Audit Sr Consultant

Job Description
Works with external and internal business partners to perform Compliance Program Effectiveness (CPE) and Business Continuity Plan (BCP) oversight (auditing/monitoring) of Aetna's delegates who support Medicare membership.

Responsibilities include:
-Requesting and reviewing delegate's CPE/BCP policies, procedures and supporting documentation to ensure they meet CMS requirements.
-Educating delegates and internal business partners on CMS's CPE/BCP requirements as needed.
-Issuing audit findings including requests for corrective action as needed.
-Following up with delegates to ensure corrective action is implemented as appropriate.
-Engaging network partners timely to assist when delegates are non-responsive to requests for documentation.
-Assisting with the annual review and update as appropriate applicable policies, procedures and workflows.
-Assisting with the reporting of findings to leadership monthly/quarterly as appropriate.

Required Qualifications
-Strong communication skills and the ability to interact with a variety of other departments/business partners.
-Collaboration and teamwork skills.
-Attention to detail and accuracy.
-Time management skills
-Ability to maintain a positive attitude

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
-Knowledge of CMS Compliance Program Effectiveness (CPE) and Business Continuity Plan (BCP) requirements helpful.
-Compliance and/or auditing background helpful.
-Skilled in Microsoft office programs: Word, Excel, PowerPoint, Teams.
-Experience with QuickBase and/or other database systems.
-Experience with AdobeSign.

Bachelors degree or equivalent business 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.