This is an experienced/career-level compliance position that supports the activities of a Medicare compliance program for MMP and SNP products.

You will work in partnership with and under the direction of health plan Compliance Officers, this position will help develop and maintain systems and processes that demonstrate the principles of an effective Compliance program and promote compliant and ethical behavior in Aetna’s MMP and SNP health plans.

Responsibilities include, but are not limited to:

• Proven project management skills to maintain the systems and tools to track, monitor, review, and submit required mandates, contracts and regulatory and compliance related deliverables and responses internally and to state Medicaid agencies and CMS on or before required due dates; prepares moderately complex regulatory reports as needed on behalf of the compliance team
• Conduct research and develop recommendations to help develop compliant business operations, processes and policies in accordance with new regulatory mandates, CMS and applicable state program requirements
• Develop appropriate compliance related communications on behalf of the health plan in response to numerous regulatory communications.
• Maintain an in-depth working knowledge of various contractual, regulatory, and program policy related obligations and serve as a resource to business
• Support the external audit review process in conjunction with designated subject matter experts, including, but not limited to project management and tracking of required deliverables, responses, and corrective action plans
• Utilize systems unique to job functions, including standard-issue software such as Microsoft products and compliance specific tools such as Archer; maintain system documentation
• Conduct or support auditing and monitoring to evaluate levels of compliance with Medicare and Medicaid requirements across the business; support compliance and business partners in management of corrective action plans and effectively escalate risks, concerns and other issues through appropriate channels
• Maintain positive, productive relationships with internal and external constituents to effectively communicate and influence ethical and compliant outcomes
• Other duties as assigned

Pay Range
The typical pay range for this role is:
Minimum: 40,560
Maximum: 83,400

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.

Required Qualifications
1+ years regulatory compliance position in government healthcare programs, managed care, health care, or insurance
1+ years of experience utilization of Microsoft skills (e.g., Excel, PowerPoint, SharePoint, Word etc.).

Preferred Qualifications

• Experience with Quickbase
• Experience with Medicare or Medicaid
• Audit experience
• Highly organized
• Project management experience

Education
Bachelor's Degree or equivalent experience required

Business Overview
Bring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.