Senior Manager, Network Compliance

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 regulators.

In 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 SmartFront 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 - $182,549.00

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 includes an award target in the company’s equity award program. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 01/31/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.