Senior Manager, Regulatory Affairs (Individual Contributor)

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Position Summary

As the Senior Manager, Regulatory Affairs for CVS Health, you will be a crucial contributor to the Medicare regulatory agenda of the Government Services division and broader Prescription Benefits Management (PBM) business. Your role will be a regulatory position applying Medicare regulatory knowledge to support and manage the implementation of Medicare guidance and regulatory updates.

As the Senior Manager, Regulatory Affairs, you must be able to work independently, as well as collaboratively, with other Medicare Regulatory Affairs subject matter experts, internal PBM business owners and Government Affairs. You must have strong skills in understanding and translating complex regulatory guidance to advise internal business partners on pending and final regulatory change in Medicare policy.

Your duties will include:

• Regularly scans political environment for emerging policy trends based on regulatory proposals, data and research provided by Congress, HHS or CMS.
• Analyze and interpret proposed and/or newly enacted regulatory guidance, such as Notice of Proposed Rulemaking or Final Rules, including legislative history, comparisons to existing or proposed guidance and provide detailed explanations for how the guidance may impact internal departments’ operational processes.
• Support the coordination of responses to proposed regulatory change taking into consideration impact to business processes and goals, while meeting regulator’s expectations.
• Be an effective influencer to support CVSC’s various regulatory positions and work in partnership with CVS Health’s Government Affairs team in assisting to advocate for positive Federal regulatory change.
• Create effective and flawless client communications explaining and providing clear interpretation of CVS Caremark’s responsibilities related to CMS guidance.
• Collaborate with internal business and IT partners to drive and ensure requirements and rollout plans are validated and comply with Medicare requirements, as per CMS's guidelines and interpretations.
• Participate in client meetings and client webinars as required to ensure health plan clients fully understand the activities CVS Caremark Part D Services is taking on their behalf to fully comply with new and/or updated CMS requirements, resolve issues and inform on CVS Caremark updates related to CMS requirements.
• Potential management responsibilities may apply.

To be a candidate for this role you will possess the following:

• Solid verbal and written communication skills (be comfortable articulating complex issues).
• Excellent organizational and time management skills.
• Proven strong interpersonal and collaborative skills.
• Competent in researching complex topics and disseminating key details to varied audiences verbally and in written communication.
• Ability to work in independently in a fast-paced, highly matrixed organization.
• Proven analytical skills with the ability to diagnose complex problems and recommend practical strategies.
• Ability to solution quickly cross-functionally to meet demanding timelines.

** This position is a remote role and can be located anywhere in the US.**

Required Qualifications

• 7+ years of experience in PBM or Health Plans.
• 3+ years of experience in interpreting regulations and understanding public policy (preferably CMS and HHS guidance).
• Experience working with complex information technology systems.
• Experience presenting to and communicating effectively at webinars for internal business partners and external clients.

Preferred Qualifications

• Experience working for or with government agency in a healthcare company.
• Knowledge of prescription claims adjudication and RxClaim system preferred.
• Ability to lead and influence others and to effectuate positive change; particularly with large employers, health plans (PBM clients), regulatory bodies and trade associations (PCMA, NCP