Medicaid Compliance Manager — Regulatory Excellence

9025 CVS Shared Services Resources LLC; Phoenix (AZ); On-site; USD 60,000 - 133,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Other resources, based on eligibility

Job summary

CVS Health is seeking a Medicaid Compliance Manager to support the compliance program activities within a Medicaid managed care environment. You will partner with and report to the Compliance Officer to develop systems that promote ethical behavior and regulatory adherence across Mercy Care’s Medicaid plans.

The role requires 5+ years of regulatory compliance in health care/managed care, with knowledge of Medicaid requirements; a Bachelor's degree is required, and a Master’s or JD is preferred.

Qualifications

• Minimum of 5 years of regulatory compliance position in managed care, health care, or insurance.
• Experience with Medicaid or Medicaid managed care; audit coordination and policy management preferred.
• Bachelor’s Degree preferably in Public Policy, Government Affairs, Health Care Administration, or Public Administration; Masters degree or Juris Doctor preferred.

Responsibilities

• Maintain systems and tools to track, monitor, review, and submit required regulatory and compliance deliverables to Arizona Medicaid agencies on/before due dates.
• Prepare moderately complex regulatory reports for the Medicaid compliance team.
• Develop compliant business processes and policies per Arizona Medicaid requirements.
• Create compliance communications for Mercy Care in response to Arizona Medicaid inquiries.
• Maintain knowledge of Mercy Care obligations as a Medicaid managed care organization and advise staff.

Education

Bachelor’s Degree in Public Policy / Government Affairs / Health Care Administration

Masters or Juris Doctor preferred

Tools

Archer

Microsoft Office

Job description

CVS Health is seeking a Medicaid Compliance Manager to support the compliance program activities within a Medicaid managed care environment. You will partner with and report to the Compliance Officer to develop systems that promote ethical behavior and regulatory adherence across Mercy Care’s Medicaid plans.

The role requires 5+ years of regulatory compliance in health care/managed care, with knowledge of Medicaid requirements; a Bachelor's degree is required, and a Master’s or JD is preferred.