CVS Health Compliance Consultant in Northbrook, Illinois
The Senior Compliance Consultant for the Business Compliance Office will:• Review new mandates (laws and regulations) pertaining to CVS Health pharmacy and nursing business practices.• Coordinate with Legal and Regulatory partners to identify applicability to the business segments.• Lead the compliance effort with CVS Health business segments to implement processes or programs to comply with any new law or regulation pertaining to areas which include claim adjudication and government billing. • Be the compliance lead in implementing solutions with applicable business partners in regards to any findings identified during Compliance Risk Assessments. • Implement mitigation plans and monitor business segment compliance with pharmacy Settlement Agreements. • Establish working relationships with process owners to drive and implement business practice enhancements to increase the compliance program effectiveness. • Actively participate in applicable business working groups/committees for areas of responsibility. • Drive compliance of initiatives to completion and validate their effectiveness.• Act as a BCO lead in Risk Assessments on Subject Matter areas to identify regulatory risks, business controls, and establish Compliance oversight.• Partner with the Compliance Regulatory Review team to address and implement solutions with the business for Global and High Risk observations identified.
• 3+ years of pharmacy or nursing operations experience, OR 3+ years of experience in payer relations / third party claims.• 3+ years of Project Management experience or similar work experience.
• Previous experience with legislation and/or regulatory research.• Knowledge in state and federal pharmacy laws and regulations.• Strong program management, interpersonal and communication skills, including the ability to interact and influence at various levels of the organization (Business Leadership, Field Management, Business Units within Corporate environment).• Ability to understand complex problems, identify root causes, and remain goal-oriented within a dynamic environment.• Ability to work independently and to recognize and resolve issues.• Capability to travel periodically to specific locations throughout the company to validate the effectiveness of programs and processes.• Pharmacy technician
• Bachelor’s Degree or 1 year of equivalent work experience for every year degree not acquired
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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