Sr Manager - Corporate Compliance

About the role

This position is to be filled within the state of Maryland. The role leads and manages the compliance program for Aetna's Maryland Medicaid health plan.

Responsibilities

• Serve as the Compliance Officer for Aetna's Maryland Medicaid health plan.
• Act as the primary contact with the Maryland Medicaid agency for compliance and contract-related matters.
• Track, monitor, and submit required regulatory reports and responses on time.
• Lead preparation and coordination for state audits, including corrective action plans and issue resolution.
• Manage all aspects of the Medicaid compliance program.
• Research regulatory requirements and provide recommendations to support compliant business practices.
• Draft and coordinate responses to inquiries and requests from state Medicaid agencies.
• Maintain expert knowledge of Medicaid regulations, contracts, and program requirements.
• Serve as a compliance resource for staff, providing guidance, education, and training.
• Maintain compliance tools, risk assessments, reporting systems, and tracking processes.
• Identify compliance risks, conduct monitoring activities, and recommend corrective actions.
• Support business teams in developing solutions to address compliance concerns.
• Utilize compliance management tools, including Microsoft Office and Archer.
• Build and maintain strong relationships with internal and external stakeholders.
• Provide guidance and coaching to less experienced team members.
• Perform other duties as assigned.

Requirements

• 7+ years of compliance experience in healthcare, managed care, insurance, or a related field.
• Candidates with an advanced degree may qualify with 5+ years of relevant experience.
• Project management experience.
• Experience with Medicaid or Medicaid managed care programs.
• Experience supporting audits or regulatory reviews.
• Bachelor's degree in Public Policy, Government Affairs, Healthcare Administration, Public Administration, or a related field.
• Master's degree or Juris Doctor (JD).

Qualifications

Education: Bachelor degree OR equivalent experience.

Pay

The Typical Pay Range For This Role Is $82,940.00 - $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.