance Tool #J-18808-Ljbffr Jobtailor