Manager, Business Compliance

March 1

🦌 Connecticut – Remote

Although this job is listed in Connecticut, this company may be open to hiring remote in other states.

🥔 Idaho – Remote

Although this job is listed in Idaho, this company may be open to hiring remote in other states.

+1 more states

🦌 Connecticut – Remote 🥔 Idaho – Remote 🍁 Vermont – Remote

💵 $66.3k - $145.9k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🚔 Compliance

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CVS Health

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CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

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

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

📋 Description

• Lead a team of Quality Reviewers to assess healthcare fraud and abuse investigations. • Oversee planning and execution of quality reviews for investigations. • Provide direction and counsel on case handling and quality assurance. • Conduct comprehensive case reviews and provide constructive feedback to team members. • Manage team workload to ensure equitable distribution of cases. • Develop strong relationships with law enforcement to support investigations. • Contribute to educational awareness and training programs.

🎯 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 managing multiple priorities and projects simultaneously. • Strong verbal and written communication skills. • Ability to interact effectively with diverse groups of people at various levels. • Proficient in researching information and identifying relevant resources. • Comprehensive knowledge and proficiency in Microsoft Word, Excel, Outlook, SharePoint, QuickBase Management and Visio. • Strong analytical skills.

🏖️ Benefits

• Full range of medical, dental, and vision benefits. • 401(k) retirement savings plan. • Employee Stock Purchase Plan. • 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 participating partners. • Paid Time Off (PTO) or vacation pay, and paid holidays.