Senior Business Compliance Analyst

CVS Health • Franklin, TN

11d

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. The Business Compliance Analyst position in Aetna Senior Supplemental’s Product & Regulatory Affairs area investigates and prepares written responses to policyholder complaints and inquiries from regulatory agencies and other sources. Position Summary Conduct thorough investigations of regulatory complaints, gather information, and resolve issues in a timely and efficient manner. Analyze trends in complaints to identify areas for process improvement in business areas. Conducts routine audits, reviews, and assessments of various business activities and processes. Analyzes internal controls, policies, and procedures to identify weaknesses and recommend improvements. Develops and implements, under general supervision, compliance policies and procedures, and ensures they align with relevant laws and regulations. Configures compliance reports and documentation, highlighting findings, recommendations, and areas of concern. Examines procedures and reporting to ensure efficiency and appropriate risk mitigation. Communicates with legal and regulatory teams to ensure accurate and timely reporting to external authorities. Administers investigations into potential compliance violations or breaches. Gathers evidence, conducts interviews, and prepares reports on the findings. Liaises with regulatory bodies, auditors, and legal professionals to address compliance-related matters. Maintain accurate records of complaints, investigations, resolutions, and all related research and communications.

Requirements

• 3+ years of experience in compliance, risk management, internal audit, regulatory affairs, or a related function.
• 2+ years of regulatory compliance experience in healthcare, including experience with customer service, complaint handling, or regulatory inquiries.
• Experience conducting investigations, including fact‑finding, documentation review, analysis, and written findings.
• Strong understanding of compliance principles, internal controls, and regulatory requirements applicable to healthcare or health insurance.
• Excellent verbal and written communication skills, with the ability to write clear, thorough, and professional investigative reports and regulatory responses.
• A writing sample demonstrating investigative and analytical skills will be required.
• Demonstrated analytical and critical thinking skills, with the ability to identify issues, trends, gaps, and potential risks.
• High attention to detail and accuracy, particularly when reviewing complaints, documenting findings, and preparing written responses.
• Ability to manage multiple cases or assignments while meeting regulatory deadlines.
• Proficiency with Microsoft Office tools (Word, Teams, PowerPoint) and the ability to learn new systems quickly.

Nice To Haves

• Experience working directly with or within an insurance regulatory agency or responding to regulators on behalf of a regulated entity.
• Familiarity with health insurance products, policies, and regulations, including state or federal oversight requirements.
• Experience conducting or supporting: Regulatory examinations or market conduct exams Internal compliance audits or risk assessments
• Experience developing, updating, or implementing compliance policies, procedures, or controls.
• Experience using legal research, complaint management, or workflow tools such as LexisNexis, Workfront, or comparable platforms.
• Advanced skills in documentation, reporting, and compliance recordkeeping.
• Experience collaborating with cross‑functional teams, including Legal, Regulatory, Operations, and Business stakeholders.
• Experience working in a highly regulated healthcare or insurance environment.

Responsibilities

• Conduct thorough investigations of regulatory complaints, gather information, and resolve issues in a timely and efficient manner.
• Analyze trends in complaints to identify areas for process improvement in business areas.
• Conducts routine audits, reviews, and assessments of various business activities and processes.
• Analyzes internal controls, policies, and procedures to identify weaknesses and recommend improvements.
• Develops and implements, under general supervision, compliance policies and procedures, and ensures they align with relevant laws and regulations.
• Configures compliance reports and documentation, highlighting findings, recommendations, and areas of concern.
• Examines procedures and reporting to ensure efficiency and appropriate risk mitigation.
• Communicates with legal and regulatory teams to ensure accurate and timely reporting to external authorities.
• Administers investigations into potential compliance violations or breaches.
• Gathers evidence, conducts interviews, and prepares reports on the findings.
• Liaises with regulatory bodies, auditors, and legal professionals to address compliance-related matters.
• Maintain accurate records of complaints, investigations, resolutions, and all related research and communications.

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.
• For more information, visit https://jobs.cvshealth.com/us/en/benefits

What This Job Offers

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