Senior Manager, Medicare Business Compliance
Top focus
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do.
Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. At Aetna®, part of CVS Health, we proudly serve more than 26 million medical members through our broad range of health plan offerings.
We're committed to delivering a simpler, more meaningful, and personal health care experience to each of them. As a Senior Manager Business Compliance (Medicare) you will play a critical role by leading and delivering complex compliance initiatives that support regulatory adherence and operational excellence.
This role partners closely with cross-functional business areas to plan, coordinate, and execute projects that mitigate operational and regulatory risk, with a strong emphasis on Medicare compliance. This position is a senior-level project management position within Operations Integrity and offers broad exposure to internal business partners and leadership teams and provides the opportunity to demonstrate leadership, strategic thinking, and enterprise-level influence
In This Role, You Will
- Oversee the implementation and ongoing interpretation of Medicare laws, regulations, and regulatory guidance, ensuring timely and accurate execution across impacted business areas.
- Serve as a subject matter resource for inquiries and lead responses to audit and data requests from regulators, auditors, and internal oversight partners.
- Interpret regulatory guidance, assess compliance gaps, identify root causes, and design and implement sustainable corrective action plans.
- Routinely communicate project status, risks, and outcomes to senior leaders and executive stakeholders, translating complex regulatory requirements into clear, actionable business guidance.
- Oversight of new and updated regulatory guidance implementation, leadership of Annual Enrollment Period (AEP) readiness activities across multiple business areas, proactive identification and mitigation of operational risks
- end-to-end coordination of audit and regulatory responses.
- Contributes to regulatory compliance, operational stability, and overall member satisfaction.
- Required Qualifications ·P roject Management : 5+ years of experience leading complex initiatives from planning through execution and delivery.
- Systems Expertise : Hands-on experience with QuickBase.
- Communication Skills : Demonstrated strong oral and written communication skills.
- Executive Communication : Proven ability to communicate effectively with leaders at all levels, including executive leadership.
- Problem Solving & Decision Making: Strong analytical skills with the ability to assess issues, evaluate options, and make sound decisions.
- Collaboration & Teamwork : Adept at working collaboratively across cross-functional teams to achieve shared goals.
- Growth Mindset : Demonstrated agility and commitment to continuous learning, development, and coaching of others.
- Execution & Delivery : Strong capability in planning, delivering, and supporting initiatives to achieve intended outcomes.
- Regulatory Expertise : Strong knowledge of Medicare regulations and regulatory guidance.
- Preferred Qualifications 5+ years Medicare operational experience Aetna systems experience Regulatory compliance experience · We support a hybrid work environment.
- If selected and you live near a suitable work location, you may be expected to comply with the hybrid work policy.
- Under the policy, all hires for in-scope populations should be placed into a hybrid or office-based location, working onsite three days a week.
- Aetna Service Operations office/hub locations will be discussed with the selected candidate.
- Education Bachelor’s degree or equivalent work experience Pay Range 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.
- 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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
- This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families.
- The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
- Additional details about available benefits are provided during the application process and on Benefits Moments .
- We anticipate the application window for this opening will close on: 06/19/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.