Sr. Manager, Medicare Compliance Continuous Monitoring

Job DescriptionFortune 4 CVS Health has an exciting opportunity for a Sr. Manager on our dynamic Medicare Compliance Continuous Monitoring (CM) team, part of our Compliance Center of Excellence department. The role develops and drives to completion our Medicare compliance monitoring plan activities as well as special projects. The position leads 4-5 individual contributors and is responsible for reviewing, communicating and reporting applicable findings and remediation activities to key stakeholders, including Senior Management and the Medicare Compliance Committee, among others. As a Medicare Compliance Continuous Monitoring Sr. Manager, you will: Help shape, reinvent and complete the overall program governance and strategy of Medicare Continuous Monitoring testing, including continually evaluating the efficiency and effectiveness of the Medicare Operations units we review Be responsible for providing guidance and direction to senior business and Compliance leadership and cross-functional team members as required Leverage technology and analytics to enhance automation, create simplicity and maximize efficiency. Manage and develop talent, influence and impact a broad set of stakeholders, engage and inspire others, and lead by example. Demonstrate personal integrity and adherence to the CVS Health code of conduct, appreciate diversity and promote collaboration on all activities.Required Qualifications8+ years hands-on compliance or audit experience, including developing and communicating all aspects of planning, fieldwork, reporting and remediation.Ability to travel up to 10%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 QualificationsGovernment, healthcare or pharmacy benefit management experience is highly desirable. Powerful Communication: The ability to communicate effectively and succinctly with a diverse range of constituents, both verbally and in writing, and with all levels of an organization Intellectual Curiosity and Tenacity: Ability and willingness to understand and solve complex problems and apply a forward-thinking growth mindset Structured & Logical Thinking: Ability to proactively identify potential problems and risks and develop solutions and mitigation plans. Identify and define business problems and issues, and develop strategic and analytical framework to conduct analysis and/or measure success. CHC, CIA, CPA or relevant professional designation preferredEducationBachelor's Degree or equivalent years of 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