Medicaid Compliance & Audit Leader

CVS Health; Santa Fe (NM); On-site; USD 47,000 - 112,000; Full time

Job summary

CVS Health seeks a dynamic leader to drive Medicaid provider compliance, audits and regulatory integrity across the organization. You will lead strategic initiatives to ensure accurate, timely audit results and strengthen regulatory relationships with proactive risk mitigation.

The ideal candidate will partner cross-functionally, apply deep compliance expertise, and manage complex projects to improve operational efficiency and ensure ongoing adherence to state and federal requirements.

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 and identify trends for compliance challenges.
• Advanced proficiency in Excel for data analysis and reporting.
• Ability to convey complex information clearly and influence decision-making.
• Experience leading initiatives and mentoring teams 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 sustainable corrective actions.
• Support responses to complex inquiries from internal stakeholders and regulators.
• Serve as a technical and functional leader managing multiple compliance projects.
• Oversee policy and procedural documentation and annual reviews.
• Build partnerships across organizational levels to achieve strategic goals.

Skills

Audit

Compliance

Data analysis

Microsoft Excel

Communication

Leadership

Education

Bachelor's degree preferred / specialized training / professional qualification

Tools

Microsoft Excel

Job description

CVS Health seeks a dynamic leader to drive Medicaid provider compliance, audits and regulatory integrity across the organization. You will lead strategic initiatives to ensure accurate, timely audit results and strengthen regulatory relationships with proactive risk mitigation.

The ideal candidate will partner cross-functionally, apply deep compliance expertise, and manage complex projects to improve operational efficiency and ensure ongoing adherence to state and federal requirements.