Senior Manager, Network Compliance

Senior Manager, Network Compliance page is loaded## Senior Manager, Network Compliance remote type:
Remote locations:
CA - Work from home:
Work At Home-Oregon:
Work At Home-Arizona:
Work At Home-Washington:
Work At Home-Texastime type:
Full time posted on:
Posted Todaytime left to apply:
End Date:
January 31, 2026 (30+ days left to apply) job requisition :
R0778646

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.
** Job Summary
** The Senior Manager, Network Compliance is responsible for managing business projects and programs, including all aspects of reporting, analysis, and compliance related to network filings to California  this role, you will:
* Support the compliance and network teams to execute on strategic advancement of local and national goals.
* Oversee and manage all network-related filings in DMHC filings, including network adequacy, timely access, and new product filings. This includes material modifications and amendment filings. Examples of specific filings below:  + annual HMO and PPO network reports  + new network filings  + network expansions  + network withdrawals  + alternate access filings  + 10% network termination filings
* Collaborate with cross-functional teams, including network, legal, operations, market leadership, and external vendors, to ensure alignment and adherence to regulatory requirements.
* Manage large-scale projects through the project management lifecycle, including scoping, documentation, successful launch, and implementation, and monitoring key performance indicators to measure ongoing success.
* Conduct regular progress reviews and provide transparent reporting on project performance, value realization, and return on investment (ROI)
* Exercise sound judgment and critical thinking skills, demonstrate analytical and problem-solving skills..
** The successful candidate in this role will exhibit the following:
*** Compile, organize, name and coordinate supporting exhibits and attachments
* Research provider licensing and NPIs
* Create/maintain unit reference materials
* Compile/manipulate reports in Access and other applications
* Work independently and quickly, with little oversight, as well as in a group
* Ability to pick up new systems quickly, including e-filing systems
* Manage competing priorities and meet deadlines
** Requirements:
*** 7+ years’ experience in compliance, network management, or a related field in the healthcare industry
* Advanced proficient in Excel (creating and modifying spreadsheets; sorting, filtering and manipulating data; using formulas and queries)
* Proficiency with the Microsoft Office products, including Word and Teams, as well as Adobe
* Strong organizational skills, communication skills, including communicating status updates as needed
** Preferred Requirements
*** Understanding of California compliance statutes and regulations related to network requirements including but not limited to the Knox Keene Act and Title 28 of the California Code of Regulations.
* Preference is for this candidate to reside in California but not required
* Experience with Aetna systems, EPDB and/or Smart Front End preferred
* Intermediate proficiency with data analysis and reporting tools including Microsoft Access, Microsoft BI, SQL, and Tableau.
** Pay Range
** The typical pay range for this role is:$82,940.00 - $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…