Senior Manager, Corporate Compliance

CVS Health

Senior compliance manager at CVS Health overseeing Medicare and Medicaid programs for Special Needs Plans. Leading audits, regulatory reviews, risk assessments, and corrective actions.

Posted 8/21/2026full-timeNew Albany • Florida, New Jersey, Ohio • 🇺🇸 United StatesSenior💰 $75,400 - $165,954 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates extensive knowledge of Medicare and Medicaid compliance programs, including special needs plans, and possesses strong project management skills to lead compliance initiatives and audits effectively. Capable of clear communication and collaboration with stakeholders to ensure adherence to regulatory requirements.

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 AnalysisRegulatory Inquiry ResponseTime ManagementInformation Systems Utilization

Soft Skills

Problem SolvingDecision MakingCollaborationTeamwork

Tools & Technologies

Microsoft ProductsArcher Compliance Tool

Industry Keywords

Special Needs PlansCMS RegulationsGovernment Contract RequirementsMedicare AdvantageIntegrated Duals Plans

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
Develop recommendations, direction, and escalation to ensure implementation and integration of program requirements complies with federal and state-specific requirements and the CVS Code of Conduct
Lead and implement an effective Compliance Program, including risk assessment, auditing and monitoring, and corrective action oversight
Develop and manage compliance strategies, programs, and processes
Support and facilitate compliance and contract-related communications and interactions with regulators
Develop or assist with strategic written responses to compliance-related regulatory inquiries
Lead and support external regulatory reviews and audit activities conducted by CMS and state Medicaid agencies or partners
Prepare for and manage external audits through final report and corrective action plan closure
Build and maintain relationships with senior internal and external stakeholders to drive decision-making and influence compliant outcomes
Monitor and audit according to the Medicare Compliance Work Plan
Utilize and maintain information in Microsoft products and compliance tools such as Archer
Lead and support broader compliance initiatives and other assigned projects

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
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
Mastery of problem solving and decision making skills
Adept at execution and delivery skills
Adept at collaboration and teamwork in matrixed environments
Bachelor's Degree required; equivalent work experience may substitute
Preferred: extensive knowledge of Medicare and Medicaid compliance programs and rules, including rules applying to integrated duals plans and other special needs plans

Benefits

Comp & perks

CVS Health bonus, commission or short-term incentive program
Award target in the company’s equity award program
Medical, dental, and vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being