Manager, Business Compliance Requests for Information (RFI)

CVS Health•Hartford, CT

4d•Hybrid

About The Position

The RFI Manager within the Payment Integrity Center of Excellence (PI COE) leads the team responsible for managing and responding to official requests for information from regulatory agencies, state departments, law enforcement, and internal stakeholders. The role ensures sensitive data and documentation are delivered accurately, on time, and in compliance with applicable requirements across multiple lines of business and jurisdictions. The manager oversees the full lifecycle of each request, from intake and triage through coordination, review, and final delivery, with a strong focus on meeting turnaround time commitments and maintaining accountability across RFI-related activities. The manager leads a team of Senior Reporting Analysts, including staff with embedded remote notary credentials, and works closely with partners in Legal, Compliance, and Operations to maintain transparency and consistency in all responses. This position supports a hybrid work environment. If selected and living near a suitable work location, the employee may be expected to follow the hybrid work policy, which requires onsite work three days a week for in-scope populations. Aetna Service Operations office or hub locations will be discussed with the selected candidate. This full-time position is eligible for a comprehensive benefits package. The position is also eligible for a CVS Health bonus, commission, or short-term incentive program in addition to base pay.

Requirements

At least three years managing regulatory request responses, compliance deliverables, or administrative operations supporting regulatory departments.
Seven to ten years of experience in managed care operations, compliance, regulatory affairs, or a related healthcare function.
Advanced knowledge of problem-solving and decision-making methods.
Strong analytical and problem-solving skills, including experience in data analysis and process management.
In-depth knowledge of regulatory standards, compliance requirements, and state-specific reporting obligations.
Excellent communication and leadership skills.
Experience testifying in court or formal legal proceedings, including depositions and regulatory hearings.
Strong understanding of PHI and PII handling requirements, including HIPAA, CMS, and applicable state-specific guidelines.
Proficiency with Microsoft Excel, SharePoint, and case management systems.
Ability to work independently and collaboratively in a fast-paced environment.
Experience supporting training, quality, or process improvement initiatives.
A bachelor’s degree in Criminal Justice, Healthcare Administration, Business, or a related field is preferred; equivalent professional experience and specialized training may be considered in place of a formal degree.

Nice To Haves

Experience working with Medicaid and Medicare programs.
Familiarity with state-specific regulatory reporting protocols and requirements.
Prior experience in a regulatory response, compliance, or administrative operations role.
Knowledge of claims processing, provider contracting, and credentialing workflows.
Experience in project management or process improvement.
Accredited Health Care Fraud Investigator (AHFI) credential.
Remote Online Notarization (RON) credential or experience.

Responsibilities

Lead the team responsible for managing and responding to official requests for information from regulatory agencies, state departments, law enforcement, and internal stakeholders.
Oversee the full lifecycle of each request, from intake and triage through coordination, review, and final delivery.
Ensure sensitive data and documentation are delivered accurately, on time, and in compliance with applicable requirements across multiple lines of business and jurisdictions.
Meet turnaround time commitments and maintain accountability across RFI-related activities.
Lead a team of Senior Reporting Analysts, including staff with embedded remote notary credentials.
Work with Legal, Compliance, and Operations partners to maintain transparency and consistency in responses.