Medicaid Compliance Lead

CVS Health; Denver (CO); On-site; USD 44,000 - 102,000; Full time

Job summary

CVS Health is seeking a career-level compliance professional to support our Medicaid managed care compliance program. You will help develop and maintain systems that demonstrate an effective program and promote compliant and ethical behavior across our Medicaid health plans.

Responsibilities include tracking regulatory deliverables, supporting policy development, communicating with Medicaid agencies, and assisting with audits and risk mitigation across the team.

Qualifications

• 2+ years of regulatory compliance experience in managed care, healthcare, or insurance or a Master’s degree.

Responsibilities

• Maintain systems to track, monitor, review and submit regulatory deliverables to state Medicaid agencies on time.
• Assist with research to develop compliant business operations and policies per Medicaid requirements.
• Develop compliance communications responding to Medicaid agency inquiries.
• Maintain knowledge of contractual, regulatory, and program policy obligations for the Medicaid plan.
• Support external audit reviews and coordinate deliverables and corrective action plans.

Skills

Regulatory compliance

Education

Bachelor's Degree

Tools

Archer

Job description

CVS Health is seeking a career-level compliance professional to support our Medicaid managed care compliance program. You will help develop and maintain systems that demonstrate an effective program and promote compliant and ethical behavior across our Medicaid health plans.

Responsibilities include tracking regulatory deliverables, supporting policy development, communicating with Medicaid agencies, and assisting with audits and risk mitigation across the team.