Senior Manager, Business Compliance and Risk Controls Audit

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.

This exciting role is a fast-paced healthcare provider support role, intended to foster a positive provider experience by supporting the end-to-end process of defining and supporting SOC and SOX controls through collaborating with cross‑functional teams. This position will support network across all lines of business.

• Understanding business operations to identify gaps and areas where new controls are required
• The facilitation of business process and control documentation, which includes developing new controls and ensuring controls are designed appropriately to effectively manage risk
• Identify and proactively notify all impacted areas of control changes that may require enhancements, process changes, or other updates
• Partner with stakeholders to continuously evaluate and recommend opportunities to reduce risk, strengthen the internal control environment, and introduce operational efficiencies
• Independently collect facts, utilize strong analytical capabilities to recommend appropriate actions on complex matters, and effectively communicate status and results in a concise, timely manner.
• Accountable for all steps within the life cycle of control testing including conducting walkthroughs with Internal and External auditors, maintaining Information Provided by Entity (IPE) and providing documentation as needed when audit selections are made
• Responsible for monthly and bi‑annual controls review, including audits of Provider Tab and Rate Wizard transactions, Fee Schedule, and Rate Load Tracking Database audits
• Support audits out of QNXT and PRMS systems to support Medicaid SOC and SOX controls
• Coordinate with applicable reporting areas as needed to ensure reports are generated timely and are continuously reviewed for process efficiencies
• Must be able to effectively prioritize and review the status of assigned work to track progress and manage towards business objectives and compliance due dates.
• Must exhibit leadership qualities, strong written and oral communication skills, and strategic thinking
• Able to drive decisions based on data analysis
• May be asked to support other projects as needed based on business need

This position can be remote or hybrid depending on candidate location and commutable distance to a nearby office.

• 5+ years compliance and/or audit experience in SOC and/or SOX controls
• 5+ years of project management experience
• Health insurance industry a plus
• Strong communication, critical thinking, problem resolution and interpersonal skills with proven ability to influence and collaborate with providers and internal partners at all levels.
• Excellent analytical and problem‑solving abilities
• Ability to work independently and manage multiple priorities
• Detail-oriented with a high level of integrity and professionalism

• Advance working knowledge of business systems, applications, and tools supporting network management, contracting, and provider data systems
• Experience in related business environment with exposure to provider data, processes, etc.

Bachelor's degree preferred / specialized training / relevant professional qualifications

The typical pay range for this role is:
$67,900.00 - $

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…