Medicare Part D Health Plan Compliance Manager Job in Scottsdale 85260, Arizona US
The Compliance Manager position provides a unique opportunity for the right person to manage compliance-related projects and initiatives in support of our Part D clients. In this project management role, the position offers exposure to business areas that support Medicare Part D for CVS Caremark. While a Pharmacy Benefits Management (PBM) or health insurance background is preferred, it is not a requirement. This position will work with business owners to resolve known deficiencies, identify potential compliance risks, and assist in the development of solutions. The individual must demonstrate the ability to influence others and win support to address critical issues.
Essential Job Functions:
-Supervise or lead compliance projects to remediate deficiencies and support initiatives resulting from a client or CMS imposed Corrective Action Plan (CAP).
-Develop recommendations for corrective action based on review of audit findings and work with department management to address deficiencies
-Communicate status of operational and compliance-related projects to internal teams and to the client. Act as a facilitator and coordinator of compliance focused issues.
-Attend calls with client and Centers for Medicare and Medicaid Services (CMS) regional/central offices for resolution of Part D compliance issues.
-Identify potential compliance risks and work with business partners and client to develop solutions.
Bachelors degree preferred
Minimum of 9 years experience in healthcare; external-facing experience preferred
Knowledge of CMS, Medicare and Part D regulations and guidance; Excellent written and oral communication skills; Ability to work independently, manage multiple projects and meet scheduled deadlines; Ability to interact with the client and individuals at all levels of CVS Caremark and clients; Ability to anticipate client questions and responses; Ability to apply reasoned judgment.
