Medicaid Compliance Analyst – Health Plan Operations

Colorado Psychiatric; Denver (CO); On-site; USD 44,000 - 102,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a compliance professional to support the Medicaid managed care compliance program. You will assist in delivering regulatory deliverables, researching compliant business operations, and developing communications in response to Medicaid inquiries.

The role partners with the Compliance Officer and requires strong knowledge of state Medicaid requirements. Responsibilities include maintaining tracking systems, supporting audits, and educating staff on regulatory obligations.

Qualifications

• 2+ years of regulatory compliance experience in managed care, healthcare, or insurance.
• Bachelor's Degree required; Master’s degree preferred for advanced roles.

Responsibilities

• Maintain systems and tools to track, monitor, review, and submit required regulatory and compliance deliverables to state Medicaid agencies on or before due dates.
• Assist with research and recommendations to develop compliant business operations and policies per state Medicaid requirements.
• Develop compliant communications in response to Medicaid agency inquiries or requests.
• Maintain knowledge of health plan contractual, regulatory, and program policy obligations for education and decision making.
• Support external audit reviews, including project management and tracking of deliverables and corrective action plans.

Skills

Regulatory compliance

Education

Bachelor's Degree

Master's degree

Tools

Archer

Microsoft Office

Job description

CVS Health is seeking a compliance professional to support the Medicaid managed care compliance program. You will assist in delivering regulatory deliverables, researching compliant business operations, and developing communications in response to Medicaid inquiries.

The role partners with the Compliance Officer and requires strong knowledge of state Medicaid requirements. Responsibilities include maintaining tracking systems, supporting audits, and educating staff on regulatory obligations.