Medicaid Compliance & Audit Leader

CVS Health; Tallahassee (FL); On-site; USD 47,000 - 112,000; Full time

Benefits offered by this job

Bonus program

Job summary

CVS Health is seeking a dynamic leader to drive Medicaid provider compliance, audit excellence, and regulatory integrity across the organization. You will lead strategic initiatives to ensure high-quality audit results, strengthen regulatory relationships, and mitigate risk with proactive measures.

You will partner cross-functionally to optimize audit results, standardize processes, and enable data integrity, driving compliance and operational excellence across the company.

Qualifications

• Minimum of 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 actionable solutions for compliance-related challenges.
• Experience with Microsoft Excel with advanced proficiency for data analysis and reporting to strengthen internal controls and mitigate risk.
• Exceptional ability to convey complex information clearly and concisely, build relationships across organizational levels, and influence decision-making.
• Ability to lead initiatives, mentor team members, and thrive in a fast-paced, evolving environment while maintaining compliance and quality standards.

Responsibilities

• Direct and foster best-in-class collaboration with internal teams and external auditors to deliver quality results, ensure continuous improvement, and maintain compliance.
• Interpret audit findings to recommend sustainable corrective actions and process improvements that mitigate risk.
• Support the response to complex inquiries from internal stakeholders and regulators with accuracy, timeliness, and completeness.
• Serve as a technical and functional leader, managing multiple compliance-related projects and deliverables to ensure timely execution and desired outcomes.
• Oversee policy and procedural documentation development and the timeliness of required annual reviews.
• Build and sustain productive partnerships across all organizational levels; exercise sound judgment, remove barriers, and influence ethical, compliant outcomes to achieve strategic goals.

Skills

Audit & compliance

Project management

Data analysis

Excel advanced

Communication

Leadership

Education

Bachelor's degree

Job description

CVS Health is seeking a dynamic leader to drive Medicaid provider compliance, audit excellence, and regulatory integrity across the organization. You will lead strategic initiatives to ensure high-quality audit results, strengthen regulatory relationships, and mitigate risk with proactive measures.

You will partner cross-functionally to optimize audit results, standardize processes, and enable data integrity, driving compliance and operational excellence across the company.