Medicaid Compliance Lead & Audit Excellence

CVS Health; Baton Rouge (LA); On-site; USD 47,000 - 112,000; Full time

Job summary

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

You’ll partner cross-functionally to optimize audit results and implement preventative measures to mitigate risk, while influencing best practices that enhance

Qualifications

• Minimum of 3 years of progressive experience in audit, compliance, or related healthcare operations.
• Strong analytical skills to interpret data, identify trends, and propose actionable solutions for compliance-related challenges.
• Advanced proficiency in Microsoft Excel for data analysis and reporting to strengthen internal controls and mitigate risk.
• Ability to lead initiatives, mentor team members, and communicate clearly and concisely.

Responsibilities

• Direct collaboration with internal teams and external auditors to ensure compliance and improvements.
• Interpret audit findings to recommend corrective actions and process improvements that mitigate risk.
• Support responses to complex inquiries from regulators with accuracy, timeliness, and completeness.
• Lead multiple compliance-related projects 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 and influence ethical, compliant outcomes.

Skills

Audit & compliance

Healthcare operations

Data analysis

Advanced Excel

Stakeholder influence

Project management

Education

Bachelor's degree

Tools

Provider data management platforms

Job description

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

You’ll partner cross-functionally to optimize audit results and implement preventative measures to mitigate risk, while influencing best practices that enhance