Talent.com
Sr. Manager, Regulatory Resolution Team
Sr. Manager, Regulatory Resolution TeamCVS Health • Hartford, CT, US
Sr. Manager, Regulatory Resolution Team

Sr. Manager, Regulatory Resolution Team

CVS Health • Hartford, CT, US
5 days ago
Job type
  • Full-time
Job description

Regulatory Resolution Team Leader

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 Regulatory Resolution Team is responsible for responding to highly sensitive and visible regulatory inquiries and complaints. This team is responsible for delivering thorough reviews, advocacy, risk analysis, and collaborative resolutions that uphold regulatory compliance and drive member satisfaction. These inquiries require elite execution, precision, and compliance with state and federal regulations, internal operations and company policies. The RRT's work is critical to protecting the organization's reputation and maintaining trust with members, regulatory bodies and stakeholders.

Responsibilities include :

  • Manage and lead a group of colleagues responsible for pulling together responses to member and provider regulatory complaints.
  • Oversee the scheduling, drafting, timeliness and quality of regulatory responses.
  • Proactively monitor team case load, status of response letters and associated due dates.
  • Interface and negotiate with state and federal regulators, as needed.
  • Build, maintain and promote positive and effective working relationships with internal and external stakeholders.
  • Identify opportunities to streamline processes and improve efficiencies within the RRT and key business partners. Encourage staff to embrace new processes and identify change management opportunities within the team.
  • Hold team accountable for meeting goals, due dates and expectations, identifying areas of individual performance concerns and coaching opportunities.

In order to be successful in this role you must exhibit the following :

  • Strong skills in interpreting state and federal requirements.
  • Ability to prioritize work in a fast-paced environment.
  • Expert technical and written communication skills.
  • Excellent problem solving and decision-making skills, including taking initiative to resolve complex issues and discern relevant information.
  • Required Qualifications :

  • 7+ years of experience in health care industry or regulatory environment.
  • 5+ years of experience in claim and payment policies and administration, operational, and clinical policies.
  • Preferred Qualifications :

  • Staff management experience.
  • Adept at execution and delivery (planning, delivering, and supporting) skills.
  • Adept at business intelligence.
  • Adept at collaboration and teamwork.
  • Mastery of problem solving and decision making skills.
  • Mastery of growth mindset (agility and developing yourself and others) skills.
  • Education :

    Bachelors degree required or equivalent years of related experience.

    Pay Range :

    The typical pay range for this role is : $75,400.00 - $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.

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

    Create a job alert for this search

    Sr Manager Regulatory • Hartford, CT, US

    Related jobs
    Sr. Manager, Enterprise Architect & Strategy (Hybrid)

    Sr. Manager, Enterprise Architect & Strategy (Hybrid)

    RTX • Windsor Locks, CT, United States
    Full-time
    HNC01 : UTAS Headquarters (HS) 2730 West Tyvola Road, Charlotte, NC, 28217 USA.Person, or Immigration Status Requirements : . The Strategic Business Unit (SBU) and Enterprise Architect (EA) role is res...Show more
    Last updated: 19 hours ago • Promoted • New!
    Senior Manager, Service & Program Activation

    Senior Manager, Service & Program Activation

    NY Staffing • Bristol, CT, US
    Full-time
    Senior Manager, Service & Program Activation.Sodexo North America is undertaking a bold, enterprise-wide transformation of its operating modela strategic initiative designed to simplify food and su...Show more
    Last updated: 8 hours ago • Promoted • New!
    CRNA Compliance Officer

    CRNA Compliance Officer

    Yale New Haven Health • West Haven, CT, US
    Full-time
    To be part of our organization, every employee should understand and share in the Yale New Haven Health System Vision, support our Mission, and live our Values. These values - integrity, patient-cen...Show more
    Last updated: 11 days ago • Promoted
    Sr. Manager Innovation Strategy - Urgently Hiring!

    Sr. Manager Innovation Strategy - Urgently Hiring!

    Henkel • Rocky Hill, CT, United States
    Full-time
    At Henkel, you’ll be part of an organization that’s shaping the future through innovation, sustainability and collaboration. With our trusted brands like Persil®, ‘all®, Loctite®, Snuggle®, and Schw...Show more
    Last updated: 30+ days ago
    Manager, Trial Delivery Management Cross Therapeutic Area

    Manager, Trial Delivery Management Cross Therapeutic Area

    J&J Family of Companies • Springfield, MA, US
    Full-time
    Manager, Trial Delivery Management Cross Therapeutic Area.Our expertise in Innovative Medicine is informed and inspired by patients, whose insights fuel our science-based advancements.Visionaries ...Show more
    Last updated: 3 days ago • Promoted
    Sr. Manager Innovation Strategy - Now Hiring!

    Sr. Manager Innovation Strategy - Now Hiring!

    Henkel • Rocky Hill, CT, United States
    Full-time
    At Henkel, you’ll be part of an organization that’s shaping the future through innovation, sustainability and collaboration. With our trusted brands like Persil®, ‘all®, Loctite®, Snuggle®, and Schw...Show more
    Last updated: 30+ days ago
    Sr Director - Revenue & Reimbursement

    Sr Director - Revenue & Reimbursement

    Connecticut Children's • Hartford, CT, United States
    Full-time
    The Senior Director of Revenue and Reimbursement is a trusted strategic partner to the health system’s SVP Finance / CFO as well as the broader executive management team. As a member of the Finance Le...Show more
    Last updated: 5 days ago • Promoted
    Hybrid Senior Client Partner - Strategic Compliance

    Hybrid Senior Client Partner - Strategic Compliance

    Sun Life Financial • Hartford, CT, United States
    Full-time
    A leading financial services provider in Hartford, CT is seeking a Client Relationship Manager.This role includes managing client expectations, ensuring compliance, and fostering strong client rela...Show more
    Last updated: 1 day ago • Promoted
    Senior Manager - Tax

    Senior Manager - Tax

    Baker Tilly International • Shelton, CT, United States
    Full-time
    Senior Manager - Tax page is loaded## Senior Manager - Taxlocations : USA CT Bethel : USA CT Sheltontime type : Full timeposted on : Posted Todayjob requisition id : JR104190# • •Overview • •Bake...Show more
    Last updated: 3 days ago • Promoted
    CRNA Compliance Officer​

    CRNA Compliance Officer​

    Yale New Haven Health • Milford, CT, United States
    Full-time
    Overview Overview : To be part of our organization, every employee should understand and share in the Yale New Haven Health System Vision, support our Mission, and live our Values.These values - int...Show more
    Last updated: 19 hours ago • Promoted • New!
    Product Development & Regulatory Affairs - Annuities

    Product Development & Regulatory Affairs - Annuities

    Global Atlantic Financial Group • Hartford, CT, US
    Full-time
    Product Development & Regulatory Affairs - Annuities.Global Atlantic is a leading provider of retirement security and investment solutions with operations in the U. As a wholly-owned subsidiary of K...Show more
    Last updated: 25 days ago • Promoted
    Reconciliation Senior Specialist

    Reconciliation Senior Specialist

    Cardinal Health • Hartford, CT, United States
    Full-time
    What Product or Services Marketing contributes to Cardinal Health.Marketing is responsible for assessing customer needs, market conditions and competition to inform business strategy.Marketing impl...Show more
    Last updated: 1 day ago • Promoted
    Unit Manager (RN) Short Term Rehab

    Unit Manager (RN) Short Term Rehab

    Riverside Health & Rehabilitation Center • Plainville, CT, US
    Full-time
    Riverside is a proud affiliate of National Health Care Associates.As a Certified Great Place to Work, we think that you are going to love it here. Your work will be meaningful to you.You will make a...Show more
    Last updated: 30+ days ago • Promoted
    Project Manager, Sr

    Project Manager, Sr

    Abacus Service Corporation • Hartford, CT, US
    Full-time
    This is Us The State of Connecticut is seeking a Project Manager, Sr for the Department of Transportation.The position is located in the Bureau of Information Technology Services (BITS) within the ...Show more
    Last updated: 30+ days ago • Promoted
    Director of Clinical Reimbursement

    Director of Clinical Reimbursement

    Ryders Health Management • Stratford, CT, United States
    Full-time
    Director of Clinical Reimbursement.Become part of a dedicated group of caring professionals at Ryders Health Management, a family-owned skilled nursing company encompassing eight facilities across ...Show more
    Last updated: 15 days ago • Promoted
    Senior Director, Corporate Compliance, Risk Management (Remote)

    Senior Director, Corporate Compliance, Risk Management (Remote)

    United Therapeutics • Hartford, CT, United States
    Remote
    Full-time
    California, US residents click here (https : / / www.UNITHER%20Applicant%20Notice%20-%20%2812-22-23%29%20Final%202.The job details are as follows : . We are the first publicly-traded biotech or pharmaceut...Show more
    Last updated: 11 hours ago • Promoted • New!
    Consumer Credit Risk Sr. Associate

    Consumer Credit Risk Sr. Associate

    Santander Holdings USA Inc • Hartford, CT, United States
    Full-time
    Country : United States of America.Santander is a global leader and innovator in the financial services industry.We believe that our employees are our greatest asset. Our focus is on fostering an enr...Show more
    Last updated: 18 days ago • Promoted
    Head of North America Compliance & Regulatory Affairs

    Head of North America Compliance & Regulatory Affairs

    Beazley Group • West Hartford, CT, United States
    Full-time
    Head of North America Compliance & Regulatory Affairs.General Management - Risk & Compliance.As per Beazley's organisation chart. Group Chief Risk Officer; Group Head of Compliance, North America CR...Show more
    Last updated: 30+ days ago • Promoted