Sr Mgr,Network Mgt
CVS Health
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary: The Pharmacy Network Regulatory Compliance Senior Advisor serves as the subject matter expert on applicable guidance and regulations and leads implementation and continuous improvement initiatives to ensure CVS/Caremark maintains compliance with current and emerging requirements affecting the Pharmacy Network division. This role partners with key functional leaders to translate regulatory requirements into operational processes and to initiate system enhancements needed to meet those requirements. The Senior Advisor proactively identifies, assesses, and escalates business risks and impacts to senior Pharmacy Network leadership, as appropriate. This position requires a strong understanding of local, state, and federal regulations and associated end-to-end processes. While the primary focus is on member and pharmacy network impacts, scope may expand to additional business areas as regulations and divisional responsibilities evolve. As part of regulatory issue resolution, the Senior Advisor serves as a key decision-maker for escalated client issues. Required Qualifications: Minimum of 7 years of professional experience, including experience in the health care industry. within a matrix reporting environment. Preferred Qualifications: Advanced actuarial skills within the health care industry. Advanced Microsoft Office skills; advanced knowledge of relational databases and data warehouses; and advanced proficiency with SQL, OLAP, and SAS. Demonstrated ability to apply strategic thinking, program management, and process ...
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