Medicaid Provider Compliance Lead — Audit Excellence

CVS Health; Madison (WI); 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 the organization. You will lead strategic initiatives to ensure accurate, timely audit results, strengthen regulatory relationships, and implement proactive risk mitigations.

The role requires deep compliance expertise, strong analytical and communication skills, and the ability to lead complex initiatives in a fast-paced environment.

Qualifications

• 3 years of progressive audit, compliance, or healthcare operations experience.
• Ability to develop and execute detailed project plans with accountability and rigor.
• Strong analytical skills to interpret data, identify trends, and propose solutions.
• Experience with Microsoft Excel for data analysis and reporting to strengthen controls.
• Excellent communication to convey complex information and influence decisions.
• Ability to lead initiatives and mentor team members in a fast-paced environment.

Responsibilities

• Direct collaboration with internal teams and external auditors to deliver quality results and maintain compliance.
• Interpret audit findings and recommend corrective actions and process improvements.
• Support responses to complex inquiries from stakeholders and regulators with accuracy and timeliness.
• Lead multiple compliance-related projects to ensure timely execution and outcomes.
• Oversee documentation and annual review timeliness for policy and procedures.
• Build cross-functional partnerships to achieve strategic compliance goals.

Skills

Audit leadership

Analytical skills

Excel proficiency

Regulatory compliance

Project management

Communication

Leadership

Education

Bachelor's degree

Tools

Excel

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 audit results, strengthen regulatory relationships, and implement proactive risk mitigations.

The role requires deep compliance expertise, strong analytical and communication skills, and the ability to lead complex initiatives in a fast-paced environment.