Austin, Texas, United States
Regulatory and Business Compliance, Behavioral Health Network SR MGR
This position can sit anywhere in the US.
This position will be responsible for the development of a new centralized process within the Behavioral Health network organization to ensure regulatory compliance within all departments of our organization. The Sr. Manager, will work with internal and external partners on industry standards, developing policies, and evaluating compliance. You will also be responsible to obtain regulatory approval.
To be successful in this role, you will possess extensive experience and knowledge of industry requirements and standards at the state and federal level. Accomplished compliance analysts are regulatory experts who lead their organizations toward excellence in compliance. You will report to the Executive Director, Network Manager for Aetna Behavioral Health.
*Builds, implements, and oversees the Compliance Center of Excellence for Behavioral Health
*Responsible for researching industry compliance regulations and policies.
*Evaluates internal operational and procedural compliance.
*Analyzes and updating existing compliance policies and related documentation.
*Communicates compliance policies and guidelines to Management and designated departments.
*Develops and executes new compliance policies and procedures as required.
*Develops and maintains a compliance recordkeeping system.
*Keeps abreast of compliance requirements and amendments to regulations; oversees compliance with all applicable regulatory requirements
*Tracks implementation through use of "action plans" and maintains documentation of compliance activities
*Oversees the preparation and filing of regulatory reports, non-product filings and responses to regulator inquiries, and maintains a central file for such documents
*Coordinates and oversees compliance audits and examinations (internal and external)
*Identifies and analyzes significant laws and regulations and impact on business operations
*Identifies, recommends and monitors company actions for compliance
*Updates appropriate parties of changing laws and regulations
*Represents companys interests with customers, industry groups and regulators
*Negotiates resolution of issues identified from market conduct exam, state inquiry or other source
*Communicates (oral or written) with regulators and others to discuss and resolve compliance issues
* Allocates resources as needed
The typical pay range for this role is:
Please 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.
*7+ years regulatory compliance experience in Healthcare industry, preferably with a payor
*Experience leading project teams
*In-depth knowledge of industry compliance requirements and standards for State and Federal regulations
*Proven experience formulating compliance policies, procedures, and related documentation.
*Advanced analytical abilities.
*Effective research and professional networking skills.
COVID-19 Vaccination Requirement
CVS 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.
*Behavioral Health knowledge
*Transactional/contract law experience (including drafting, reviewing, and negotiating), preferably in a corporate, in-house legal setting
*People management experience
*Accredited compliance management certification
Bachelors degree or equivalent professional experience
Bring your heart to CVS Health
Every 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.