Senior Manager, Audit and Business Oversight

CVS Health • Nevada, MO

38d

About The Position

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position SummaryPlans, monitors and manages internal projects from initiation through completion. Secures required resources and uses formal processes and tools to manage resources, budgets, risks and changes. Manages projects to ensure on-time completion according to specifications and within budgeted costs.What you will doActs as a top-level specialist on project management and develops a comprehensive plan that encompasses objectives, deliverables, and timelines for CMS and State regulatory audits and readiness reviews.Ensures alignment on key deliverables and timelines and reinforces organizational standards.Applies highly developed knowledge of external audit standards and expectations to guide operational partners through all aspects of an audit, including data production, audit practice sessions, facilitation of audit sessions, delivery of post-audit deliverables, working with operations to mitigate audit risk, and oversight of root cause and corrective action planning.Oversight of operational key performance indicators to measure progress and to analyze root cause and corrective action plans when goals are not achieved.Creates a continuous improvement environment, looking for ways to enhance delivery processes and outcomes.Effectively manages multiple audits and projects and responds to change with adaptabilityUses indirect management skills to ensure projects remain on track and escalates, as appropriate.Ensures implementation of new or revised regulatory requirements.

Requirements

• Pharmacist
• 7-10 years work experience in healthcare
• Medicare and/or Medicare-Medicaid Integrated Product Experience
• Experience with Part D Coverage Determination, Appeals and Grievances and/or Formulary Administration regulatory requirements and audit management
• Experience with Part C & D reporting requirements
• 3+ years serving as project lead
• Adept at problem solving and decision making
• Experience dealing with state or federal regulators
• Excellent written and verbal communication skills and an ability to work with all levels of the organization

Nice To Haves

• Adept at collaboration and teamwork
• Adept at growth mindset (agility and developing yourself and others) skills
• Adept at execution and delivery (planning, delivering, and supporting) skills
• Adept at business intelligence

Responsibilities

• Acts as a top-level specialist on project management and develops a comprehensive plan that encompasses objectives, deliverables, and timelines for CMS and State regulatory audits and readiness reviews.
• Ensures alignment on key deliverables and timelines and reinforces organizational standards.
• Applies highly developed knowledge of external audit standards and expectations to guide operational partners through all aspects of an audit, including data production, audit practice sessions, facilitation of audit sessions, delivery of post-audit deliverables, working with operations to mitigate audit risk, and oversight of root cause and corrective action planning.
• Oversight of operational key performance indicators to measure progress and to analyze root cause and corrective action plans when goals are not achieved.
• Creates a continuous improvement environment, looking for ways to enhance delivery processes and outcomes.
• Effectively manages multiple audits and projects and responds to change with adaptability
• Uses indirect management skills to ensure projects remain on track and escalates, as appropriate.
• Ensures implementation of new or revised regulatory requirements.

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
• Industry: Ambulatory Health Care Services
• Number of Employees: 5,001-10,000 employees