Senior Analyst, Medicare Compliance

CVS Health•Downers Grove, IL

1d•$46,988 - $102,000•Remote

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 Analyst is a compliance position that applies compliance, regulatory, business, analytical and communication skills to support, manage and develop and execute Medicare compliance programs and processes that promote compliant and ethical behavior, meet regulatory obligations, and prevent, detect and mitigate compliance risks. The individual will work independently, as well as collaboratively, with internal senior level corporate compliance and business teams that operate Medicare Advantage in a highly complex regulatory environment and highly matrixed organization environment with a current focus on integrated special needs plans. The analyst maintain productive relationships and open lines of communication with internal and key external stakeholders to effectively communicate and influence compliant outcomes and ensure that processes are enhanced or implemented to effectively address compliance requirements.

Requirements

Extensive knowledge of Medicare compliance programs and rules
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
Adept at execution and delivery (planning, delivering, and supporting) skills
Adept at collaboration and teamwork
2+ years’ experience in Medicare Compliance or regulatory work
Willingness to travel up to 10% (including by plane)

Nice To Haves

Understand Medicare Requirements
3+ years of Medicare Compliance work

Responsibilities

Lead and implement an effective Compliance Program as described in CMS Medicare Managed Care Manuals/regulations, including risk assessment, auditing and monitoring and corrective action oversight.
Develop and manage compliance strategies, programs, and processes that promote compliant and ethical behavior, meet regulatory obligations, and prevent, detect, and mitigate compliance risks.
Track, analyze, and work open issue in a timely manner
Maintain in-depth working knowledge and expertise in Medicare regulations
Builds and maintains positive relationships at senior levels to drive decision-making and influence ethical and compliant outcomes
Monitor and audit as outlined in Medicare Compliance Work Plan and direct other projects as assigned to evaluate compliance, propose remediation where necessary and monitor implementation of corrective action
Support broader compliance initiatives and needs as assigned to ensure that effective compliance programs are achieved and maintained.
Other duties as assigned.