Manager (IC), Regulatory Resolution Team at CVS Health

Hartford, Connecticut, United States

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Not SpecifiedCompensation

Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Expert technical and written communication skills
Excellent problem solving and decision-making skills, including taking initiative to resolve complex issues and discern relevant information
Strong skills in interpreting state and federal requirements
Ability to prioritize work in a fast-paced environment
5+ years of experience in health care industry or regulatory environment
3+ years of experience in claim and payment policies and administration, operational, and clinical policies
Bachelor's degree required or equivalent years of relevant experience

Responsibilities

Review and draft all responses to member and provider regulatory complaints
Work collaboratively across multiple internal stakeholders and experts to ensure accurate and compliant responses
Strategically manage complex complaints to resolution, escalating to leadership as appropriate
Ensure responses are consistent with internal policies, state and federal requirements
Ensure responses are concise, accurate and written with an eye towards the regulator recipient
Ensure responses are timely and complete, meeting all regulatory due dates

Skills

Regulatory Compliance

Risk Analysis

Technical Writing

Problem Solving

Decision Making

Stakeholder Collaboration

Complaint Resolution

State Regulations

Federal Regulations

CVS Health

Comprehensive pharmacy and healthcare services

About CVS Health

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. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.

Woonsocket, Rhode IslandHeadquarters

1963Year Founded

DEBTCompany Stage

Healthcare, Consumer GoodsIndustries

10,001+Employees

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

Risks

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.

Differentiation

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.

Upsides

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.

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