Medicaid Compliance Analyst – Risk & Regulation

CVSHealth; Illinois; On-site; USD 44,000 - 94,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision coverage

Retirement savings

Paid time off

Wellness programs

Job summary

CVS Health is seeking a full-time Medicaid compliance professional to support regulatory program activities within a Medicaid managed care setting. The role works under the Compliance Officer to develop systems and processes that demonstrate effective compliance and ethical behavior across the health plan.

Responsibilities include tracking regulatory deliverables, supporting policy development, and maintaining tools, contracts, risk assessments and reporting.

Qualifications

• Bachelors degree required; Risk Management degree strongly preferred.
• 0-2 years of experience in regulatory compliance, managed care, healthcare, insurance, audit, risk management, or related field.

Responsibilities

• Maintain systems to track, monitor, review, and submit regulatory/compliance deliverables to state Medicaid agencies on time; prepare basic regulatory reports.
• Assist with research to develop compliant business operations and policies per Medicaid requirements.
• Develop compliance communications in response to Medicaid agency inquiries.
• Maintain working knowledge of health plan obligations as a Medicaid managed care organization.
• Support external audit review processes with project management and tracking of deliverables and corrective action plans.
• Maintain tools and internal deliverables to ensure monitoring and oversight of compliance processes.
• Utilize systems including Archer and Microsoft products; train users and contribute to system design/maintenance.
• Support oversight to evaluate compliance levels across the business and develop mitigation plans.
• Maintain relationships to communicate and influence ethical and compliant outcomes.
• Other duties as assigned.

Skills

Regulatory compliance

Risk management

Project management

Education

Bachelors Degree

Risk Management degree

Tools

Archer

Microsoft Office

Job description

CVS Health is seeking a full-time Medicaid compliance professional to support regulatory program activities within a Medicaid managed care setting. The role works under the Compliance Officer to develop systems and processes that demonstrate effective compliance and ethical behavior across the health plan.

Responsibilities include tracking regulatory deliverables, supporting policy development, and maintaining tools, contracts, risk assessments and reporting.