Senior Manager, Corporate Compliance – Special Needs Plans

CVS Health

Sr. Manager managing Medicare and Medicaid compliance programs at CVS Health.

Posted 7/31/2026full-timeIrving • Illinois • 🇺🇸 United StatesSenior💰 $82,940 - $182,549 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates extensive knowledge of Medicare and Medicaid compliance programs, including the ability to analyze complex regulatory rules and communicate requirements effectively. Proven experience in leading compliance initiatives, project management, and fostering relationships with stakeholders to ensure ethical and compliant outcomes.

Highest-signal resume keywords

Medicare ComplianceMedicaid ComplianceProject ManagementRegulatory AnalysisAuditing and Monitoring

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Compliance Program DevelopmentRisk AssessmentCorrective Action OversightRoot Cause AnalysisQuality Improvement Programs

Soft Skills

Time ManagementCollaborationTeamworkCommunication

Tools & Technologies

Information Systems

Industry Keywords

CMS RegulationsSNP Models of CareNCQA StandardsGovernment Contract Requirements

About the role

Key responsibilities & impact

Serve as market compliance officer for assigned Special Needs Plans (SNPs)
Track, analyze, research, interpret, communicate and monitor applicable CMS and state regulations and government contract requirements
Lead and implement an effective Compliance Program as described in CMS Medicare Managed Care Manuals/regulations, applicable Medicaid rules and government contracts, including risk assessment, auditing and monitoring and corrective action oversight
Develop and manage compliance strategies, programs, and processes that promote compliant and ethical behavior
Maintain in-depth working knowledge and expertise in Medicare, Medicaid and State requirements
Support and/or facilitate multiple compliance and contract related communications, activities and interactions with regulators
Build and maintain positive relationships with internal and external constituents at senior levels to drive decision-making and influence ethical and compliant outcomes

Requirements

What you’ll need

7+ years experience in Medicare or Medicare Advantage government healthcare program compliance or regulatory work
2+ years of Project Management experience
Ability to travel up to 10%
Extensive knowledge of Medicare and Medicaid compliance programs and rules, including rules applying to special needs plans and CMS, NCQA and state rules and standards governing SNP Models of Care, Care Management and Quality Improvement Programs
Experience in validation, auditing and monitoring, root cause analysis and corrective action oversight
Outstanding time management and project management
Proficient in utilization of information systems
Mastery in complex regulatory rule analysis and clear communication of requirements to support business stakeholders
Adept at collaboration and teamwork in matrixed environments

Benefits

Comp & perks

medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
CVS Health bonus, commission or short-term incentive program
equity award program