Medicaid Compliance Analyst: Risk & Audit Support

CVS Health; Columbus (OH); On-site; USD 44,000 - 94,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a compliance professional to support Medicaid managed care compliance programs, reporting to the Compliance Officer and team. The role involves building systems, delivering regulatory deliverables, and ensuring ethical operations across health plans.

Qualifications include a Bachelor's degree (risk management preferred) with 0–2 years of related experience. The role offers full-time hours, 40 weekly, and a competitive pay range with benefits.

Qualifications

• Bachelor's degree required; risk management degree strongly preferred.
• 0–2 years of experience in regulatory compliance, managed care, healthcare, insurance, audit, or a related field.

Responsibilities

• Maintain systems and tools to track, monitor, review, and submit regulatory/compliance deliverables to state Medicaid agencies on time.
• Assist with research and recommendations to develop compliant business operations and policies for Medicaid programs.
• Develop compliant communications in response to Medicaid inquiries or requests.
• Maintain knowledge of obligations as a Medicaid managed care organization and advise staff accordingly.
• Support external audit reviews with project management & tracking of deliverables and corrective action plans.
• Maintain internal tools, contract libraries, regulatory reporting, risk assessments, and other oversight resources.
• Utilize systems like Microsoft Office and Archer; train users and contribute to system design/maintenance.
• Support oversight to evaluate compliance levels across the business; assist in mitigation and upscaling risks.
• Maintain positive relationships with internal and external stakeholders to promote ethical and compliant outcomes.

Skills

Regulatory compliance

Risk management

Project management

Audit

Education

Bachelor's Degree

Risk Management degree preferred

Tools

Microsoft Office

Archer

Job description

CVS Health is seeking a compliance professional to support Medicaid managed care compliance programs, reporting to the Compliance Officer and team. The role involves building systems, delivering regulatory deliverables, and ensuring ethical operations across health plans.

Qualifications include a Bachelor's degree (risk management preferred) with 0–2 years of related experience. The role offers full-time hours, 40 weekly, and a competitive pay range with benefits.