Medicaid Compliance Analyst — Regulatory & Audit Support

CVSHealth; California; On-site; USD 43,000 - 102,000; Full time

Benefits offered by this job

Bonus program

Comprehensive benefits

Job summary

CVS Health in California seeks a career-level compliance professional to support Medicaid managed care compliance program activities. You will help develop systems, monitor regulatory deliverables, and promote ethical behavior across the health plan.

You will partner with the Compliance Officer and team to analyze requirements, prepare reports, and implement corrective actions while ensuring timely responses to state Medicaid agencies.

Qualifications

• 2+ years of regulatory compliance experience in managed care, healthcare, or insurance; or a Master's degree.

Responsibilities

• Maintain systems and tools to track, monitor, review, and submit regulatory and compliance deliverables to state Medicaid agencies on time.
• Assist with research to develop compliant business operations, processes and policies for Medicaid requirements.
• Develop compliance communications responding to Medicaid agency inquiries or requests.
• Maintain knowledge of contracts and regulatory obligations as a Medicaid managed care organization.
• Support external audit reviews and track deliverables, responses, and corrective action plans to closure.
• Maintain internal tools and resources to ensure monitoring and oversight of compliance processes.
• Train users on systems, contribute to design or maintenance of compliance systems.

Skills

Regulatory compliance

Healthcare knowledge

Education

Bachelor's Degree

Tools

Archer

Microsoft Office

Job description

CVS Health in California seeks a career-level compliance professional to support Medicaid managed care compliance program activities. You will help develop systems, monitor regulatory deliverables, and promote ethical behavior across the health plan.

You will partner with the Compliance Officer and team to analyze requirements, prepare reports, and implement corrective actions while ensuring timely responses to state Medicaid agencies.