Compliance Manager, FDR Oversight Program
4 weeks ago
This role follows a hybrid working schedule of three days onsite per week at one of our core locations. The Compliance Manager, FDR Oversight Program is an individual contributor career level position within Medicare Compliance who will execute operational and compliance program effectiveness reviews to support our FDR Oversight program.
Key Responsibilities- Conducts oversight activities, as outlined in the Medicare Compliance Work Plan to verify compliance with Aetna standards and regulatory requirements.
- Applies compliance knowledge to address compliance issues, including evaluation of root cause analysis, recommends corrective action for compliance gaps, monitors completion and conducts validation of action plan effectiveness.
- With little to no guidance, obtains and reviews evidence ensuring oversight activity results and work papers are clear, concise, well-documented, and retained in accordance with department guidelines.
- Independently identify and assess moderately complex compliance issues, communicates (oral or written) with leaders and others to discuss, and actively collaborates towards resolving the identified compliance issues.
- Works independently, as well as in collaboration with, colleagues from across the organization to assess compliance strategies.
- Assists with supporting and educating internal and external constituents in their understanding of FDR requirements, and the oversight processes, to comply with the regulatory requirements.
- Participates and presents at required oversight committees, as needed.
- 5+ years of experience in government healthcare programs related to compliance or regulatory work
- 3+ years of project management experience
- Ability to travel up to 10%
- Experience with CMS and/or State Medicare/Medicaid audits
- Experience with administration of the FDR Requirements outlined in CMS' Compliance Program Guidelines (Chapters 9 and 21)
- Project management experience
- Bachelor's degree required or equivalent professional years of experience
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.
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Compliance Manager, FDR Oversight Program
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