Medicare Compliance Analyst
Job ID: R0193767
Category: Compliance
Address:
Location: Phoenix, AZ
Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
Position Summary
- Compliance position that supports the compliance program activities and deliverables of a Medicare managed care organization.
- In partnership with and under the direction of the health plan Medicare Compliance Officer and other team members, this position will help develop and maintain systems and processes that demonstrate the principles of an effective Compliance program and promote compliant and ethical behavior in our Medicare Advantage health plans. Responsibilities include, but are not limited to:
- Maintain an in-depth working knowledge of the health plan’s contractual, regulatory, and program policy related obligations as a Medicare Advantage organization
- In partnership with other senior members of the team, assist with the oversight and monitoring activities used to evaluate the levels of compliance with the Medicare Part C and Part D regulations
- Provide support for the elements and compliance department responsibilities required under the Medicare Compliance Program, which include but are not limited to meeting attendance, capturing meeting minutes, OIG/GSA screening of Board Members, monitoring Compliance mailbox, tracking and assisting in responding to compliance inquiries and serving as a resource to health plan staff
- Effectively escalate identified risks, concerns, and other issues through appropriate channels
- Maintain the systems and tools used to track, monitor, review, communicate Medicare Advantage Part C and D contract deliverables
- Review, interpret, and distribute regulatory guidance materials and track required health plan implementation timeframes
- Support external and internal audit processes in conjunction with senior members of the team; including but not limited to project management and tracking of required audit deliverables
- Utilize systems unique to job functions, including standard-issue software such as Microsoft products and compliance specific tools; maintain system documentation
- Maintain positive, productive relationships with internal and external constituents to effectively communicate and influence ethical and compliant outcomes
- Other duties as assigned
Required Qualifications
- 2+ years regulatory compliance position in Medicare Advantage Managed Care
Preferred Qualifications
- Experience with Medicare Part C and D regulations and Medicare Advantage Managed Care
- Project Management experience
- Strong written and verbal communication skills
- Audit experience
Education
- Bachelor's degree or equivalent experience
Pay Range
The typical pay range for this role is:
$40,600.00 – $85,100.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits
We anticipate the application window for this opening will close on: 05/03/2024
