Senior Advisor - Medicare FP&A

CVS Health • Island, KY

1d

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Senior Manager serves as a key leader responsible for ensuring the accuracy, compliance, and operational integrity of the organization’s Medicare Part D programs -- Medicare Advantage, SSIC, DSNP, and MMP programs. Operating as a highly visible subject matter expert, this role manages critical CMS Part D reporting requirements, and provides strategic guidance on regulatory and financial matters that directly influence enterprise performance of Part D. This individual contributor role will routinely partner with Compliance, Finance, Audit, Pharmacy Operations, and external stakeholders including the PBM to resolve complex issues, strengthen operational controls, and ensure adherence to CMS standards for our Part D programs. The Senior Manager also contributes to automation, data governance, and ETL optimization initiatives to enhance efficiency and reliability of enterprise reporting and accuracy of Part D.

Requirements

• 7+ years of professional experience.
• Strong financial reporting and financial analysis experience.
• Proficiency with SAS/SQL, Python, GCP, and advanced data management tools.
• Demonstrated ability to interpret complex datasets and translate findings into actionable recommendations.
• Strong analytical, mathematical, and problem‑solving abilities.

Nice To Haves

• Experience in Medicare Part D accounting, financial operations, or regulatory compliance.
• 5+ years of Medicare Part D finance experience with expertise in data mining, analytics, and operational improvement.
• Experience supporting or leading compliance activities within a health plan or regulated environment.

Responsibilities

• Oversee annual and ongoing CMS Part D submissions, including PDE and HPMS attestation requirements. This will include monitoring completeness and accuracy of Part D submissions to CMS.
• Ensure alignment with evolving CMS Part D guidance by coordinating with Compliance and Operational Integrity teams and our PBM.
• Lead and assist in annual reporting, testing, and validation efforts of Part D for PDE, claims, LEP, MSP, COB, and rebate workflows.
• Assist in managing resolution of Acumen PDE tickets, ensuring timely and accurate responses.
• Partner with Pharmacy Operations teams on PBM‑related issues, including Service Warranty reviews and SWAT investigations.
• Provide mentorship and guidance to associates, fostering skills in analysis, regulatory compliance, and Medicare Part D operations.
• Collaborate with internal leaders and external partners to ensure consistent understanding of regulatory requirements for Part D.
• Synthesize complex data into clear, meaningful insights for senior leadership and Compliance partners.
• Lead analytical reviews related to CMS PDE submissions and reconciliations to paid claims data.
• Identify opportunities to optimize accuracy, improve internal controls, and streamline operational processes for Part D PDE submissions.

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees