Medicaid Compliance Analyst: Regulatory & Audit Focus

CVS Health; Salt Lake City (UT); 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

Job summary

CVS Health is seeking a career level compliance professional to support the compliance program activities of a Medicaid managed care organization. You will partner with the Compliance Officer to develop systems and processes that promote compliant and ethical behavior across the plan.

Responsibilities include tracking regulatory deliverables, researching and recommending compliant operations, and developing communications for Medicaid inquiries.

Qualifications

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

Responsibilities

• Maintain systems and tools to track, monitor, review, and submit regulatory and compliance deliverables to state Medicaid agencies on or before due dates.
• Assist with research and recommendations to develop compliant business operations per state Medicaid requirements.
• Develop compliant communications in response to Medicaid agency inquiries or requests.
• Maintain knowledge of contractual, regulatory, and program obligations of the Medicaid managed care organization.
• Support external audit reviews and manage deliverables, responses, and corrective action plans.
• Maintain tools and resources such as contract libraries, regulatory reporting, risk assessments, and internal systems.
• Utilize systems like Archer and Microsoft products; train users and contribute to system maintenance.

Skills

Regulatory compliance

Regulatory program

Education

Bachelor's Degree

Tools

Archer

Microsoft Office

Job description

CVS Health is seeking a career level compliance professional to support the compliance program activities of a Medicaid managed care organization. You will partner with the Compliance Officer to develop systems and processes that promote compliant and ethical behavior across the plan.

Responsibilities include tracking regulatory deliverables, researching and recommending compliant operations, and developing communications for Medicaid inquiries.