Medicaid Compliance Analyst: Risk, Audits & Policy

CVS Health; Jefferson City (MO); Sur place; USD 44 000 - 102 000; Plein temps

Avantages offerts par ce poste

Medical, dental, vision coverage

Paid time off

Retirement savings options

Résumé du poste

CVS Health seeks a career level compliance professional to strengthen the Medicaid managed care compliance program. You will partner with the Compliance Officer to build robust systems supporting ethical and compliant operations across the health plans.

Your responsibilities include tracking and submitting regulatory deliverables, aiding policy development, and maintaining tools and reports. You will support audits and communicate effectively with state Medicaid agencies.

Qualifications

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

Responsabilités

• Maintain systems and tools to track, monitor, review, and submit required regulatory and compliance deliverables.
• Prepare regulatory reports on behalf of the Medicaid compliance team.
• Assist with research and recommendations to develop compliant business operations and policies.
• Develop compliance communications in response to Medicaid agency inquiries or requests.
• Maintain knowledge of contractual, regulatory, and program policy obligations as a Medicaid managed care organization.
• Support external audit reviews and track deliverables, responses, and corrective action plans.
• Maintain internal tools and resources to ensure monitoring and oversight of compliance processes.
• Utilize compliance systems and train users; contribute to system design and maintenance.
• Support oversight and monitoring of Medicaid compliance across the business; raise risks through proper channels.

Connaissances

Regulatory compliance

Healthcare/Managed care

Project management

Formation

Bachelor's Degree

Outils

Archer

MS Office

Description du poste

CVS Health seeks a career level compliance professional to strengthen the Medicaid managed care compliance program. You will partner with the Compliance Officer to build robust systems supporting ethical and compliant operations across the health plans.

Your responsibilities include tracking and submitting regulatory deliverables, aiding policy development, and maintaining tools and reports. You will support audits and communicate effectively with state Medicaid agencies.