Medicaid Compliance & Audit Lead

CVS Health Corporation; Washington (District of Columbia); On-site; USD 54,000 - 159,000; Full time

Benefits offered by this job

Comprehensive benefits

Bonus program

Job summary

CVS Health Corporation is seeking a strategic Manager, Medicaid Provider Compliance to lead enterprise-wide provider compliance, audit readiness, and regulatory initiatives. You will serve as a senior subject matter expert shaping strategy and guiding cross-functional teams.

Responsibilities include developing risk-based monitoring, improving data integrity and internal controls, and presenting findings to senior leadership. A Bachelor's degree and 7+ years in healthcare compliance are required.

Qualifications

• 7+ years of healthcare compliance, audit, or provider operations experience.
• Proven ability to lead complex projects and compliance initiatives.
• Experience managing audits, CAPs, and regulatory responses.
• Strong analytical, risk assessment, and problem-solving skills.
• Knowledge of Medicaid regulations and provider compliance requirements.
• Excellent communication and stakeholder influence skills.
• Ability to drive results across teams and manage competing priorities.
• Advanced Excel and data analysis proficiency.

Responsibilities

• Drive enterprise priorities, manages risk, and translates regulatory requirements into business solutions.
• Leads the development and execution of compliance strategies that support contractual, regulatory, and business objectives while promoting a culture of accountability, continuous improvement, and risk awareness.
• Serves as a recognized subject matter expert for provider compliance and audit readiness, driving initiatives that improve data integrity, strengthen internal controls, standardize processes, and enhance organizational performance.

Skills

Healthcare compliance

Audit management

Regulatory risk

Data analysis

Stakeholder management

Excel

Education

Bachelor's degree

Tools

Excel

Job description

CVS Health Corporation is seeking a strategic Manager, Medicaid Provider Compliance to lead enterprise-wide provider compliance, audit readiness, and regulatory initiatives. You will serve as a senior subject matter expert shaping strategy and guiding cross-functional teams.

Responsibilities include developing risk-based monitoring, improving data integrity and internal controls, and presenting findings to senior leadership. A Bachelor's degree and 7+ years in healthcare compliance are required.