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A new day in healthcare. Together, CVS Health and Aetna help people on their path to better health.

Senior Compliance Consultant - Medicaid Compliance

Primary Location: Louisville, Kentucky
Additional Locations: KY-Louisville

This position is off-based in Louisville, KY. Experienced / career level compliance position that applies compliance, business, analytical and communication skills to support, manage and help develop compliance programs and processes that promote compliant and ethical behavior, meet regulatory obligations.

Fundamental Components:

Independently demonstrates the principles of 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. Prepares moderately complex and more complex regulatory reports, filings and follow-ups, and supports regulatory review and audit activities. Manages multiple moderately complex regulatory interactions including drafting regulatory correspondence and responding to routine regulatory inquiries requiring an understanding of business processes and regulatory requirements. Supports moderately complex compliance business process reviews, corrective actions and other projects involving internal and external constituents. Independently develops forms and related materials that meet regulatory and legal requirements. Maintains positive, productive relationships with internal and external constituents and effectively communicates and influences decision-making and ethical and compliant outcomes at various levels necessary to accomplish goals. Appropriately escalates issues requiring resolution. Applies industry and compliance knowledge to support and manage moderately complex matters involving established compliance system and operations, including processes for implementation of laws and regulations, supports the Company’s Privacy Office on privacy matters monitoring of compliance issues, and handling of moderately complex complaints. Independently identifies and assesses moderately complex compliance issues and risks that need resolution using established rules, regulations and guidelines, assists in the development of appropriate action plans and communications, monitors remediation and risk mitigation activity and appropriately informs and escalates matters to managers and subject matter experts. Independently collects the facts related to an issue, performs analysis and effectively prepares and communicates concise summaries on moderately complex matters. Responds to moderately complex requests for information within area of responsibility from internal and external constituents. Acts as resource for colleagues and effectively guides less experienced team members to accomplish goals. Other components relevant to the specific role.

Background Experience:

  • 3-5 years’ experience in a regulatory compliance position in healthcare or relevant work experience in a business area.
  • Possessing Project Management skills is a plus.
  • Bachelor's degree or equivalent experience.

Additional Job Information:

Highly skilled in Microsoft Office, including Word, Excel, One Note

Experience managing databases

Required Skills:
General Business - Consulting for Solutions, Leadership - Collaborating for Results, Leadership - Driving a Culture of Compliance

Desired Skills:
General Business - Demonstrating Business and Industry Acumen, Leadership - Creating Accountability, Leadership - Driving Change

Functional Skills:
Administration / Operation - Data Entry, Administration / Operation - File Maintenance, Communication - Communication Delivery - Public Speaking, Communication - Employee communications

Potential Telework Position:

Percent of Travel Required:
0 - 10%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

Benefit Eligibility:
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Candidate Privacy Information:
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Click To Review Our Benefits (PDF)


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