Full-Time

Sr Manager

Corporate Compliance, PBM Market Conduct Exam Support

Posted on 12/12/2024

CVS Health

CVS Health

10,001+ employees

Comprehensive pharmacy and healthcare services

Healthcare
Consumer Goods

Compensation Overview

$75.4k - $182.5kAnnually

+ Bonus + Commission + Equity Award Program

Senior, Expert

Company Historically Provides H1B Sponsorship

Northbrook, IL, USA + 4 more

More locations: Berkeley Springs, WV, USA | Scottsdale, AZ, USA | Hartford, CT, USA | Irving, TX, USA

Hybrid working schedule: three days onsite and two days from home per week.

Category
Risk & Compliance
Legal & Compliance

You match the following CVS Health's candidate preferences

Employers are more likely to interview you if you match these preferences:

Degree
Experience
Requirements
  • 7+ years of combined experience in a PBM role/Market conduct exam role.
  • Ability to travel up to 10%
Responsibilities
  • Work with the internal CVS Health Corporate Compliance Market Conduct Exam team and other internal business partners (e.g., Legal, CVS Caremark business teams, etc.)
  • Directly interact with state regulators and / or third-party auditors / examiners as needed.
  • Serve as intermediary between the state regulators/auditors and the PBM business owners.
  • Lead the communication efforts between state regulators and CVS Caremark.
  • Assist in the identification, prioritization, and completion of exam/audit deliverables.
  • Improve CVS Health’s PBM Market Conduct Exam communications and process flow standards across the CVS Caremark organization.
  • Support the development and delivery of any responses related to a CVS Caremark’s examination report / audit findings (recommendations).
  • Ensure strong and detailed record-keeping of all deliverables from business partners to examiners.
  • Monitor the creation and delivery of any CVS Caremark corrective action plans due to exam findings.
  • Perform other duties as assigned.
Desired Qualifications
  • Prior experience in a relevant auditing or market conduct exam role in managed care, health care, or PBM.
  • Prior experience in strategizing, planning, and developing business compliant audit project plans and corrective action plans.
  • Prior project management experience.
  • Prior experience in building relationships with state regulators/ third-party auditors.
  • JD.

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. The company serves individual consumers, businesses, and communities, offering prescription medications, over-the-counter health products, beauty items, and general merchandise. CVS Health also functions as a pharmacy benefits manager, managing health plans for over 75 million members, and provides specialized care for seniors and patients requiring specialty medications. This integrated approach allows CVS Health to enhance access to healthcare, improve health outcomes, and reduce costs. Unlike many competitors, CVS Health combines retail pharmacy services with clinical care, making it a significant player in the healthcare sector with a goal of helping people achieve better health.

Company Stage

Debt Financing

Total Funding

N/A

Headquarters

Woonsocket, Rhode Island

Founded

1963

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Simplify's Take

What believers are saying

  • Expansion of telehealth services allows CVS to reach more patients remotely.
  • Increased consumer interest in wellness boosts demand for CVS's health-related products.
  • The trend towards value-based care aligns with CVS's integrated healthcare approach.

What critics are saying

  • Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.
  • The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.
  • The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.

What makes CVS Health unique

  • CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.
  • The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.
  • CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

INACTIVE