Compliance Manager

CVS Health

Compliance Manager responsible for APCD reporting and compliance activities. Ensuring regulatory requirements are met and managing communications with regulators and vendors.

Posted 7/14/2026full-timeHartford • Connecticut, Illinois • 🇺🇸 United StatesMid-LevelSenior💰 $66,330 - $145,860 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in managing compliance programs and reporting requirements within the healthcare and insurance sectors, with a strong focus on interpreting regulations and developing business requirements. Proven ability to lead projects, mentor teams, and enhance processes through data analysis and effective communication.

Highest-signal resume keywords

Compliance ManagementHealthcare Products KnowledgeProject LeadershipData AnalysisTraining and Mentoring

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Compliance ReportingBusiness Requirements WritingData AnalysisHealthcare Claims ProcessingRegulatory InterpretationWorkflow AutomationIssue InvestigationProcess DocumentationPharmacy Benefit Manager OperationsIndustry Coding Structures

Soft Skills

Effective CommunicationTeam CollaborationRelationship BuildingProblem SolvingMentoring

Tools & Technologies

Reporting ToolsDatabases

Industry Keywords

Healthcare ComplianceInsuranceFinancial ServicesHMOPPOMedicare AdvantageMedicare Part DSpecialty DrugsPharmacy OperationsRegulator Communications

About the role

Key responsibilities & impact

Manage APCD compliance programs and reporting requirements across multiple states
Lead projects from start to finish, including timelines, regulator communications, and extension requests
Interpret state regulations and convert them into business and system requirements
Oversee timely submission of reports, files, and responses to regulators and vendors
Investigate compliance, reporting, and system issues; identify root causes and support corrective actions
Write detailed business requirements to address compliance and data issues
Use reporting tools, databases, and data analysis to monitor compliance and improve processes
Identify opportunities to automate and streamline workflows
Train, mentor, and coach team members and business partners
Develop and maintain training materials, policies, procedures, and process documentation
Build relationships across departments to improve collaboration and results
Communicate effectively with regulators, vendors, clients, account managers, IT teams, and leadership
Escalate risks, issues, and compliance concerns when appropriate
Create management reports and provide recommendations for issue resolution

Requirements

What you’ll need

5+ years of compliance or legal experience in healthcare, insurance, or financial services
5+ years of experience with healthcare products, including: HMO PPO Medicare Advantage Medicare Part D
2+ years of pharmacy-related experience, including: Specialty drugs Medicare Part D PBM (Pharmacy Benefit Manager) operations
Understanding of healthcare claims processing and industry coding structures
Ability to travel up to 10%

Benefits

Comp & perks

medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs