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Lead Director Corporate Compliance

Company: CVS Pharmacy
Location: Downers Grove
Posted on: September 17, 2022

Job Description:

Job DescriptionSenior level compliance position that is responsible for the management, execution, and oversight of the compliance program activities and deliverables of a Medicaid managed care organization operating in a highly complex regulatory environment. Oversees the activities of other compliance team members assigned to the market. This position is responsible for developing and maintaining systems and processes that demonstrate the principles of an effective Compliance program and promote compliant and ethical behavior in the assigned Medicaid health plan. Responsibilities include, but are not limited to:--- Serve as the designated Compliance Officer for Aetna's Illinois Medicaid health plan--- Acts as the primary liaison to the state Medicaid agency, facilitating compliance and contract-related communications and activities --- Facilitates the preparation for and management of external audits conducted by state Medicaid and related agencies or partners in conjunction with health plan leadership through final report and corrective action plan closure --- Lead and execute all elements of the Medicaid compliance program for Aetna's Illinois Medicaid health plan--- Conduct research and develop recommendations to help develop compliant business operations, processes and policies in accordance with state specific Medicaid program requirements--- Develop compelling, strategic, and appropriate compliance related communications on behalf of the health plan in response to state Medicaid agency inquiries or requests--- Maintain an in-depth working knowledge of the health plan's contractual, regulatory, and program policy related obligations as a Medicaid managed care organization and serve as a resource to health plan and growth partner staff for education, training, and business decision making purposes--- Ensure that current resource tools and other internal deliverables such as current contract library, regulatory reporting assignments, risk assessments, risk tracking lists, internal reporting systems and summaries, and other department wide tools are current and accessible to business partners to ensure the appropriate monitoring and oversight of health plan compliance processes--- Utilize systems unique to job functions, including standard-issue software such as Microsoft products and compliance specific tools such as Archer; maintain system documentation, serve as subject matter expert, train users of system, contribute to system design, oversight or maintenance--- Lead and direct oversight and monitoring activities to evaluate levels of compliance with new and existing Medicaid managed care organization requirements across the business; support business partners in the development of mitigation and corrective action plans and effectively escalate risks, concerns and other issues through appropriate channels--- Maintain positive, productive relationships with internal and external senior level constituents to effectively communicate and influence ethical and compliant outcomes --- Provide training and guidance to less experienced team members to accomplish goals--- Other duties as assignedPay RangeThe typical pay range for this role is:Minimum: 100,000Maximum: 221,000Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.Required Qualifications--- 10+ years compliance experience--- 7+ years previous experience in Medicaid or Medicaid managed care--- 2+ previous management experience--- Project Management--- Must be located in Illinois--- Ability to be on site at the Downers Grove office as neededCOVID 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--- Audit experience--- Master's degree in Public Policy, Health Care Administration, Public Administration or similar fields or a law degreeEducation--- Bachelor's degree with equivalent work experience--- Master's degree preferredBusiness 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.

Keywords: CVS Pharmacy, Downers Grove , Lead Director Corporate Compliance, Executive , Downers Grove, Illinois

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