Medicaid Compliance Analyst: Policy, Audits & Risk

CVS Health; Sacramento (CA); In loco; USD 44.000 - 102.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Descrizione del lavoro

CVS Health is seeking a compliance professional to support the Medicaid managed care compliance program. You will help track and respond to regulatory demands, develop compliant processes, and communicate effectively with state Medicaid agencies.

Responsibilities include audit support, policy development, and maintaining compliance systems. Requires 2+ years in regulatory compliance and a Bachelor's degree, with preferred Medicaid experience.

Competenze

• 2+ years of regulatory compliance experience in managed care, healthcare, or insurance.
• Bachelor’s degree required.
• Experience with Medicaid or Medicaid managed care preferred.

Mansioni

• Maintain systems to track, monitor, review, and submit required regulatory deliverables to state Medicaid agencies on or before due dates.
• Research and recommend compliant business operations per state Medicaid requirements.
• Develop clear compliance communications for state Medicaid inquiries or requests.
• Maintain knowledge of contractual and regulatory obligations for Medicaid managed care; advise staff on decisions.
• Support external audit activities, track deliverables, and develop corrective action plans through to closure.
• Maintain tools, policies, and systems (e.g., contract library, risk registers, reporting) to ensure monitoring of compliance processes.

Conoscenze

Regulatory compliance

Healthcare

Formazione

Bachelor's degree

Strumenti

Archer

Microsoft Office

Descrizione del lavoro

CVS Health is seeking a compliance professional to support the Medicaid managed care compliance program. You will help track and respond to regulatory demands, develop compliant processes, and communicate effectively with state Medicaid agencies.

Responsibilities include audit support, policy development, and maintaining compliance systems. Requires 2+ years in regulatory compliance and a Bachelor's degree, with preferred Medicaid experience.