Sr. Manager Network Audit Government Oversight Adherence

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.The PBM is currently looking for an energetic individual to join our Government Oversight Accountability Team for our Networks division in a Senior Manager role. This position will act as an important member of the team while managing projects to support strategies, work, and deliverables related to regulatory oversight and exams of PBM network activities that are being performed by regulatory bodies, such as department of insurances. This role will work cross-functionally and proactively with internal business partners to focus on the most important risks/assessments areas within the organization and develop strategies to gather deliverables and create easy to understand materials to provide meaning insights to external state regulatory agencies and their contracted auditing organizations to demonstrate compliance with applicable regulatory requirements. This role will be responsible for continuously evaluating and recommending operational and process improvements.

• Lead and manage the daily processes, including timeline development and project management, as it relates to responding to regulatory agencies and their contracted auditing organizations.
• Serve as intermediary between the BCO/auditors and the PBM Networks division business owners.
• Assist in the identification, prioritization, and completion of exam/audit deliverables.
• Improve CVS Health's PBM Market Conduct Exam communications and process flow standards.
• Prepare preliminary responses to examiner inquiries, criticisms, or findings.
• Creating demonstratives and scenarios to assist auditor(s) with understanding compliance.
• 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.

• Excellent analytical, verbal, and writing communication skills.
• Proven track record in meeting project milestones and deliverables.
• Experience with engaging, motivating, and managing cross-functionally across teams.
• Able to communicate effectively with all levels of management with timely escalation of any high-risk issues to senior management.
• Proven ability to work independently and in collaboration with solid organizational skills.

• Minimum of 7 years professional work experience in Pharmacy Benefit Management Industry or healthcare industry
• Minimum 5 years' experience in Network Services operations in key functional areas specific to regulator exam questions
• Must be willing and able to travel to and work from the Scottsdale corporate office as required with minimal notice (e.g. same day and for variable durations).

• 5+ years of experience within Pharmacy Benefit Management
• Prior experience in a relevant auditing role
• Prior experience in strategizing, planning, and developing business compliant audit project plans and corrective action plans.
• Prior project management experience.
• Prior experience working in retail pharmacy
• Prior experience with pharmacy audit
• Master's degree

• Bachelor's degree required or equivalent years of experience.

• 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.