Medicaid Provider Compliance Lead

CVS Health; Richmond (VA); On-site; USD 47,000 - 112,000; Full time

Benefits offered by this job

Bonus eligibility

Benefits package

Equal opportunity employer

Job summary

CVS Health is seeking a dynamic leader to drive Medicaid provider compliance, audit excellence, and regulatory integrity across the organization. You will lead strategic initiatives to ensure accurate, timely, and high-quality audit results while strengthening regulatory relationships and proactive risk mitigation.

The ideal candidate is a strategic, solutions-oriented leader with strong analytical and communication skills, capable of influencing outcomes and guiding cross-functional teams in a

Qualifications

• 3+ years of progressive experience in audit, compliance, or related healthcare operations.
• Ability to develop and execute detailed project plans with accountability and rigor.
• Strong analytical skills to interpret data, identify trends, and recommend actionable solutions.
• Advanced proficiency in Microsoft Excel for data analysis and reporting.
• Excellent ability to convey complex information clearly and concisely, and influence decisions.
• Experience leading initiatives, mentoring teams, and thriving in a fast-paced, compliant environment.

Responsibilities

• Direct collaboration with internal teams and external auditors to deliver quality results and maintain compliance.
• Interpret audit findings and recommend sustainable corrective actions and process improvements.
• Support responses to complex inquiries from internal stakeholders and regulators.
• Lead multiple compliance projects and deliverables to ensure timely execution and outcomes.
• Oversee policy and procedural documentation and annual reviews.

Skills

Audit & Compliance

Data analysis

Excel proficiency

Leadership

Communication

Education

Bachelor's degree

Job description

CVS Health is seeking a dynamic leader to drive Medicaid provider compliance, audit excellence, and regulatory integrity across the organization. You will lead strategic initiatives to ensure accurate, timely, and high-quality audit results while strengthening regulatory relationships and proactive risk mitigation.

The ideal candidate is a strategic, solutions-oriented leader with strong analytical and communication skills, capable of influencing outcomes and guiding cross-functional teams in a