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Senior Manager, Regulatory Affairs (Individual Contributor)

AT CVS Health
CVS Health

Senior Manager, Regulatory Affairs (Individual Contributor)

Springfield, IL

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. Position Summary

As the Senior Manager, Regulatory Affairs for CVS Health, you will be a crucial contributor to the Medicare regulatory agenda of the Government Services division and broader Prescription Benefits Management (PBM) business. Your role will be a regulatory position applying Medicare regulatory knowledge to support and manage the implementation of Medicare guidance and regulatory updates.As the Senior Manager, Regulatory Affairs, you must be able to work independently, as well as collaboratively, with other Medicare Regulatory Affairs subject matter experts, internal PBM business owners and Government Affairs. You must have strong skills in understanding and translating complex regulatory guidance to advise internal business partners on pending and final regulatory change in Medicare policy.Your duties will include:

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  • Regularly scans political environment for emerging policy trends based on regulatory proposals, data and research provided by Congress, HHS or CMS.
  • Analyze and interpret proposed and/or newly enacted regulatory guidance, such as Notice of Proposed Rulemaking or Final Rules, including legislative history, comparisons to existing or proposed guidance and provide detailed explanations for how the guidance may impact internal departments' operational processes.
  • Support the coordination of responses to proposed regulatory change taking into consideration impact to business processes and goals, while meeting regulator's expectations.
  • Be an effective influencer to support CVSC's various regulatory positions and work in partnership with CVS Health's Government Affairs team in assisting to advocate for positive Federal regulatory change.
  • Create effective and flawless client communications explaining and providing clear interpretation of CVS Caremark's responsibilities related to CMS guidance.
  • Collaborate with internal business and IT partners to drive and ensure requirements and rollout plans are validated and comply with Medicare requirements, as per CMS's guidelines and interpretations.
  • Participate in client meetings and client webinars as required to ensure health plan clients fully understand the activities CVS Caremark Part D Services is taking on their behalf to fully comply with new and/or updated CMS requirements, resolve issues and inform on CVS Caremark updates related to CMS requirements.
  • Potential management responsibilities may apply.
To be a candidate for this role you will possess the following:
  • Solid verbal and written communication skills (be comfortable articulating complex issues).
  • Excellent organizational and time management skills.
  • Proven strong interpersonal and collaborative skills.
  • Competent in researching complex topics and disseminating key details to varied audiences verbally and in written communication.
  • Ability to work in independently in a fast-paced, highly matrixed organization.
  • Proven analytical skills with the ability to diagnose complex problems and recommend practical strategies.
  • Ability to solution quickly cross-functionally to meet demanding timelines.
This position is a remote role and can be located anywhere in the US. Required Qualifications
  • 7+ years of experience in PBM or Health Plans.
  • 3+ years of experience in interpreting regulations and understanding public policy (preferably CMS and HHS guidance).
  • Experience working with complex information technology systems.
  • Experience presenting to and communicating effectively at webinars for internal business partners and external clients.
Preferred Qualifications
  • Experience working for or with government agency in a healthcare company.
  • Knowledge of prescription claims adjudication and RxClaim system preferred.
  • Ability to lead and influence others and to effectuate positive change; particularly with large employers, health plans (PBM clients), regulatory bodies and trade associations (PCMA, NCPDP, AHIP).
  • Project management experience.
Education
  • Bachelor's degree required. Equivalent experience may be considered.
Pay Range

The typical pay range for this role is:$67,900.00 - $182,549.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit Benefits | CVS HealthWe anticipate the application window for this opening will close on: 02/01/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Client-provided location(s): Springfield, IL, USA
Job ID: CVS-R0480739_1001
Employment Type: Other

Perks and Benefits

  • Health and Wellness

    • Health Insurance
    • Dental Insurance
    • Vision Insurance
    • Life Insurance
    • HSA
    • HSA With Employer Contribution
    • Pet Insurance
    • Mental Health Benefits
  • Parental Benefits

    • Fertility Benefits
    • Adoption Assistance Program
    • Family Support Resources
  • Work Flexibility

    • Flexible Work Hours
    • Remote Work Opportunities
    • Hybrid Work Opportunities
  • Vacation and Time Off

    • Paid Vacation
    • Paid Holidays
    • Personal/Sick Days
  • Financial and Retirement

    • 401(K) With Company Matching
  • Professional Development

    • Tuition Reimbursement
  • Diversity and Inclusion

    • Employee Resource Groups (ERG)
    • Diversity, Equity, and Inclusion Program