Medicaid Compliance Strategy Lead

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

Benefits offered by this job

Bonus eligibility

Comprehensive benefits package

Paid time off

Retirement savings options

Job summary

CVS Health seeks a Manager, Medicaid Provider Compliance to lead compliance strategy and audit readiness across the organization. You will partner with executive leadership, health plan stakeholders, compliance, and legal teams to proactively identify risks and implement enterprise-wide mitigation strategies.

The role focuses on strengthening data integrity, improving internal controls, and delivering sustainable compliance improvements.

Qualifications

• 7+ years of healthcare compliance, audit, or provider operations experience.
• Experience leading audits, CAPs, and regulatory responses.
• Strong analytical and risk assessment skills.
• Knowledge of Medicaid regulations and provider compliance requirements.
• Excellent communication and stakeholder influence skills.
• Ability to lead complex projects across teams.

Responsibilities

• Drive enterprise priorities, manages risk, and translates regulatory requirements into business solutions.
• Lead the development and execution of compliance strategies that support contractual, regulatory, and business objectives while promoting a culture of 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, standardize processes, and enhance organizational performance.
• Use data and compliance expertise to optimize processes, strengthen controls, and deliver sustainable results.
• Build trusted partnerships, communicates effectively with senior leaders, and influences outcomes across functions.
• Lead enterprise-wide provider compliance, audit preparedness, and regulatory initiatives that support organizational objectives and reduce compliance risk.
• Serve as the primary subject matter expert for complex provider compliance matters, providing strategic guidance to leadership and business partners.
• Develop and execute audit response and remediation strategies that address root causes, improve controls, and drive long-term compliance improvements.

Skills

Healthcare compliance

Project leadership

Audits

Data analysis

Regulatory knowledge

Education

Bachelor's degree or equivalent

Master's degree preferred

Tools

Excel

Compliance software

Job description

CVS Health seeks a Manager, Medicaid Provider Compliance to lead compliance strategy and audit readiness across the organization. You will partner with executive leadership, health plan stakeholders, compliance, and legal teams to proactively identify risks and implement enterprise-wide mitigation strategies.

The role focuses on strengthening data integrity, improving internal controls, and delivering sustainable compliance improvements.