Manager Business Compliance - Fully Remote

Job Description1. Leads, implements, and maintains effective business Compliance policies & procedures, including, but not limited to, risk assessment, auditing and monitoring, maintaining effective compliance policies and procedures, and effective communication and training. 2. Independently develops strategy, processes, forms and related materials to meet the most complex regulatory and legal requirements. Specifically, the person in this role will support Surprise Billing implementation, product development activities associated with a new claim pricing negotiation offering, and Independent Dispute Resolution processes.3. May assist in compiling regulatory reports, client filings and follow-ups, or manage regulatory review and audit activities. 4. Independently manages regulatory interactions including drafting regulatory correspondence, responding to regulatory inquiries and negotiating resolution of regulatory matters requiring a sophisticated understanding of business processes and regulatory requirements. 5. Builds and maintains positive, productive relationships with internal and external constituents at the most senior and regulatory organizational levels, and is able to remove significant barriers, drive decision-making and influence ethical and compliant outcomes at all organizational levels necessary to accomplish goals. 6. Applies industry and compliance knowledge to lead matters involving established compliance system and operations, including processes for implementation of laws and regulations, support of the Company's Privacy Office on privacy issues, monitoring of compliance issues, and handling of client or provider complaints. 7. Acts as resource and subject matter expert for colleagues and effectively guides teams to accomplish complex goals.Required Qualifications- 4+ years' experience in a regulatory compliance position in healthcare insurance - Have or able to quickly develop an understanding of Aetna's products and services. - Experience leading complex projects.COVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred Qualifications- Strong preference for working knowledge of ACA, specifically Surprise Billing Laws- Preference for demonstrated working knowledge of Federal laws concerning health care and health insurance law including federal healthcare reform, HIPAA, ERISA, and federal mental health parity. - Preference for demonstrated working knowledge of state insurance laws, and the relationship between state and federal laws. - Experience providing legal advice and counsel to internal customers preferredEducationBachelor's degree or JD preferred or equivalent experienceBusiness OverviewBring your heart to CVS HealthEvery 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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Created: 2025-11-15