Medicaid Compliance Analyst: Drive Health-Plan Integrity

4004 Aetna Medicaid Administrators; Baton Rouge (LA); On-site; USD 44,000 - 102,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Other resources

Job summary

CVS Health is seeking a Career level compliance professional to support the compliance program activities for a Medicaid managed care organization. You will work with the Compliance Officer and team to develop systems and processes ensuring ethical behavior and regulatory adherence across Medicaid plans.

Responsibilities include tracking regulatory deliverables, preparing reports, and developing communications with state Medicaid agencies.

Qualifications

• 2+ years of regulatory compliance experience in managed care, healthcare, or insurance.
• Bachelor’s degree required; Master’s preferred.
• Proficiency with compliance tools such as Archer.

Responsibilities

• Maintain systems to track, monitor, review, and submit regulatory deliverables to state Medicaid agencies on or before due dates.
• Prepare basic regulatory reports as needed for Medicaid compliance.
• Assist with research and recommendations to develop compliant business operations and policies per state Medicaid requirements.
• Develop compliance communications in response to state Medicaid inquiries or requests.
• Maintain knowledge of contracts, regulatory, and program policy obligations for Medicaid managed care.

Skills

Regulatory compliance

Managed care knowledge

Education

Master's degree

Bachelor’s Degree

Tools

Archer

Job description

CVS Health is seeking a Career level compliance professional to support the compliance program activities for a Medicaid managed care organization. You will work with the Compliance Officer and team to develop systems and processes ensuring ethical behavior and regulatory adherence across Medicaid plans.

Responsibilities include tracking regulatory deliverables, preparing reports, and developing communications with state Medicaid agencies.