Job Description Business Overview: As part of the bold vision to deliver the âœNext Generationâ of managed care in Ohio Medicaid, Ohio RISE will help struggling children and their families by focusing on the individual with strong coordination and partnership among MCOs, vendors, and ODM to support specialization in addressing critical needs. The OhioRISE Program is designed to provide comprehensive and highly coordinated behavioral health services for children with serious/complex behavioral health needs involved in, or at risk for involvement in, multiple child-serving systems.
The Senior Compliance Officer is an expert level position that applies specialized expertise in compliance, business, analytical and communication skills to support, manage and help develop compliance strategies, programs and processes to promote compliant and ethical behavior, meet regulatory obligations and prevent, detect and mitigate compliance risks. Must reside in Ohio. Some travel is anticipated, less than 10% of the time.
Fundamental Components: â¢ Leads, implements, and maintains an effective Compliance program, including, but not limited to, risk assessment, auditing and monitoring, maintaining effective compliance policies and procedures, and effective communication and training. â¢ Prepares highly complex regulatory reports, filings and follow-ups, and manages highly complex regulatory review and audit activities. â¢ Independently manages multiple highly complex regulatory interactions including drafting regulatory correspondence, responding to regulatory inquiries and negotiating resolution of regulatory matters requiring a sophisticated understanding of business processes and regulatory requirements. â¢ Leads highly complex compliance business process reviews, corrective actions and other projects involving internal and external constituents. Independently develops strategy, processes, forms and related materials to meet the most complex regulatory and legal requirements. â¢ Builds and maintains positive, productive relationships with internal and external constituents at the most senior and regulatory organizational levels, and is able to remove significant barriers, drive decision-making and influence ethical and compliant outcomes at all organizational levels necessary to accomplish goals. â¢ Applies expert industry and compliance knowledge to lead highly complex matters involving established compliance system and operations, including processes for implementation of laws and regulations, support of the Companyâ™s Privacy Office on privacy issues, monitoring of compliance issues, and handling of the most complex complaints. â¢ Independently identifies and assesses the most complex compliance issues and risks, engages appropriate enterprise resources, supports internal and external constituents in the development and monitoring of effective corrective action, error prevention and risk mitigation plans and related activities and communications. â¢ This may include the development of new or updated policies and processes. â¢ Appropriately informs and escalates matters to senior management. â¢ Independently collects facts and utilizes strong analytical capabilities to recommend appropriate actions on the most complex matters and effectively communicates status and results in a concise and timely manner. â¢ Responds to the most complex requests for information within area of responsibility from internal and external constituents. â¢ Acts as resource and subject matter expert for colleagues and effectively guides teams to accomplish complex goals. â¢ Identifies shifting strategic priorities and leads the implementation of both tactical and strategic solutions. â¢ Other components relevant to the specific role.
Specific to the OhioRISE contract, responsibilities include but are not limited to: -Developing and implementing a compliance program and policies and procedures designed to ensure compliance with the requirements in this Agreement.
Required Qualifications â¢ 8+ yearsâ™ experience in a regulatory compliance position in healthcare, insurance or financial services or work experience in a relevant business area. â¢ Experience leading complex projects. â¢ Ability to travel as needed; in-state travel anticipated for state meetings, etc. Qualified candidates must possess reliable transportation, active/valid drivers license, and proof of vehicle insurance. Some travel to corporate office in Phoenix may also be required. â¢ Demonstrated proficiency with personal computer, keyboard navigation skills and with MS Office Suite applications (Outlook, Word, Excel, PowerPoint, SharePoint, etc.)
COVID Requirements COVID-19 Vaccination Requirement CVS Health requires its Colleagues in certain positions to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.
If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 30 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 60 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.
If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 30 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.
Preferred Qualifications Advanced education/degree is preferred.
Education Bachelorâ™s degree and advanced degree desired or certification or equivalent experience.
Business Overview At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation’s premier health innovation company. Through our health services, insurance plans and community pharmacists, we’re pioneering a bold new approach to total health. As a CVS Health colleague, you’ll be at the center of it all.
At CVS Health, we work every day to help people on their path to better health. Never has it been more important for us to deliver on our purpose to our valued customers, patients, members, and employees. With a presence in communities across the country, CVS Health colleagues are and will continue to be a critical piece of the country’s health care solution. The health and safety of our employees, patients, customers, and members is our top priority as we face the impact of COVID-19 together. If you would like to learn about the actions we are taking as a company as we learn more about COVID-19 and its spread, we encourage you to visit our COVID-19 resource center at https://cvshealth.com/covid-19
We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to... attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.
CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran – we highly value and are committed to all forms of diversity in the workplace. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. Please note that we only accept applications for employment via this site.
We provide reasonable accommodations to qualified individuals with disabilities. If you need to request an accommodation, a qualified interpreter, written information in other formats, translation or other services, please contact our Advice and Counsel Reasonable Accommodations team by emailing Advice and Counsel Reasonable Accommodations team or calling 877-805-9511.
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