Medicaid Compliance Specialist — Impact & Growth

CVS Health; Annapolis (MD); On-site; USD 44,000 - 102,000; Full time

Job summary

CVS Health in Annapolis, MD, is seeking a compliance professional to support the Medicaid managed care program. You will help develop and maintain systems, track regulatory deliverables, and support audit activities for our health plan.

The role emphasizes regulatory research, policy development, and timely communication with Medicaid agencies. A 2+ year background in regulatory compliance is required, with a Bachelor’s degree and Medicaid experience preferred.

Qualifications

• 2+ years of regulatory compliance experience in managed care, healthcare, or insurance.
• Bachelor's degree required.
• Experience with Medicaid preferred.

Responsibilities

• Maintain systems and tools to track, monitor, review, and submit regulatory and compliance deliverables to state Medicaid agencies on or before due dates.
• Assist with research and recommendations to develop compliant business operations, processes, and policies per Medicaid requirements.
• Develop compliant communications in response to Medicaid agency inquiries or requests.
• Maintain knowledge of health plan obligations as a Medicaid managed care organization and advise staff accordingly.
• Support external audit processes, including project management and corrective action tracking through to closure.
• Maintain internal tools and resources to ensure monitoring and oversight of compliance processes.
• Utilize standard software (Microsoft products) and Archer; train users and contribute to system design/maintenance.

Skills

Regulatory compliance

Education

Bachelor's Degree

Tools

Archer

Job description

CVS Health in Annapolis, MD, is seeking a compliance professional to support the Medicaid managed care program. You will help develop and maintain systems, track regulatory deliverables, and support audit activities for our health plan.

The role emphasizes regulatory research, policy development, and timely communication with Medicaid agencies. A 2+ year background in regulatory compliance is required, with a Bachelor’s degree and Medicaid experience preferred.