Medicaid Compliance & Audit Leader

CVS Health Corporation; Tallahassee (FL); On-site; USD 54,000 - 159,000; Full time

Benefits offered by this job

Bonus eligibility

Comprehensive benefits package

Job summary

CVS Health Corporation seeks a strategic Manager of Medicaid Provider Compliance to lead enterprise-wide compliance initiatives, influence senior leaders, and ensure robust audit readiness. The role focuses on shaping compliance strategy and enhancing regulatory performance across the organization.

The position requires strong governance, data-driven decision making, and collaboration with regulators, health plans, and business partners to reduce risk and improve operational excellence.

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.

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 accountability and continuous improvement.
• Serve as a subject matter expert for provider compliance and audit readiness, driving initiatives that improve data integrity, strengthen internal controls, and standardize processes.

Skills

Healthcare compliance

Project leadership

Audits & CAPs

Data analysis

Regulatory knowledge

Stakeholder management

Excel

Education

Bachelor's degree or equivalent

Tools

Excel

Job description

CVS Health Corporation seeks a strategic Manager of Medicaid Provider Compliance to lead enterprise-wide compliance initiatives, influence senior leaders, and ensure robust audit readiness. The role focuses on shaping compliance strategy and enhancing regulatory performance across the organization.

The position requires strong governance, data-driven decision making, and collaboration with regulators, health plans, and business partners to reduce risk and improve operational excellence.