Medicaid Compliance & Audit Leader

CVS Health; Columbia (SC); On-site; USD 47,000 - 112,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a dynamic leader to drive Medicaid provider compliance, audit excellence, and regulatory integrity across our organization. You will lead strategic initiatives to ensure accurate, timely audit results, strengthen regulatory relationships, and mitigate risk while coordinating with cross-functional teams.

This role focuses on delivering high-quality internal and external audits, developing proactive controls, and guiding a team through complex inquiries.

Qualifications

• 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 with data interpretation and trend identification for compliance.
• Advanced proficiency in Microsoft Excel for data analysis and risk mitigation.
• Excellent written and verbal communication across organizational levels.
• Ability to lead initiatives and mentor team members in a fast-paced environment.

Responsibilities

• Direct and foster collaboration with internal teams and external auditors to deliver quality results.
• Interpret audit findings to recommend corrective actions and process improvements.
• Support responses to inquiries from internal stakeholders and regulators.
• Serve as a technical and functional leader for multiple compliance projects.
• Oversee policy and procedural documentation and annual reviews.
• Build partnerships across all levels to influence compliant outcomes.

Skills

Audit experience

Compliance

Healthcare operations

Data analysis

Excel proficiency

Project management

Regulatory knowledge

Communication

Education

Bachelor's degree

Tools

Microsoft Excel

Job description

CVS Health is seeking a dynamic leader to drive Medicaid provider compliance, audit excellence, and regulatory integrity across our organization. You will lead strategic initiatives to ensure accurate, timely audit results, strengthen regulatory relationships, and mitigate risk while coordinating with cross-functional teams.

This role focuses on delivering high-quality internal and external audits, developing proactive controls, and guiding a team through complex inquiries.