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Bring your heart to CVS Health. Every 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.

Role is fully remote, candidate could be Hybrid if desired.

Position Summary As a senior Analyst you will lead, implement, and maintain effective business Compliance policies & procedures, including, but not limited to, risk assessment, auditing and monitoring, and effective communication and training.Independently develops strategy, processes, reports and related materials to meet complex regulatory and legal requirements. Specifically, the person in this role will support the business in securing and maintaining NCQA Accreditation.

Additional Responsibilities

• May assist in compiling regulatory reports, client filings and follow-ups, support of the Company’s Privacy Office on privacy issues, or manage regulatory review activities including processes for implementation of laws and regulations.

• Builds and maintains positive, productive relationships with internal and external constituents; is able to remove significant barriers, drive decision-making and influence ethical and compliant outcomes at all organizational levels necessary to accomplish goals.

• Applies industry and compliance knowledge to respond to clinical business inquiries and issues.

Required Qualifications

• 2 - 4 years’ experience in a regulatory compliance position in healthcare insurance

• Have or able to quickly develop an understanding of Aetna / American Health Holding products and services.

Preferred Qualification

• Experience with URAC

• Experience with NCQA -Experience supporting Clinical Business - Utilization Management, Case Management

• 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.

Education:

• Bachelor's degree or equivalent experience

Pay Range

The typical pay range for this role is:

$43,700.00 - $107,200.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 05/15/2024

We are an equal opportunity and affirmative action employer. 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.