Lead Director Corporate Compliance

At CVS Health were building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nations leading health solutions company we reach millions of Americans through our local presence digital channels and more than 300000 purposedriven 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.

Position Summary

***This position is located in OKC following a hybrid working schedule***

Senior level compliance position that is responsible for the management and oversight of the compliance program activities and deliverables of a Medicaid managed care organization operating in a highly complex regulatory environment. Oversees the activities of other compliance team members assigned to the market. This position is responsible for developing and maintaining systems and processes that demonstrate the principles of an effective Compliance program and promote compliant and ethical behavior in the assigned Medicaid health plan. Responsibilities include but are not limited to:

• Serve as the designated Compliance Officer for Aetnas Oklahoma Medicaid health plan

• Acts as the primary liaison to the state Medicaid agency facilitating compliance and contractrelated communications and activities

• Facilitates the preparation for and management of external audits conducted by state Medicaid and related agencies or partners in conjunction with health plan leadership through final report and corrective action plan closure

• Lead and execute all elements of the Medicaid compliance program for Aetnas Oklahoma Medicaid health plan

• Conduct research and develop recommendations to help develop compliant business operations processes and policies in accordance with state specific Medicaid program requirements

• Develop compelling strategic and appropriate compliance related communications on behalf of the health plan in response to state Medicaid agency inquiries or requests

• Maintain an indepth working knowledge of the health plans contractual regulatory and program policy related obligations as a Medicaid managed care organization and serve as a resource to health plan and growth partner staff for education training and business decision making purposes

• Ensure that current resource tools and other internal deliverables such as current contract library regulatory reporting assignments risk assessments risk tracking lists internal reporting systems and summaries and other department wide tools are current and accessible to business partners to ensure the appropriate monitoring and oversight of health plan compliance processes

• Utilize systems unique to job functions including standardissue software such as Microsoft products and compliance specific tools such as Archer; maintain system documentation serve as subject matter expert train users of system contribute to system design oversight or maintenance

• Lead and direct oversight and monitoring activities to evaluate levels of compliance with new and existing Medicaid managed care organization requirements across the business; support business partners in the development of mitigation and corrective action plans and effectively escalate risks concerns and other issues through appropriate channels

• Maintain positive productive relationships with internal and external senior level constituents to effectively communicate and influence ethical and compliant outcomes

• Oversee the submission of required regulatory reports (standard and ad hoc) including the completion of high level quality reviews prior to submission and the maintenance of tracking systems and tools to document ownership reporting requirements and monitor timely delivery and acceptance of reports

• Provide training and guidance to less experienced team members to accomplish goals

• Other duties as assigned

Required Qualifications

• 10 years of professional related work experience.

• 7 years of experience in Medicaid or Medicaid managed care.

• 2 years of Project Management experience.

• Must be located in Oklahoma.

Preferred Qualifications

• Audit experience.

• Masters degree in Public Policy Health Care Administration Public Administration or similar fields or a law degree.

• Previous management experience.

• Regulatory compliance position in managed care health care or insurance.

Education

• Bachelors degree required or equivalent years of related experience.

Pay Range

The typical pay range for this role is:

This pay range represents the base hourly rate or base annual fulltime 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 shortterm incentive program in addition to the base pay range listed above. This position also includes an award target in the companys equity award program.

Our people fuel our future. Our teams reflect the customers patients members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits investing in the physical emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages our great benefits include:

• Affordable medical plan options a 401(k) plan (including matching company contributions) and an employee stock purchase plan.

• Nocost 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.

For more information visit anticipate the application window for this opening will close on: 05/30/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal state and local laws.