Medicaid Compliance Analyst — Drive Regulatory Excellence

CVS Health; Nashville (TN); On-site; USD 44,000 - 102,000; Full time

Benefits offered by this job

Bonus eligibility

Comprehensive benefits

Job summary

CVS Health is seeking a career-level compliance professional to support the Medicaid managed care compliance program. The role partners with the Compliance Officer to develop systems and processes for compliant operations and ethical behavior in our Medicaid health plans.

Responsibilities include tracking regulatory deliverables, assisting with policy development, and supporting audit processes. Strong knowledge of Medicaid requirements and experience with Archer and Microsoft tools are valued.

Qualifications

• 2+ years of regulatory compliance experience in managed care, healthcare, or insurance; or a Master’s degree.
• Bachelor's Degree in a related field is required.
• Experience with Medicaid or Medicaid managed care is preferred.

Responsibilities

• Maintain systems to track, monitor, review, and submit regulatory deliverables to state Medicaid agencies by due dates.
• Assist with research and recommendations to develop compliant business operations and policies.
• Develop compliance communications in response to Medicaid inquiries or requests.
• Maintain knowledge of contractual and program obligations as a Medicaid managed care organization.

Skills

Regulatory compliance

Managed care experience

Healthcare knowledge

Education

Bachelor's Degree

Master's degree

Tools

Archer

Microsoft Office

Job description

CVS Health is seeking a career-level compliance professional to support the Medicaid managed care compliance program. The role partners with the Compliance Officer to develop systems and processes for compliant operations and ethical behavior in our Medicaid health plans.

Responsibilities include tracking regulatory deliverables, assisting with policy development, and supporting audit processes. Strong knowledge of Medicaid requirements and experience with Archer and Microsoft tools are valued.