Medicaid Compliance & Audit Lead

CVS Health; City of Albany (NY); On-site; USD 47,000 - 112,000; Full time

Benefits offered by this job

Medical coverage

Dental and vision

Paid time off

Retirement savings options

Job summary

CVS Health is seeking a dynamic leader to drive Medicaid provider compliance, audits, and regulatory integrity. You will lead strategic initiatives to ensure accurate audit results, strengthen regulatory relationships, and implement preventative measures to mitigate risk across the organization.

You will partner cross-functionally to optimize audit outcomes, standardize processes, and enable data integrity while mentoring teams in a fast-paced environment.

Qualifications

• Minimum 3 years of progressive experience in audit, compliance, or related healthcare operations.
• Ability to develop and execute detailed project plans with accountability and rigor.
• Strong analytical skills to interpret data, identify trends, and recommend solutions.
• Proficiency with Microsoft Excel for data analysis and reporting.

Responsibilities

• Direct and foster collaboration with internal teams and external auditors to deliver quality results and maintain compliance.
• Interpret audit findings to recommend corrective actions and process improvements.
• Support responses to complex inquiries from stakeholders and regulators with accuracy and timeliness.
• Lead multiple compliance-related projects to ensure timely delivery and outcomes.
• Oversee policy and procedural documentation and annual reviews.
• Build partnerships across organizational levels and influence compliant outcomes.

Skills

Audit management

Regulatory compliance

Data analysis

Stakeholder engagement

Leadership

Education

Bachelor's degree

Tools

Excel

Job description

CVS Health is seeking a dynamic leader to drive Medicaid provider compliance, audits, and regulatory integrity. You will lead strategic initiatives to ensure accurate audit results, strengthen regulatory relationships, and implement preventative measures to mitigate risk across the organization.

You will partner cross-functionally to optimize audit outcomes, standardize processes, and enable data integrity while mentoring teams in a fast-paced environment.