Medicaid Compliance & Audit Leader

CVS Health; Frankfort (KY); On-site; USD 47,000 - 112,000; Full time

Benefits offered by this job

Medical coverage

Dental 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. You will lead strategic initiatives to ensure accurate audit results, strengthen regulatory relationships, and implement proactive risk mitigation across the organization.

You will partner cross-functionally to optimize audit outcomes, standardize processes, and enable data integrity, contributing to operational excellence and compliant performance.

Qualifications

• 3+ years in audit/compliance or healthcare operations.
• Ability to develop and execute detailed project plans with accountability.
• Strong analytical skills to interpret data and identify trends.

Responsibilities

• Lead internal and external Medicaid provider audit results and regulatory activities.
• Develop corrective actions and process improvements to mitigate risk.
• Respond to inquiries from stakeholders and regulators with accuracy and timeliness.
• Serve as a technical and functional leader for multiple compliance projects.
• Oversee policy documentation and annual review timelines.
• Cultivate cross-functional partnerships to achieve compliant outcomes.

Skills

Audit leadership

Regulatory compliance

Data analysis

Advanced Excel

Communication

Project management

Cross-functional collaboration

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. You will lead strategic initiatives to ensure accurate audit results, strengthen regulatory relationships, and implement proactive risk mitigation across the organization.

You will partner cross-functionally to optimize audit outcomes, standardize processes, and enable data integrity, contributing to operational excellence and compliant performance.