Senior Manager, Medicare Business Compliance

CVS Health•Hartford, CT

1d•$82,940 - $182,549•Hybrid

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. At Aetna®, part of CVS Health, we proudly serve more than 26 million medical members through our broad range of health plan offerings. We're committed to delivering a simpler, more meaningful, and personal health care experience to each of them. As a Senior Manager Business Compliance (Medicare) you will play a critical role by leading and delivering complex compliance initiatives that support regulatory adherence and operational excellence. This role partners closely with cross-functional business areas to plan, coordinate, and execute projects that mitigate operational and regulatory risk, with a strong emphasis on Medicare compliance. This position is a senior-level project management position within Operations Integrity and offers broad exposure to internal business partners and leadership teams and provides the opportunity to demonstrate leadership, strategic thinking, and enterprise-level influence.

Requirements

Project Management: 5+ years of experience leading complex initiatives from planning through execution and delivery.
Systems Expertise: Hands-on experience with QuickBase.
Communication Skills: Demonstrated strong oral and written communication skills.
Executive Communication: Proven ability to communicate effectively with leaders at all levels, including executive leadership.
Problem Solving & Decision Making: Strong analytical skills with the ability to assess issues, evaluate options, and make sound decisions.
Collaboration & Teamwork: Adept at working collaboratively across cross-functional teams to achieve shared goals.
Growth Mindset: Demonstrated agility and commitment to continuous learning, development, and coaching of others.
Execution & Delivery: Strong capability in planning, delivering, and supporting initiatives to achieve intended outcomes.
Regulatory Expertise: Strong knowledge of Medicare regulations and regulatory guidance.

Nice To Haves

5+ years Medicare operational experience
Aetna systems experience
Regulatory compliance experience

Responsibilities

Oversee the implementation and ongoing interpretation of Medicare laws, regulations, and regulatory guidance, ensuring timely and accurate execution across impacted business areas.
Serve as a subject matter resource for inquiries and lead responses to audit and data requests from regulators, auditors, and internal oversight partners.
Interpret regulatory guidance, assess compliance gaps, identify root causes, and design and implement sustainable corrective action plans.
Routinely communicate project status, risks, and outcomes to senior leaders and executive stakeholders, translating complex regulatory requirements into clear, actionable business guidance.
Oversight of new and updated regulatory guidance implementation, leadership of Annual Enrollment Period (AEP) readiness activities across multiple business areas, proactive identification and mitigation of operational risks, and end-to-end coordination of audit and regulatory responses.
Contributes to regulatory compliance, operational stability, and overall member satisfaction.