Medicaid Compliance Analyst — Risk & Audit

CVS Health; Austin (TX); On-site; USD 44,000 - 102,000; Full time

Benefits offered by this job

Bonus program

Comprehensive benefits

Job summary

CVS Health is seeking a Career level compliance professional to support the compliance program for a Medicaid managed care organization. The role partners with the Compliance Officer to develop systems that promote compliant and ethical behavior across Medicaid plans.

Responsibilities include tracking regulatory deliverables, developing compliant operations, and preparing communications to Medicaid agencies.

Qualifications

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

Responsibilities

• Track, monitor, review, and submit regulatory and compliance deliverables to state Medicaid agencies on or before due dates.
• Assist with research to develop compliant business operations and policies per Medicaid requirements.
• Develop compliance communications in response to Medicaid agency inquiries.
• Maintain knowledge of contractual and regulatory obligations as a Medicaid MCO and advise staff.
• Support external audit reviews and manage deliverables, actions and timelines.
• Maintain tools and resources such as contract libraries and risk tracking lists.
• Train users on compliance systems (e.g., Archer) and contribute to system improvements.
• Elevate risks and issues through appropriate channels and coordinate mitigation plans.

Skills

Regulatory compliance

Managed care

Healthcare

Insurance

Education

Bachelor’s Degree

Tools

Archer

Microsoft Office

Job description

CVS Health is seeking a Career level compliance professional to support the compliance program for a Medicaid managed care organization. The role partners with the Compliance Officer to develop systems that promote compliant and ethical behavior across Medicaid plans.

Responsibilities include tracking regulatory deliverables, developing compliant operations, and preparing communications to Medicaid agencies.