# Senior Manager of Medicaid Compliance **Company**: CVS Health **Experience**: senior **Job type**: full-time **Salary**: $75,400.00 - $165,954.00 **Category**: Healthcare **Industry**: Healthcare **Apply**: https://cvshealth.wd1.myworkdayjobs.com/en-US/CVS_Health_Careers/job/Southfield-2-Towne-Square/Senior-Manager--Medicaid-Compliance---MI_R1051290?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply **Canonical**: https://yubhub.co/jobs/job_1d1a5791-66c ## Description We're building a world of health around every individual , shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by colleagues who care deeply, innovate with purpose, hold themselves accountable and prioritize safety and quality in everything they do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. As a Senior Manager of Medicaid Compliance, you are responsible for the management, execution, and oversight of the compliance program activities and deliverables of a Medicaid managed care organization operating in a moderately complex regulatory environment. This role will allow you to serve as the designated Compliance Officer for Aetna's Michigan (MI) Medicaid health plan. You will oversee the activities of other compliance team members assigned to the MI market. You will be 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: - Acting as the primary liaison to the state Medicaid agency, facilitating compliance and contract-related communications and activities - Maintaining systems and tools to track, monitor, review, and submit required regulatory and compliance related deliverables and responses to state Medicaid agencies on or before required due dates - Facilitating 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 - Leading and executing all elements of the Medicaid compliance program for Aetna's MI Medicaid health plan - Conducting research and developing recommendations to help develop compliant business operations, processes, and policies in accordance with state specific Medicaid program requirements - Developing compelling, strategic, and appropriate compliance related communications on behalf of the health plan in response to state Medicaid agency inquiries or requests - Maintaining an in-depth working knowledge of the health plan's contractual, regulatory, and program policy related obligations as a Medicaid managed care organization and serving as a resource to health plan and growth partner staff for education, training, and business decision making purposes - Ensuring that current resource tools and other internal deliverables are current and accessible to business partners to ensure the appropriate monitoring and oversight of health plan compliance processes - Identifying key areas of risk or concern and proactively conducting oversight and monitoring to evaluate levels of compliance with Medicaid managed care organization requirements across the business - Utilizing systems unique to job functions, including standard-issue software such as Microsoft products and compliance specific tools such as Archer - Leading and directing oversight and monitoring activities to evaluate levels of compliance with new and existing Medicaid managed care organization requirements across the business - Maintaining positive, productive relationships with internal and external senior level constituents to effectively communicate and influence ethical and compliant outcomes - Providing training and guidance to less experienced team members to accomplish goals Required Qualifications: - 7+ years of regulatory compliance experience in managed care, health care, or insurance - 2+ years of project management experience Preferred Qualifications: - Experience with Medicaid or Medicaid managed care - Audit experience - Master's degree or Juris Doctor Education: - Bachelor's Degree required or equivalent years of related professional work experience The typical pay range for this role is: $75,400.00 - $165,954.00. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program. ## Skills ### Required - regulatory compliance - managed care - healthcare - insurance - project management - Microsoft products - Archer ### Nice to have - Medicaid - audit experience - Master's degree - Juris Doctor --- Source: [Apply at cvshealth.wd1.myworkdayjobs.com](https://cvshealth.wd1.myworkdayjobs.com/en-US/CVS_Health_Careers/job/Southfield-2-Towne-Square/Senior-Manager--Medicaid-Compliance---MI_R1051290?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)