Manager, Business Compliance

2 days ago

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CVS Health

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Retail • Pharmacy Benefits Management • Health Insurance • Health Care • Pharmacy

10,000+

Description

• Lead a team of Quality Reviewers to prevent and investigate healthcare fraud. • Oversee planning and execution of quality reviews for investigations. • Provide direction and counsel on case handling. • Assist in identifying resources and timely action. • Conduct comprehensive case reviews and provide feedback. • Evaluate team members for professional development. • Manage team workload for equitable distribution. • Assess training needs and collaborate on development plans. • Develop relationships with law enforcement for investigations. • Participate in audits ensuring compliance with regulations.

Requirements

• Minimum of five years of experience managing healthcare fraud, waste, and abuse investigations. • At least four years of people leading experience. • Documented record of leading a team greater than eight colleagues. • Experience collaborating with state and law enforcement partners. • Experience in project management, capable of managing multiple priorities. • Strong verbal and written communication skills. • Ability to interact effectively with diverse groups of people. • Proficient in Microsoft Word, Excel, Outlook, SharePoint, QuickBase Management, and Visio. • Strong analytical skills for data-driven decision-making. • Ability to travel up to 20%.

Benefits

• Full range of medical, dental, and vision benefits. • Enrollment in 401(k) retirement savings plan. • Employee Stock Purchase Plan available. • Fully-paid term life insurance plan. • Short-term and long-term disability benefits. • Numerous well-being programs. • Education assistance and free development courses. • CVS store discount and discount programs with partners. • Paid Time Off (PTO) and paid holidays. • Time off consistent with relevant state law and Company policies.