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At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

Assists in ensuring the organization adheres to contractual and regulatory requirements, mitigates risks, and maintains a strong compliance culture. Assists in the management of Medicare key performance indicators, including root cause and corrective action plan management for indicators not meeting goals.

+ Contributes to implementing complex monitoring systems and procedures to assess compliance with contractual and regulatory requirements.

+ Conducts reviews and assessments of various business activities and processes.

+ Analyzes internal controls, policies, and procedures to identify weaknesses.

+ Implements and modifies, under direct supervision, new key performance indicators to align with new and changing regulatory and contractual requirements.

+ Compiles compliance reports and documentation, highlighting findings, recommendations, issue root cause analysis, and corrective action plans.

+ Examines procedures and reporting, under close supervision, to ensure efficiency and appropriate risk mitigation.

+ Communicates with internal teams to ensure accurate and timely reporting.

+ Manages administrative tasks such as monitoring and taking action on department email account.

Required Qualifications

+ 1-3 years of experience in with Medicare Advantage and/or Medicaid experience regulations and contractual requirements

+ Project management experience, including root cause and corrective action development and tracking

+ Problem solving and decision-making skills

+ Ability to work in Excel, PowerPoint, and QuickBase

+ Experience with data analysis or compliance monitoring systems

+ Good verbal and written communication

Preferred Qualifications

+ Compliance, audit, or quality management experience

+ Familiarity with CMS audit protocols and reporting requirements

Education

+ Bachelors degree preferred but can substitute experience.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$43,888.00 - $93,574.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

+ **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** .

+ **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

+ **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 12/01/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

We are an equal opportunity and affirmative action employer. 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.